It is noteworthy to understand that an affirmative PAR decision follows the patient not the provider. Supplier A could have done all the work to obtain the PAR and the patient can choose another provider to supply them with the DMEPOS.
Be careful if a patient has obtained a PAR approval with another supplier. As you may still require all their documentation if you are subject to either a TPE or post payment review.Thus if you find yourself in this position (within the 60 day window), do not submit another PAR as it may l be denied as a duplicate
Instead contact the other supplier and obtain all the information they submitted to Medicare.
If a PAR is continued to be denied, you have several choices.
Refuse to provide the service and find an alternative meeting the patient’s needs
Have the patient sign a very specific ABN. Theclaim would need to be amended with the GA modifier.
Part II on PA program.
It is noteworthy to understand that an affirmative PAR decision follows the patient not the provider. Supplier A could have done all the work to obtain the PAR and the patient can choose another provider to supply them with the DMEPOS.
Be careful if a patient has obtained a PAR approval with another supplier. As you may still require all their documentation if you are subject to either a TPE or post payment review.Thus if you find yourself in this position (within the 60 day window), do not submit another PAR as it may l be denied as a duplicate
Instead contact the other supplier and obtain all the information they submitted to Medicare.
If a PAR is continued to be denied, you have several choices.
Refuse to provide the service and find an alternative meeting the patient’s needs
Have the patient sign a very specific ABN. Theclaim would need to be amended with the GA modifier.