Prior Authorization Details
Prior Authorization Exemption Status Inquiry Tool Alert
National Government Services continues to see PARs submitted by exempt providers.
In an effort to prevent unnecessary submission, NGS has developed a self-service inquiry tool that can be used by anyone tasked with submitting PARs on behalf of the HOPD. This tool is accessible to Part A and Part B providers as well J6 and JK jurisdictions.
Do you fall into one of these categories?
- I am a frequent submitter of PARs.
- I submit PARs for the HOPD.
- I am from a physician practice; however, I submit PARs on behalf of the HOPD.
If you have ever found yourself asking any of the following questions, this is a great resource for you:
- Do I need prior authorization?
- Is the service I am requesting being performed at an exempt HOPD?
- How do I know the exempt status of the HOPD?
How To Access the Tool
NGSMedicare.com > Accept the Attestation > Select your line of business and state > from the home page drop-down, Resources > Tools & Calculators > Prior Authorization Exemption Status Inquiry Tool
NGSMedicare.com > Accept the Attestation > Select your line of business and state > from the home page, Medicare Compliance > Prior Authorization > drop down Prior Authorization for Certain Hospital Outpatient Department Services > Exemption Process
Please be sure to read the full description of the tool prior to entering the PTAN/CCN of the HOPD into the search bar.
Prior Authorization Reminders
PARs should not be submitted for exempt providers for the purpose of obtaining a rejection letter for medical record keeping.
- OPD Operational Guide
- The Exemption Process Frequently Asked Questions
- Prior Authorization Exemption Status Inquiry Tool