Prior Authorization Exemption Status Inquiry Tool Alert

National Government Services continues to see PARs submitted by exempt providers.

In an effort to prevent unnecessary submission, NGS has developed a self-service inquiry tool that can be used by anyone tasked with submitting PARs on behalf of the HOPD. This tool is accessible to Part A and Part B providers as well J6 and JK jurisdictions.

Do you fall into one of these categories?

• I am a frequent submitter of PARs.
• I submit PARs for the HOPD.
• I am from a physician practice; however, I submit PARs on behalf of the HOPD.

If you have ever found yourself asking any of the following questions, this is a great resource for you:

• Do I need prior authorization?
• Is the service I am requesting being performed at an exempt HOPD?
• How do I know the exempt status of the HOPD?

How To Access the Tool

NGSMedicare.com > Accept the Attestation > Select your line of business and state > from the home page drop-down, Resources > Tools & Calculators > Prior Authorization Exemption Status Inquiry Tool

OR

NGSMedicare.com > Accept the Attestation > Select your line of business and state > from the home page, Medicare Compliance > Prior Authorization > drop down Prior Authorization for Certain Hospital Outpatient Department Services > Exemption Process

Please be sure to read the full description of the tool prior to entering the PTAN/CCN of the HOPD into the search bar.

Prior Authorization Reminders

PARs should not be submitted for exempt providers for the purpose of obtaining a rejection letter for medical record keeping.

Related Content

• OPD Operational Guide
• The Exemption Process Frequently Asked Questions
• Prior Authorization Exemption Status Inquiry Tool  

Posted 9/1/2022