Palmetto GBA E-mail Update: Monday, May 22, 2017

Action Needed: Due to Increased CMS Security Requirements, eServices Portal Users Must Sign Up for Multi-Factor Authentication (MFA) by July 1, 2017
This article informs providers who use the eServices Portal that they must sign up for MFA by July 1, 2017. Instructions on how to register for MFA are also included in this article. Please review this information and share it with your staff who uses eServices.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

Comprehensive Error Rate Testing (CERT) Question and Answer Fact Sheet
This article includes updates to questions and responses about the Comprehensive Error Rate Testing (CERT) program. Please review this information and share it with your staff.

Applies to:

  • JM Part A//General
  • JM Part B//General
  • JM Home Health and Hospice//General

Provider Contact Center (PCC) To Close May 29 For Memorial Day
The Provider Contact Center (PCC) will be closed on Monday, May 29, 2017, in observance of Memorial Day. The Call Center will reopen on Tuesday, May 30. Please review and share with your staff.

Applies to:

  • JM Part A//General
  • JM Part B//General
  • JM Home Health and Hospice//General

Ask the Contractor Part B Teleconference May 11, 2017: eServices Auditing and Reports Topic Discussion and Questions and Answers
The Ask the Contractor Part B Teleconference May 11, 2017: eServices Auditing and Reports Topic Discussion and Questions and Answers are now available. Please share with appropriate staff.

Applies to:

  • JM Part B//General

Email and Faxed Inquiries
CMS requires all providers to utilize the Provider Contact Center (PCC) (855-696-0705) as their point of contact with their Medicare Administrative Contractors. If you submit an unsolicited fax or email inquiry directly to a specific department, your inquiry will be routed to the written correspondence area within the PCC for proper logging, tracking, research and response. An escalation process is used for complex issues. Submitting inquires directly to the PCC will assure CMS compliance and allow for the most timely response. Please share with appropriate staff.

Applies to:

  • JM Part B//General

June 2017 Medicare Part B Updates, Changes and Reminders: June 8
Palmetto GBA will host the Medicare Administrative Contract Part B June 2017 Quarterly Updates, Changes and Reminders Webcast on June 8, 2017, at 10 am. ET. These updates, changes and re minders include any new billing regulations, hot topics that impact provider billing, and a Q & A segment for questions on covered material. Note: An NPI and PTAN are required to register. You should only enter ‘n/a’ if you do not have an NPI or PTAN. Please share with your staff, and register today.

Applies to:

  • JM Part B//General

Medicare Basics for Part B Providers Webcast: June 26
On June 26, 2017 at 10 am ET, Palmetto GBA will host a webcast for new Part B providers and billers with a beginner level experience. If you are new to Medicare or have new billing staff, this webcast is for you. This learning tool gives a general overview of the following topics: The four parts of Medicare; Billing provider enrollment requirements; Mandatory claim submission regulations; Completion of the CMS 1500 claim form and Resources for new providers. Please plan to attend.

Applies to:

  • JM Part B//General

There is Still Time to Evaluate Our Services!
There is still time to share your experiences about the services we provide. Please complete the MAC Satisfaction Indicator (MSI) survey. These survey results will help us find ways to better serve you.

Applies to:

  • JM Part B//General

Palmetto GBA E-mail Update: Tuesday, April 04, 2017

eServices Makes Asking a Medicare Question Easier
Palmetto GBA has Secure eChat to make asking Medicare questions easier. This innovative feature allows providers to interact with designated Palmetto GBA staff so they can receive real-time assistance locating information on any topics or specialties they are searching for on the Palmetto GBA website or within the eServices online portal. The Secure eChat feature also allows users to dialogue with an online operator who can assist with patient or provider specific inquires or address questions that require the sharing of PHI information! Using Secure eChat is simple! Please share with appropriate staff.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General

What Can You Expect to Receive from the CERT Contractor?
You can expect to receive the following from the CERT Contractor: Information on the CERT process; Health Insurance Portability Accountability Act (HIPAA) compliance information; What documentation to submit; Timeframe for responding to the request; and Claim information.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

Inquiries for Unprocessable/Rejected Claims
Did you know the top two reasons for Palmetto GBA Provider Contact Center inquiries in February all had to do with claims that were unprocessable or rejected? When a claim is rejected (also referred to as unprocessable) the claim is not afforded appeal rights. You must correct and refile the claim correcting the missing, invalid or incomplete information. Reason code MA-130 will appear on your remittance advice (RA) along with one or more remark codes that outline the error causing a claim to be considered unprocessable. If your clearinghouse is not providing you with associated remarks code to explain why a claim was rejected, speak with your clearinghouse to receive that information. Please share with appropriate staff.

Applies to:

  • JM Part B//General

Unprocessable/Rejected Claims Webcast: April 13
Jurisdiction M will hold a Part B Unprocessable/Rejected Claims Webcast on April 13, 2017, at 10 am, ET. This webcast will include identifying, correcting, and reviewing examples and resources to resolve and prevent rejected claims. Please plan to attend.

Applies to:

  • JM Part B//General

E/M Weekly Tip: History Component – Status of Three Chronic/Inactive Conditions
An extended History of Present Illness (HPI) ma y consist of the status of three chronic/inactive conditions for either set of guidelines (1995 or 1997) for services performed on or after on or after September 10, 2013. Please share with appropriate staff.

Applies to:

  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

New Waived Tests
Change Request (CR) 9956 informs MACs of new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests approved by the Food and Drug Administration (FDA). Since these tests are marketed immediately after approval, the Centers for Medicare & Medicaid Services (CMS) must notify MACs of the new tests so that they can accurately process claims. Make sure that your billing staffs are aware of these CLIA-related changes.

Applies to:

  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

Palmetto GBA E-mail Update: Wednesday, October 05, 2016

New CERT Documentation Contractor Effective October 14, 2016
AdvanceMed, the current Comprehensive Error Rate Testing (CERT) Review Contractor will also be operating the CERT Documentation Center, effective October 14, 2016. Beginning October 7, 2016, all CERT inquires and medical records should be sent to AdvanceMed. Visit the CERT website for more information. Please make your staff aware.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare