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Posting Date: 12/31/2024
How to Pay the Application Fee
The application fee must be paid electronically. Important: If submitting a hardship request, it must be submitted with the enrollment application. It cannot be accepted separately. To pay the application fee using the Provider Enrollment, [...]
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Posting Date: 06/09/2021
About Hospital OPD PA Model
About Hospital OPD PA Model Table of Contents General Information Related Content [Return to Top] General Information Question Description WHO It is the responsibility of the hospital OPD to submit all [...]
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Posting Date: 10/26/2022
Prior Authorization OPD Alerts
Prior Authorization OPD Alerts Month/Year Topic August 2024 Removal of Facet HCPCS Codes July 2023 Prior Authorization Outpatient Department Rejections Alert July 2023 Prior [...]
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Posting Date: 06/09/2021
Expedited Requests
Expedited Requests The requester may submit an expedited review of the PAR if it is determined that a delay could seriously jeopardize the beneficiary’s life, health, or ability to regain maximum function. If the medical documentation does not [...]
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Posting Date: 06/23/2025
Part A Ambulance Transport: Understanding the Basics
The purpose of this presentation is to give Medicare Part A Ambulance providers a better understanding of who is responsible to report services to Medicare.
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Posting Date: 06/09/2021
Ways to Submit Requests
Ways to Submit Requests NGSConnex Part A: NGSConnex User Guide Part B: NGSConnex User Guide esMD Content type 8.5 Fax JK: 317-841-4530 J6: 317-841-4528 Mail National Government Services, Inc. [...]
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Posting Date: 06/14/2022
Documentation Information
Documentation Information It is recommended that PARs are submitted at least seven calendar days prior to the expected date of service to allow National Government Services (NGS) the full standard timeframe to receive and review requests. [...]
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Posting Date: 06/09/2021
OPD Facility/Physician Communication
OPD Facility/Physician Communication The implementation of the Outpatient Department (OPD) Prior Authorization (PA) program has specific implications for Part B physicians performing services within hospital OPDs. Each prior authorization [...]
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Posting Date: 01/31/2022
Exemption Process
Exemption Table of Contents Exemption Exemption Database Standard Review Cycle Process Exemption Cycle Process Ten Claim Sample Additional Documentation Requests (ADRs) Related Content [Return to Top] Exemption Exemption is a [...]
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Posting Date: 05/03/2024
About Prior Authorization
About Prior Authorization CMS has implemented Prior Authorization (PA) programs nationwide to ensure that Medicare beneficiaries continue to receive reasonable and necessary care while protecting the Medicare Trust Fund from improper payments. [...]
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