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Fact Sheet

Prior Authorization Smart Submission (PASS) Fact Sheet

Prior Authorization Smart Submission (PASS) is a guided process in the myCGS DME Web Portal to help suppliers send all the information needed for a prior authorization.

PASS lets you know exactly what information to include. It detects mistakes in real-time and tells you how to correct them. Here are examples of PASS edits that will reduce the chance of rejection:

  • Beneficiary information does not match our records. Verify your information and try again.
  • The beneficiary does not live in the jurisdiction selected.
  • Documentation verification. PASS allows you to combine all your documents into one file, or you can attach your documents separately. PASS will ask you to verify you  included all the required documentation in your attachments.

Here are tips to help you get a speedy decision:

  • See the myCGS User Manual for detailed instructions and images of the PASS screens.
  • Upload all documentation with your request. The Support Documentation screen in PASS will list required documents and ask you to verify they are attached. Any documents sent later by fax cannot be tied to the submission and will not be included in the review.
  • If you get an error message when you upload your documents, you may have a corrupt document. Try to convert the file to another format or contact your IT department for help with your document security features. See Uploading Documents in the myCGS DME Web Portal.
  • If the supplier already delivered the item because of retroactive Fee-for-Service (FFS) Medicare coverage, select “Yes” on the Delivery Confirmation screen. See Prior Authorization for Beneficiaries with Retroactive Medicare Coverage.

See the Prior Authorization page for more information about the prior authorization program, required HCPCS codes, time frames for decisions, and other details.

PASS

Published: June 5, 2024

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