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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).
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.
View targeted probe and educate (TPE) round results for 15271-15278.
The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA) program for certain hospital outpatient department (OPD) services.