Palmetto GBA E-mail Update: Tuesday, August 01, 2017

CMS National Provider Enrollment Conference: September 6 and 7, 2017
The Centers for Medicare & Medicaid Services (CMS) will hold a National Provider Enrollment Conference on Wednesday, September 6, 2017 from 8 a.m. to 5 p.m. EDT and Thursday, September 7, 2017 from 8 a.m. to 3 p.m. EDT. This session will be held at the Charleston Area Convention Center located at 5000 Coliseum Dr., North Charleston, SC 29418. Don’t miss this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts. Registration for this free conference ends August 29, 2017. Please plan to attend.

Applies to:

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

Rendering Physicians Can Now Review Their Individual Medicare Billing Activities!
Palmetto GBA is excited to announce that rendering physicians now have access to eReview functions via the eServices portal to review and analyze their Medicare billing activity. JM Part B rendering physicians who are currently listed in PECOS may register for a rendering physician account in eServices.

Applies to:

  • JM Part B//General

Palmetto GBA E-mail Update: Monday, July 31, 2017

Correct Date of Service for Specific Services
This article is applicable to physicians, non-physician practitioners, and others submitting claims on a CMS-1500 form for reimbursement for Medicare Part B services. Physicians and non-physician practitioners need to identify the correct date of service for the services they provide to a Medicare patient.Please review and share it with your staff.

Applies to:

  • JM Part B//General

Opt Out Listing
This article includes a listing of those providers who have elected to opt out of the Medicare program. If you’ve recently opted out of the Medicare Program it’s possible that your name will not appear on the website until the next quarterly update. Please share with appropriate staff.

Applies to:

  • JM Part B//General

New Waived Tests
Change Request (CR) 10198 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: Friday, July 21, 2017

CMS National Provider Enrollment Conference: September 6 and 7, 2017
The Centers for Medicare & Medicaid Services (CMS) will hold a National Provider Enrollment Conference on Wednesday, September 6, 2017 from 8 a.m. to 5 p.m. EDT and Thursday, September 7, 2017 from 8 a.m. to 3 p.m. EDT. This session will be held at the Charleston Area Convention Center located at 5000 Coliseum Dr., North Charleston, SC 29418. Don’t miss this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts. Registration for this free conference ends August 29, 2017. Please plan to attend.

Applies to:

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

August 2017 Medicare Advisory
The August 2017 Medicare Advisory is now available. Please review this issue for Medicare policy and coverage updates as well as announcements for upcoming provider education opportunities. Please remember to share this information with your staff.

Applies to:

  • JM Part B//General

September 2017 Medicare Part B Updates, Changes and Reminders: September 20
Palmetto GBA will host the Medicare Administrative Contract Part B September 2017 Quarterly Updates, Changes and Reminders Webcast on September 20, 2017, at 10 am. ET. These updates, changes and reminders 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

Palmetto GBA E-mail Update: Monday, July 17, 2017

Claims Payment/Processing Issues Log Webcast: July 26
Palmetto GBA will host a Part B Claims Payment/Processing Issues Log (CPIL) webcast on July 26, 2017 at 10 am, ET. This 60-minute Webcast is designed to provide an overview of the CPIL available on the Part B Palmetto GBA website and will include a question and answer period for questions related to accessing and using the CPIL. This webcast will include: how to access the CPIL, types of issues included on the log, and how to sign up for email notification of an individual CPIL updates. Please plan to attend.

Applies to:

  • JM Part B//General

North Carolina Part B Providers: Quality Payment Program (QPP) Webcast: July 25
North Carolina Part B providers, do you need help in being successful under the Quality Payment Program? Please join Alliant as we partner with Palmetto GBA on Tuesday, July 25th at 1:00 pm ET, for information concerning the Quality Payment Program. This webcast is intended for North Carolina Part B providers. The Quality Payment Program improves Medicare by helping practices focus on care quality and the one thing that matters most – making patients healthier. If you participate in Medicare Part B, the Quality Payment Program will provide new tools and resources to help you give your patients the best possible care. Please plan to attend.

Applies to:

  • JM Part B//General

Part B Top 10 Medical Review Denials Webcast: July 31
Please join Palmetto GBA on July 31, 2017, at 10:30 a.m. ET as we share the Top 10 Medical Review Denials and provide a better understanding of medical review denial reasons. During this 45 minute webcast, providers can expect to learn about: top medical review denials; edit effectiveness letter; denial documentation examples; medical necessity; and documentation tips. Please plan to attend.

