Provider Outreach and Education Advisory Group (POEAG) Meeting Minutes - October 25, 2018

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 cannot 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: Leonard Coulombe, Patty Donndelinger, Noel Neil, Lesleigh Sisson, Rhonda Turner, Michelle Wullstein

Noridian Attendees: Diana Duchscherer, Cindy White, Colleen Harryman, Trina St. Ours, Jessica Gaddie, Kathileen Stilljes,

Standing agenda items

  1. Medicare Beneficiary Identifier (MBI)
    • Supplier inquired what sort of outreach are we conducting with beneficiaries to ensure proper number is being used? Noridian responded that we do not conduct beneficiary education, this is completed by the Social Security Administration (SSA).
  2. Targeted Probe and Educate (TPE) Noridian is receiving good responses from supplier community regarding the program.
    • Inquiry was made regarding the bench mark for prompting the progression from one round to the next. Noridian confirmed that each case is evaluated on an individual basis to determine if moving to the next round is appropriate.
    • Inquiry was made about suppliers that were excluded from the TPE program and if they will be subjected to the program after the one-year time frame has been exhausted. Noridian shared that there are many conditional elements that determine when/if supplier will be placed in TPE. Once they are off the excluded list, they are eligible to be included again.
    • A member asked if it is possible new suppliers will be subjected to TPE when they start billing again or become new suppliers based on changes coming in January. Noridian will continue to provide the global education through webinars but do not plan on conducting individual training at this time. All suppliers billing DMEPOS are potentially eligible to be selected for TPE.
Review Criteria Error Rate July Meeting Error Rate October (April 2018 – June 2018)
Ankle Foot/Knee-Ankle-Foot Orthosis (AFO/KAFO) TPE Reviews 40% 34%
Knee Orthosis TPE Reviews 73% 57%
Spinal Orthoses: TLSO and LSO TPE Reviews 42% 51%
Therapeutic Shoe TPE Reviews 25% 33%

 

Follow up information from previous meeting

  1. Training Curriculum status
    • Outline complete identifying topics and existing resources
    • An overview of the plan was provided with emphasis on making this curriculum more interactive and personalizing where we can. 
    • Supplier selects which items will be beneficial from the checklist providing options for various formats of training. E-visit followed up by future checkpoints to see how self-paced portions are going.
    • Group wanted to know if it would be updated on regular basis.
      • Noridian will monitor this curriculum for necessary updates.
    • Suppliers will have long term benefit of consistency and less need to outsource billing if they can learn the process.
  2. CMS Medicare Learning Network (CMS MLN)
    • Error concerns reviewed
    • Concern expressed that there are errors in the templated CMS forms. Noridian to follow up with CMS on correction.
    • Remains pending
  3. Clinician's Corner
    • Continue to promote awareness
  4. Qualified Medicare Beneficiary (QMB) education
    • It was noted that recoupments could occur in the mass adjustment to provide updated remittance advice. Concern was expressed by members on same/similar. Noel Neil will follow up off line with Noridian and provide examples.
    • Examples not yet provided
    • Noel followed up to indicate that the examples were a result of a change on the beneficiaries or suppliers file and the claims have since been appealed. No reflection on the adjustment process that took place.
  5. Noridian led the effort to provide the first ALL MAC collaborative web tutorial on Documentation needed for DMEPOS.
    • At the last meeting, members indicated they were unaware of this tutorial so Noridian requested that everyone view it prior to the next meeting to provide feedback
    • One member informed the group that he viewed it and thought it was good.
    • Another member noted that the webinar stated the information is current as of today; however, there was no date referenced. Noridian will review that omission. It was also noted that there are references to MLN articles, however the member was not sure clinicians would know what that is or how to access. It is important that we answer the question of "How do clinician's tie the webinar into the documentation needs from referral sources?"
  6. Request for a quick link to the supplier manual
    • Pending

New Items

  1. Does this group have suggestions for education to alleviate the improper use of telemedicine and assist in understanding the proper use of telemedicine? Members wanted to know the proper and improper ways to use telemedicine.
    • Can it be used out of the country? Member has received two inquiries regarding O&P in the last two weeks. Noridian responded that telemedicine cannot be used out of the country and the beneficiary must be at an approved originating site.
    • What types of orders and documentation are needed when using this avenue? Significant amount of information on CMS website. Based on member input, the education team can better develop training materials.
  2. Expect the quarterly schedule for 2019 by December 2018.

Suggestions, Comments, and Open Discussion from POE Advisory Group Members

  1. What educational enhancements should POE be working on?
    • More tools and making them visible to suppliers will remain a focus
    • Other thoughts?
  1. Is same or similar on NMP based on claims submitted or paid?
    • Claims paid within that specific Jurisdiction are reflected on NMP
    • If a beneficiary has lived in more than one Jurisdiction, suppliers need to verify same/similar from each Jurisdiction.
  1. Other MAC portals display all claim submitted information. Can Noridian have this same information on their website? Noridian suggested that a comment be added to the survey requesting this information become available.
  2. Member recommendation for 2019 include Noridian creating a pre-review program for O&P, especially the ones that don't have LCDs to have them reviewed by clinicians before suppliers are obligated to provide.
  3. It was noted that there was not a recorded webinar for knee orthoses and the member couldn't find needed information. Noridian asked that this member help us understand where we can improve that educational piece without providing a recorded webinar, as CMS hasn't approved this method yet.
  4. Noel – sent Cindy and POEAG group an email. Cindy to follow up.
  5. An idea had been shared that it may be beneficial to create ann education track for O&P Master's program to expose students early on in their career. This was introduced in JA POEAG and shared with this group as a potential project for 2019.

Contact us: DMEPOS-POEAG@noridian.com

 

Last Updated Tue, 11 Feb 2020 16:06:07 +0000