POE AG Meeting Minutes - April 11, 2019

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 can't 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.

Noridian Attendees: Cindy White – facilitator, Diana Duchscherer, Trina St Ours, Colleen Harryman, Megan Schrock, Jessica Gaddie, Kathileen Stelljes

POEAG Attendees: Wayne Bradberry, Sharon Briggman, Rosa Gomez, Dawn Jorgensen, Carolyn Koster, Noel Neil, Robin Nyberg, Jan Palmer, Erica Rochelle, Deb Silvers, Barb Stockert, Katie Workman

Standing agenda items

  1. Medicare Beneficiary Identifier (MBI)
    • Member (Dawn) indicated they have been using MBIs and have not had any issues
  2. Targeted Probe and Educate (TPE)
    • Inquiry regarding consideration for listing error rate by round? That would be a better visual as these numbers cannot really be compared due to the addition of new suppliers. Noridian to investigate this possibility
    • Member (Barb) suggested that it would be interesting to the supplier community to be provided the number that was included in each round that was being audited
    • Member (Sharon) requested clarification be provided regarding initial 10 audits, does it pertain to curable errors within the round? (example, supplier forgot to send in DWO and it was sent in during the round to resolve the claim)
Review Criteria Error Rate July meeting Error Rate October
(April - June 2018)
Error Rate January
(July - September 2018)
Error Rate April
(October - December 2018)
Diabetic Supplies TPE Reviews 66% 65% 61% 64%
Enteral Nutrition TPE Reviews 14% 20% 53% 60%
Hospital Bed TPE Reviews 34% 72% 72% 72%
Immunosuppressive Drug TPE Reviews 14% 18% 39% 34%
Manual Wheelchair TPE Reviews 43% 32% 58% 29%
Nebulizer TPE Reviews 15% 19% 19% 19%
Oxygen TPE Reviews 37% 40% 45% 38%
Parenteral Nutrition   100% 59% 60%
Positive Airway Pressure (PAP) TPE Reviews 7% 12% 10% 17%
Surgical Dressing TPE Reviews 93% 86% 69% 77%
Urological Supplies TPE Reviews 33% 40% 36% 27%

 

Follow up information from previous meeting

  1.  Flow chart for dentists for steps in providing Oral Appliances
    • Pending
    • Targeted completion Q2 2019
  2. Training Curriculum status
    • Remains with Communications and Web team
    • Experiencing technical difficulties
    • Continued work toward implementation
  3. G Codes for transitional home infusion therapy
    • Webinar conducted 1/23/19
    • FAQs released by DMDs
    • Discussed at NHIA in March
  4. Webinar specifically for Continuous Glucose Monitors
    • Webinar with CGM focus held 3/6/19
    • Members suggested tips and tricks to proper billing
  5. Zip Code Tool for former competitive bide areas
    • Test link provided to POEAG in January
    • Implemented into full production early February
    • Rural zip code enhancement added March
  6. Refractive lens error/training
    • Webinar held 2/27/19
    • POEAG members invited
    • Send examples if additional training needed
  7. Request for more education on provision of DMEPOS in collaboration with Part B for ambulatory services, for example total hip replacement with a one-day hospital stay and prescription of walkers, canes and CPM machines
    • Could Noridian get examples from this group of specifics you find require more training?
  8. Suggestions for enhanced training include:
    • Continuous Passive Motion (CPM)
    • Non-invasive ventilation
    • Respiratory Assist Devices (RAD)
    Note: Multi-function ventilator DME on Demand posting within a week
  9. Short webinar or DME on Demand for telemedicine
    • In process

New Items

  1. MAC Satisfaction Indicator (MSI) Survey
    • Limited time availability
  2. RT/LT Modifiers
    • Member (Erica) questioned whether CMS will be sending any educational information to secondaries? Suppliers need to combine lines and resubmit to secondary suppliers in mass quantities. Every cross over claim (especially) Medicaid, is being rejected and needs to be reworked. Wanted to know if there is any education the DME MAC can provide to the secondary insurances
      • Noridian is unable to target education to secondary insurance.
    • Member (Sharon) wanted to know if there is list of HCPC codes that need to be billed with RT/LT. Noridian will investigate this request

Suggestions from POE Advisory Members

  • It was suggested that for same and similar braces Noridian provide additional education on how suppliers can verify same/similar items. A supplier recently received RAC audits for the same HCPCS code billed several months apart and the claims paid.
    • Noridian emphasized use of Noridian Medicare Portal (NMP) and communication with beneficiary
    • Emphasis will be given to these avenues in future education

Next meeting: July 11, 2019

 

Last Updated Wed, 12 Feb 2020 09:32:38 +0000