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This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
Top denial/ partial denial reasons and high-level results are listed below from each round of Transitional Care Management (TCM) services TPE reviews that have been conducted thus far by Medical Review.
View these round results for rehabilitation services outpatient.
View targeted probe and educate (TPE) round results for clinical laboratory services.
Review the top denial / partial denial reasons and high-level results listed for DRG 885.
Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
Follow this instructions to learn how to file a claim once you received the unique tracking number (UTN) related to the prior authorization of repetitive, scheduled non-emergency ambulance transports.
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within 20-calendar days.