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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.
Read this article for information about how CERT may grant temporary administrative relief to certain affected providers and suppliers during a disaster.
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for nursing home services.
Learn how PWK, the paperwork segment of the X12N version 5010, allows providers to submit medical documentation with their initial claim.
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…
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.
Repetitive, scheduled non-emergent ambulance transport (RSNAT) has been effective as of April 1, 2022. Through this program, a unique tracking number (UTN) is issued for each medical decision provided – whether affirmed or non-affirmed. Whe…
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption would remain in effect for a 12-month peri…