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Access tools and forms related to the prior authorization program, CERT, and provider audit.
Use these checklists to ensure you have met medical documentation requirements based on specific services.
View targeted probe and educate (TPE) round results for ambulance services: basic life support non-emergent transport and mileage (HCPCS A0428 and A0425).
Learn about various programs which focus on ensuring Medicare compliance. Topics include: Comprehensive error rate testing (CERT), prior authorization, and targeted probe and educate.
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).
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.