Articles

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...

First Coast is receiving first-level appeals (redeterminations) based on claim denials for providers not including the ordering...

To determine if a claim was medically reviewed, providers should submit the requests correctly.

View targeted probe and educate (TPE) round results for diagnostic radiology.

This article will assist providers with proper billing relating to the Mpox vaccine and laboratory codes. This article was...

View this important information you must know when billing for Prolia (denosumab) injections, J0897.

The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 4.625% is in effect...

When submitting a prior authorization request (PAR), be mindful of specific guidelines relating to proper submission to avoid...

View these instructions for the CMS-855I form.

The following article provides a list of common terms used by the medical review department for prior authorization requests.