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As Prior Auth Gets Underway, Hospitals Will Have Several Chances for Claims Approval

Published on 6/8/2020

Hospitals are required to ask Medicare for prior authorization for five outpatient procedures, but there’s no such thing as flat-out rejection. If the answer is “no,” hospitals can keep asking Medicare to approve payment, assuming there’s documentation of medical necessity somewhere. Learn more from ACPA Advisory Board member, Ronald Hirsch, MD, FACP, CHCQM, CHRI in this Report on Medicare Compliance article by Nina Youngstrom.

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