Prior Authorization Request Coversheet Being Filled Out Incorrectly

Medical Review would like to share they are seeing the requestor portion of the Part A Prior Authorization Request Coversheet filled out incorrectly with beneficiary information. The Requestor portion of the form is for the individual from the facility requesting the prior authorization.

In addition, a facility shall not give out a clinical reviewer’s phone number to beneficiaries.

Please call the Provider Contact Center (PCC) at 1-855-609-9960 for assistance in completing the Part A Prior Authorization Request Coversheet.

 

Last Updated Aug 08 , 2022