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Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any service that was part of a partially affirmed decision, must include the 14-byte unique tracking number (UTN) number…
Questions and answers regarding reasons for returned to provider (RTP) and rejected claims.
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you to submit Part A claims.
Read this article for tips on how to prevent claim adjustment reason code (CARC) CO B9.
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7 and after with dates of service June 3 or later.
CMS is implementing a prior authorization program for certain hospital outpatient department services for dates of service on or after July 1, 2020. Review the fax coversheet needed for submission.
Ambulance modifiers identify the place of origin and destination of the ambulance trip and must be included on all ambulance claims.
CMS has removed CPT codes 64492 and 64495 from the listing of codes requiring prior authorization. View our article to learn more about these changes.
A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks. Repetitive ambulance services are often needed…
A procedure can have other policies or guidelines besides an LCD. Search our website for additional information.
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