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View this summary for outpatient rehabilitation services (January through August 2021).
View this summary for outpatient rehabilitation services (August - November 2020).
View this summary for psychotherapy services (December 2020 - March 2021).
TPE is one process that a MAC can utilize when providers are selected by medical review.
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.
View this article for information concerning requirements of change request 13164.
Duplicate claim denials continue to be one of the top billing errors. Duplicate submission of Medicare claims causes an increase in cost, valuable time, and resources for you, as well as First Coast.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for critical care services.
CMS entered into an agreement with the Department of Veterans Affairs (VA), which allows First Coast to recover duplicate payments for the same services made to providers by both Medicare and the VA. This recovery effort is referred to as t…