Trailblazer Strikes Again??

[Guest guest]

Has anyone dealt with this yet?  Any comments?

 

= = = = = = = = = =

 

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

 

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Date:  (6/22/2011)

Notice ID:  14409

 

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

 

 

http://www.trailblazerhealth.com/Tools/Notices.aspx?DomainID=1&ID=14409

 

[Guest guest]

Steve,

Yes, the Texas Ambulance Association has been following this issue closely.

Contact me off list if you have some questions and I'll try and find a resource

to help you.

Dave

Sent via BlackBerry by AT&T

Trailblazer Strikes Again??

Has anyone dealt with this yet?  Any comments?

 

= = = = = = = = = =

 

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

 

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Date:  (6/22/2011)

Notice ID:  14409

 

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

 

 

http://www.trailblazerhealth.com/Tools/Notices.aspx?DomainID=1&ID=14409

 

[Guest guest]

Steve,

Yes, the Texas Ambulance Association has been following this issue closely.

Contact me off list if you have some questions and I'll try and find a resource

to help you.

Dave

Sent via BlackBerry by AT&T

Trailblazer Strikes Again??

Has anyone dealt with this yet?  Any comments?

 

= = = = = = = = = =

 

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Automated Denials for Non-Emergency Ambulance Transports in Texas

 

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Date:  (6/22/2011)

Notice ID:  14409

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

Date:  (6/22/2011)

Notice ID:  14409

 

Through statistical analysis, TrailBlazer identified a potential overutilization

of HCPCS code A0428 (non-emergency ambulance transport services), billed with

modifiers RJ and JR, and its associated services (e.g., A0425) across the

provider community in Texas. Multiple postpayment probe reviews and prepayment

audits have been conducted and validated that significant overutilization

exists.

Based on the results of these reviews, TrailBlazer will implement an automated

ambulance audit for A0428 services in Texas billed with modifiers RJ and JR and

will cover no more than 12 ambulance trips per beneficiary per year. This audit

will be effective on or about July 1, 2011.

For additional information, refer to the “Utilization Guidelines†section in

the Ambulance Local Coverage Determination (LCD) posted on our Web site.

 

 

http://www.trailblazerhealth.com/Tools/Notices.aspx?DomainID=1&ID=14409