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Medicare Launches Initiative for Documentation Look-Up Tool

Medicare recently announced a plan to streamline the process of finding coverage and documentation requirements for applicable services. Currently, documentation requirements appear in various locations and on separate websites requiring physicians and staff to navigate multiple websites for information.

The first step in the initiative is the development of a pilot program for a Medicare Fee-For-Service Documentation Requirement Lookup Service. The prototype look-up will include a list of items/services for which prior authorization is required. CMS is participating in private and government industry workgroups to develop standards for the Look-Up tool.

The goal is for providers to access prior authorization and documentation requirements at the time of service and within the electronic health record or integrated practice management system. Medicare is also encouraging all payers to consider similar approaches to streamline workflow access to coverage documents. This is one of several initiatives being taken by CMS to reduce provider burden.

Visit the CMS website for more information on this initiative and other Medicare Fee-For-Service Compliance Programs. 

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