Prior authorization program for repetitive, scheduled non-emergent ambulance transports (RSNAT)
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in...
Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services
Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain...
Ambulance Prior Authorization Documentation Requirements
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization...
Ambulance prior authorization - documentation checklist for medical professionals
Review this checklist to learn about the documentation requirements for medical professionals related to the repetitive...
Hospital outpatient department (OPD) prior authorization exemption process
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to...
New provider roadmap: Claims submission
Once enrolled as a Medicare provider, a billing method with Medicare needs to be established.
Step 1: Choose your billing method
T...
Common definitions for claim submission types
See common definitions for claim submission types that may impact your billing.
Billing unlisted drug procedure codes J3490 and J9999
When billing for unlisted drug codes, include the name, strength, and dosage of the drug.
Locate guidelines on the First Coast website
A procedure can have other policies or guidelines besides an LCD. Search our website for additional information.
Step 1: Perform...
Submitting claims when the dollar amount exceeds $99,999.99
First Coast has seen an increase in claims for drugs, hemophilia clotting factors, and skin substitutes that exceed the dollar...