November 10, 2015- Special Open Door Forum: Prior Authorization of Representative Scheduled Non-Emergent Ambulance Transport Expansion

Special Open Door Forum: Prior Authorization of Representative Scheduled Non-Emergent Ambulance Transport Expansion is scheduled for Tuesday, November 10, 2015 from 12:30pm-1:30pmET. CMS will host a Special Open Door Forum (ODF) to allow ambulance suppliers, other Medicare providers, and additional interested parties to learn about the upcoming expansion of the Prior Authorization of Repetitive Scheduled Non-Emergent Ambulance Transport model toDelaware, the District of Columbia, Maryland, North Carolina, Virginia, and West Virginia. The model began in New Jersey, Pennsylvania, and South Carolina in December 2014. This Special ODF will include information on the prior authorization process and a Q&A period.

The purpose of this model is to test whether prior authorization helps reduce expenditures, while maintaining or improving quality of care. CMS believes 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 before claims are submitted for payment. 

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 rendering services and to avoid an appeal process. 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. If you wish to participate dial: 1-800-837-1935 and reference conference ID: 70012700. Please see the Downloads section for the full announcement. Thank you for your continued interest in the CMS Open Door Forums.