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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.
View targeted probe and educate (TPE) round results for 15271-15278.
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for nursing home services.
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.
This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
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.
Learn how PWK, the paperwork segment of the X12N version 5010, allows providers to submit medical documentation with their initial claim.
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.
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF admission. This criteria is required to meet Medicare guidelines for a SNF covered stay and medical necessity.