Prior authorization for hospital outpatient department services: Don’t wait too long to submit your prior authorization requests
When submitting prior authorization requests, be aware of response timeframes and documentation guidelines.
Prior authorization requests (PARs): How to avoid potential non-affirmations
When submitting a prior authorization request (PAR), be mindful of specific guidelines relating to proper submission to avoid...
Submitting unsolicited paperwork (PWK) segments for electronic claims
The PWK (paperwork) segment of the X12N version 5010 allows for submission of supporting documentation with a version 5010 837...
2025 anesthesia conversion factors for the U.S. Virgin Islands
This article contains the conversion factors for use in calculating payment for anesthesia services (procedure codes 00100...
2025 anesthesia conversion factors for Puerto Rico
This article contains the conversion factors for use in calculating payment for anesthesia services (procedure codes 00100...
2025 anesthesia conversion factors for Florida
This article contains the conversion factors for use in calculating payment for anesthesia services (procedure codes 00100...
Pre-exposure Prophylaxis (PrEP) using antiretroviral therapy to prevent HIV infection
CMS has issued a final NCD for FDA-approved Pre-exposure Prophylaxis (PrEP) using antiretroviral drugs to prevent HIV infection...
Requesting duplicate remittance advice
This article provides information on how providers can obtain duplicate remittance notices.
Electronic remittance advice -- what you need to know
This article contains the background information and resources you need regarding electronic remittance advice.
Medicare remit easy print (MREP)
An updated Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) “Codes.ini” file is now available for...