Provider Outreach and Education Advisory Group (POEAG) Meeting Minutes - April 15, 2020

POE Advisory Group Mission and Goals

Mission

  • To determine the best methods of providing quality education and training to our supplier community.

Goals

  • Develop timely, useful, relevant educational opportunities for our suppliers
  • Provide input in the creation, implementation and review of Provider Education and Training
  • Determine innovative, cost effective methods of using technology in provider education and training CMS Internet Only Manual (IOM), Publication 100-09, Chapter 6.

Reminder: We meet on a quarterly basis to discuss educational opportunities that Noridian Education can provide to suppliers through workshops, our website, and our listserv. We aren't able to discuss claim-specific questions or issues you may be seeing with claims. Please direct those questions to our Supplier Contact Center where they can be researched and resolved.

Member attendees: Kim Brummett, Ronda Buhrmester, Tami Carter, Dawn Cetti, Kristine Cram, Melinda Eberhart, Valerie Eriole, Crissy Hill, Sharee Hummer, awn Jorgensen, Tugba Koca, Maria Koehnlein, Bridget LaScala, Heidi Lernihan, Gary Marano, Rica Nebrich, William Noyes, Yvette Nugent, Tara Oliveri, Tina Padden, Jan Palmer, Joyce Perrone, Caryn Plessinger, Kimberlie Rogers-Bowers, Wendy Russalesi, Debra Silvers, Randy Stevens Rachelle Tritinger, Rhonda Turner, Yvonne Weiler

Noridian attendees: Cindy White, Courtney Willis, Jessica Bennett, Megan Schrock, Melissa Kuznia

Standing agenda items

  1. Medicare Beneficiary Identifier (MBI)
    • Removing as a standing item
  2. Targeted Probe and Educate (TPE)
    • Suspended during the COVID-19 Public Health Emergency (PHE)
  3. Education for Practitioners
    • Addition as we look for opportunities

Follow up information from previous meeting

General

  1. Increased Fraud & Abuse education
    1. More to come in the future - other projects took priority
  2. Tool that encompasses codes that are not covered/allowed
    1. The scope of this project is too large at this time and would be very difficult to maintain
  3. CERT following SWO guidelines - yes confirmed with CERT for dates of service on/after 1/1/2020

DME

  1. L200 for Ventilators
    1. In Process
  2. Provide denial rate affirmation on prior authorization and conduct targeted training
    1. Under investigation
    2. PAR voluntary during PHE
  3. Clarification of short-term oxygen need
    1. Covered under PHE
    2. Following PHE will resume work on topic
  4. More detailed education on CGM / update DME on Demand
    1. DME on Demand updated on April 7 to include the KF modifier

O & P

  1. O & P Training Program for Competitive Bid
    1. In process of preparation, but will be deployed closer to implementation of CB
  2. List of same and similar tips to avoid unnecessary denials
    1. Remains in process
  3. Off the shelf coding more visible/training
    1. Plan to include in Q2 quarterly email to Associations
    2. Attempts to schedule individual education for suppliers experiencing denials did not result in suppliers agreeing to education
  4. Upper Extremity orthotic training
    1. Webinar held March 24

New Items

General

  1. Documentation Checklists
  2. Disasters and Emergencies
  3. DME on Demands (SWO updates)
  4. Extended Monday Live Chat
  5. Thursday Live Chat - Special Edition

DME

  1. Current use of CR modifier for COVID-19 PHE

O & P

  1. Lower Limb Prosthetics Prior Authorization
    1. Postponed due to the COVID-19 PHE

Suggestions from POE Advisory Members

  • Thank you's were conveyed for the updates provided for CGM education
  • The POEAG group advised that education will be needed for CMS guidance following the PHE for COVID-19.
  • Appreciation was expressed for the collaborative COVID-19 webinar
  • Suggestions were made to disseminate new COVID-19 information to previous webinar attendees to alleviate the need to attend every new webinar. Ideas included the following:
    • Send the latest presentation to all previous attendees
    • Update online to allow suppliers to view the newest information
  • Suppliers expressed that much of the CMS guidance on COVID-19 is very high level and they are looking for more FAQ information assisting in understanding what is allowed.

 

Last Updated Wed, 06 May 2020 20:22:02 +0000