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This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
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.
First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering psychiatrist on the claim when billing for transcranial magnetic stimulation (TMS). Read this article to learn m…
Background
Submissions
Extended affirmation periods
Claim submission tips
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory Surgical Centers (ASCs) and will be implementing the demonstration in two phases.