Good morning Ambulance Association partners. We ask that you share the important information listed below with your members to assist with the Medicare Prior Authorization Model one-year extension. This information is also being posted on the Palmetto GBA website and shared in our next listserv message.
We ask that you copy and paste the information rather than forwarding this email.
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As a follow-up to CMS’ December 4, 2017 announcement of a one-year extension of the Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transports, Palmetto GBA would like to provide instructions for providers who submitted a Prior Authorization request for a period that ended after 12/1/17 and Palmetto GBA revised the end date to 12/1/17. Please note the following:
- If the request was affirmed, you may submit only a Prior Authorization request form, including the affirmed UTN for this request, and Palmetto GBA will review the previously submitted documentation for consideration of the originally requested time period and number of transports. You will receive a decision letter with a new UTN for the additional dates of service and transports.
- NOTE: No new documentation will be required, but the program conditions of a 60 day transport period and maximum of 80 transports will still apply.
- If the request was non-affirmed, please resubmit your request as you would any new resubmission. Your request will be considered for the entire transport period and number of transports requested, accompanied by the necessary medical documentation, under the Prior Authorization program conditions.
Thank You.
Palmetto GBA Provider Outreach and Education Team