Ambulance: Who’s Looking at You скачать в хорошем качестве

Ambulance: Who’s Looking at You

This training occurred 2/19/26. Many different entities are performing medical review (MR) on ambulance suppliers. The review is to ensure the documentation supports medical necessity as defined in the Social Security Act. This webinar: • Reviews who is looking at claims • Explains what reviewers are looking for • Provides resources to help in the future Resources CMS Additional Documentation Request webpage https://www.cms.gov/data-research/mon... WPS Responding to a Medical Review Additional Documentation Request (ADR) resource https://www.wpsgha.com/guides-resourc... CMS Comprehensive Error Rate Testing (CERT) webpage https://www.cms.gov/data-research/mon... WPS Medical Review Guides and Resources webpage https://www.wpsgha.com/topics/medical... OIG Workplan webpage https://oig.hhs.gov/reports-and-publi... CMS Medicare Fee for Service Recovery Audit Program webpage https://www.cms.gov/data-research/mon... CMS Supplemental Medical Review Contractor webpage https://www.cms.gov/data-research/mon... CMS Additional Documentation Request webpage https://www.cms.gov/data-research/mon... CMS Map: Review Contractor Directory - Interactive Map webpage https://www.cms.gov/node/1243226 WPS Ambulance Documentation Requirements webpage https://www.wpsgha.com/guides-resourc... WPS sample PCS https://www.wpsgha.com/forms/view/1000 CMS Advance Beneficiary Notice of Noncoverage webpage https://www.cms.gov/medicare/forms-no... Medicare Benefit Policy Manual, Chapter 10 - Ambulance Services https://www.cms.gov/regulations-and-g... Medicare Claims Processing Manual, Chapter 15 - Ambulance https://www.cms.gov/regulations-and-g... Medicare Program Integrity Manual, Chapter 6 – Medicare Contractor Medical Review Guidelines for Specific Services https://www.cms.gov/regulations-and-g... Chapters 00:00 Intro 03:22 Basic Medical Review Information 15:13 Entities Looking at Suppliers 43:41 Documentation Elements 55:55 Closing Comments