Nationwide Expansion Implementation Dates: Updated For more information, please visit the Special Open Door Forums webpage. Presentation materials can be found in the Downloads section. (PDF)ĬMS hosted a Special Open Door Forum call to discuss the upcoming national expansion of the Repetitive, Scheduled Non-Emergent Ambulance Transport Prior Authorization Model on Thursday, October 28 from 2:00-3:30 pm Eastern Time. The Ambulance Operational Guide National Expansion (PDF) provides operational details about the RSNAT Prior Authorization model.Īdditionally, ambulance suppliers can share an Ambulance Prior Authorization Physician/Practitioner Letter (PDF) with physicians and other entities to help ensure that they obtain the necessary documentation in a timely manner.Īmbulance suppliers can email questions to :ĬMS is releasing updated stats on the RSNAT Prior Authorization model. Claims for the first three round trips are permitted to be billed without prior authorization and without being subject to prepayment medical review. However, if an ambulance supplier elects to bypass prior authorization, applicable RSNAT claims will be subject to a prepayment medical review. Prior authorization for RSNAT is voluntary. Prior authorization allows providers and suppliers to address issues with claims prior to rendering services and submitting claims for payment, which has the potential to reduce appeals for claims that may otherwise be denied. Instead, it requires the same information that is already required to support Medicare payment, just earlier in the process. Prior authorization does not create new clinical documentation requirements. The citizens we serve deserve better than the current state of affairs, which poses a significant risk to their lives.Prior authorization helps ambulance suppliers ensure that their services comply with applicable Medicare coverage, coding, and payment rules before services are rendered and before claims are submitted for payment. Our inability to provide appropriate medical equipment, especially functional AEDs, represents a clear violation of safety standards and compromises the well-being of our community members. I implore the Georgia Department of Public Health to intervene promptly and conduct a comprehensive inspection of Central EMS in Richmond County. This blatantly contradicts the state’s requirements for medical first responder vehicles and places both our staff and the individuals we are duty-bound to assist in grave danger. However, this has resulted in a distressing directive for us (QRVs) to operate without a cardiac monitor or an AED. In an attempt to ensure the availability of cardiac monitors, they have made the decision to transfer these monitors from Quick Response Vehicles (QRVs) to ambulances. The response from upper management to address this crisis has been far from satisfactory. This means that our units have been operating with expired equipment for several months, jeopardizing the effectiveness of emergency medical interventions. Shockingly, the AEDs we do possess have all exceeded their expiration dates, including the critical electrodes required for their proper function. In addition to the absence of cardiac monitors for ALS crews, our limited number of AEDs presents a grave issue. Specifically, the lack of essential resources such as cardiac monitors for our Advanced Life Support (ALS) crews and an inadequate supply of Automated External Defibrillators (AEDs) has placed both our first responders and the community we serve in imminent danger. Unfortunately, the situation has worsened considerably since my previous communication.
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