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Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for critical care services.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for musculoskeletal system and connective tissue procedures (DRG 515, 516 and 517).
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for outpatient hospital services.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for hyperbaric oxygen (HBO) therapy services.
Read this article for information about how CERT may grant temporary administrative relief to certain affected providers and suppliers during a disaster.
This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization request (PAR) for repetitive, scheduled, non-emergency transport.
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in Florida, Puerto Rico and the US Virgin Islands. Learn more about the program and how you can participate.