Physicians, Nurses and Allied Health Professionals Open Door Forum Update

Centers for Medicare & Medicaid Services

Special Open Door Forum:

Prior Authorization of Repetitive Scheduled Non-Emergent Ambulance Transport

Tuesday, August 5, 2014

1:30-2:30 pm Eastern Time

Conference Call Only

CMS will host a Special Open Door Forum (ODF) to allow ambulance providers, other Medicare providers, and additional interested parties to learn about the upcoming Prior Authorization of Repetitive Scheduled Non-Emergent Ambulance Transport model in the states of New Jersey, Pennsylvania, and South Carolina.

The purpose of this model is to test whether prior authorization helps reduce expenditures, while maintaining or improving quality of care. CMS believes using a prior authorization process will help ensure services are provided in compliance with applicable Medicare coverage, coding, and payment rules before services are rendered and claims are paid.

Prior authorization will not create new clinical documentation requirements. Instead, it will require the same information necessary to support Medicare payment, just earlier in the process. Prior authorization allows providers and suppliers to address issues with claims prior to rending services and to avoid an appeal process. This will help ensure that all relevant coverage, coding, and clinical documentation requirements are met before the service is rendered to the beneficiary and before the claim is submitted for payment.

You can find more information on the model by going to:

http://go.cms.gov/PAAmbulance.

Questions on the model can be sent to: AmbulancePA@cms.hhs.gov.

We look forward to your participation.

Special Open Door Participation Instructions:

Participant Dial-In Number: 1-800-837-1935

Conference ID #: 79236332

Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

A transcript and audio recording of this Special ODF will be posted to the Special Open Door Forum website athttp://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp for downloading.

             

For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.gov/opendoorforums/.

Thank you for your interest in CMS Open Door Forums.