Applies to:

  • JM Part B//General

Signature Log Can Be the Key
Do you have questions regarding the signature log? A signature log is a typed listing of the provider(s) identifying their name with a corresponding handwritten signature. This may be an individual log or a group log. A signature log may be used to establish signature identity as needed throughout the medical record documentation.

Applies to:

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

Did you know you can view your latest electronic Comparative Billing Report (eCBR) in eServices?
Did you know you can view your latest electronic Comparative Billing Report (eCBR) in eServices? Be sure to check them out today!

Applies to:

  • JM Part B//General
  • JM Part B//Chiropractic
  • JM Part B//Physician
  • JM Part B//Primary Care

eServices makes it easy to monitor the use of your NPI!
eUtilization reports provide rendering providers and ordering and referring providers access to their personal data. Check them out today.

Applies to:

  • JM Part B//General
  • JM Part B//Physician
  • JM Part B//Primary Care

E/M Weekly Tip

E/M Weekly Tip: History Component ‘Unable to Obtain’
If you are unable to obtain the review of systems (ROS) and past, family and social history from the patient/source, the documentation must clearly describe the patient’s condition or other circumstance. Please share with appropriate staff.

Applies to:

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

Palmetto GBA Update – Proposed 2018 Policy and Payment Rate Changes

Hospital Outpatient, ASC: CMS Proposes 2018 Policy and Rate Changes

Proposed rule and Request for Information promote improvements to quality, accessibility, and affordability of care

On July 13, CMS issued a proposed rule that updates payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. The proposed rule is one of several for 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility and innovation in the delivery of care.

The OPPS and ASC payment system are updated annually to include changes to payment policies, payment rates, and quality provisions for those Medicare patients who receive care at hospital outpatient departments or receive care at surgical centers. Among the provisions in this rule, CMS is proposing to change the payment rate for certain Medicare Part B drugs purchased by hospitals through the 340B program. The proposed rule also includes a provision that would alleviate some of the burdens rural hospitals experience in recruiting physicians by placing a two-year moratorium on the direct supervision requirement currently in place at rural hospitals and critical access hospitals. In addition, CMS is releasing within the proposed rule a Request for Information to welcome continued feedback on flexibilities and efficiencies in the Medicare program.

For More Information:

Physician Fee Schedule: CMS Proposes 2018 Payment and Policy Updates

Proposed rule & Request for Information provide flexibility, support strong patient-doctor relationships

On July 13, CMS issued a proposed rule that would update Medicare payment and policies for doctors and other clinicians who treat Medicare patients in CY 2018. The proposed rule is one of several Medicare payment rules for CY 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery of care.

The Physician Fee Schedule is updated annually to include changes to payment policies, payment rates, and quality provisions for services furnished to Medicare beneficiaries. This proposed rule would provide greater potential for payment system modernization and seeks public comment on reducing administrative burdens for providing patient care, including visits, care management, and telehealth services. The rule takes steps to better align incentives and provide clinicians with a smoother transition to the new Merit-based Incentive Payment System under the Quality Payment Program. The rule encourages fairer competition between hospitals and physician practices by promoting greater payment alignment, and it would improve the payment for office-based behavioral health services that are often the therapy and counseling services used to treat opioid addiction and other substance use disorders. In addition, the proposed rule makes additional proposals to implement the Center for Medicare and Medicaid Innovation’s Medicare Diabetes Prevention Program expanded model starting in 2018.

For More Information:

Palmetto GBA E-mail Update: Friday, June 16, 2017

Provider Enrollment Revalidation – Cycle 2
Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers/suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. In an effort to streamline the revalidation process and reduce provider/supplier burden, CMS has implemented several revalidation processing improvements that are captured within this article. Make sure your staff is aware.

Applies to:

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

Reminder of Advance Beneficiary Notice of Noncoverage (ABN) Renewal
The Centers for Medicare & Medicaid have renewed the Advance Beneficiary Notice of Noncoverage (ABN) Form CMS-R-131. Please note no changes have been made to the form itself; however, the newly incorporated expiration date is March 2020. Please share with appropriate staff.

Applies to:

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

E/M Weekly Tip: General Documentation
You may only use one set of evaluation and management (E/M) guidelines when selecting the appropriate CPT code. Mixing or combining of the two sets of guidelines is not acceptable. Please share with appropriate staff.

Applies to:

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

Signatures, Credentials and Dates: They Are Important
Each entry in the patient’s medical record requires the acceptable signature of the person writing the note along with the date. Palmetto GBA also recommends the inclusion of the applicable credentials (e.g. P.A., D.O. or M.D.), especially when the services being billed are only coverable when performed by certain credentialed professionals. Please share with appropriate staff.

Applies to:

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

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