Submit Documentation for Drugs and Biologicals & Emergency Room, Observation for processing
Drugs and Biologicals
· Please be sure documentation submitted is legible.
· Please submit records for all dates of service on the claim.
· Please ensure that the medical records submitted provide proof the service(s) was ordered and rendered. Also, ensure the medical records provide justification supporting medical necessity for the service by submission of the following documentation:
o Pretreatment/initial treatment plan including history and physical.
o Plan of care including the drug dosage, frequency and expected duration of treatment.
o Progress notes – initial and most recent (including patient weight at each treatment).
o Medication records/infusion flow sheets.
o Laboratory reports.
o Consultation report.
o Documentation of any drug wastage.
o Signatures/credentials of professionals providing services.
o Any other documentation a provider deems necessary to support medical necessity of services billed, as well as documentation specifically requested in the Additional Documentation Request (ADR) letter.
Emergency Room, Observation
· Please be sure documentation submitted is legible.
· Please submit records for all dates of service on the claim.
· Please ensure that the medical records submitted provide proof that the service(s) was ordered and rendered. Also, ensure the medical records provide justification supporting medical necessity for the service by submission of the following documentation:
o History and physical.
o Medication records.
o Nurse’s notes.
o Operative reports.
o Pathology reports.
o Physician’s progress notes.
o Physician’s orders.
o Procedure notes.
o Signatures/credentials of professionals providing services.
o Any other documentation a provider deems necessary to support medical necessity of services billed, as well as, documentation specifically requested in the Additional Documentation Request (ADR) letter.
Drugs and Biologicals
· Please be sure documentation submitted is legible.
· Please submit records for all dates of service on the claim.
· Please ensure that the medical records submitted provide proof the service(s) was ordered and rendered. Also, ensure the medical records provide justification supporting medical necessity for the service by submission of the following documentation:
o Pretreatment/initial treatment plan including history and physical.
o Plan of care including the drug dosage, frequency and expected duration of treatment.
o Progress notes – initial and most recent (including patient weight at each treatment).
o Medication records/infusion flow sheets.
o Laboratory reports.
o Consultation report.
o Documentation of any drug wastage.
o Signatures/credentials of professionals providing services.
o Any other documentation a provider deems necessary to support medical necessity of services billed, as well as documentation specifically requested in the Additional Documentation Request (ADR) letter.
Emergency Room, Observation
· Please be sure documentation submitted is legible.
· Please submit records for all dates of service on the claim.
· Please ensure that the medical records submitted provide proof that the service(s) was ordered and rendered. Also, ensure the medical records provide justification supporting medical necessity for the service by submission of the following documentation:
o History and physical.
o Medication records.
o Nurse’s notes.
o Operative reports.
o Pathology reports.
o Physician’s progress notes.
o Physician’s orders.
o Procedure notes.
o Signatures/credentials of professionals providing services.
o Any other documentation a provider deems necessary to support medical necessity of services billed, as well as, documentation specifically requested in the Additional Documentation Request (ADR) letter.
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