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Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing the service. The contractor will then al…
This edition includes information on men’s health, preventing claim denials for hospital beds and accessories, the clinical laboratory fee schedule annual public meeting, and more.
This edition includes information on crushing fraud, opioid use disorder, the Medicare participating physician agreement form expiration, and more.
This edition encourages public input on improving technology to empower beneficiaries.
This edition includes information on the Medicare Shared Savings Program, providers accepting CHAMPVA, national coverage determination 20.36, and more.
Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the paravertebral facet joints. Imaging guidance (fluoroscopy or CT per code descriptor) is used to assure accurate p…
Is your facility receiving denials for a claim overlapping a skilled nursing facility (SNF) stay? Claims overlapping with a skilled nursing facility (SNF) stay can occur for several reasons. This article is intended to assist providers with…