Provider Outreach and Education Advisory Group (POE AG) Meeting Minutes - March 08, 2022

Roll Call

POEAG Member or Other (CMS) Attendees

Angela Amey, Chelsey Kekahuna-Kalaukoa, Cheryl Bradley, Greg Labow, Lisa Morphis, Mitchel Kaye, Susan LaPadula, and Allie Davita

Noridian Attendees

Teresa Cirelli, Elizabeth Barton, Cheryl Hanson, Katie Hove, Tammy Ewers, Tim Morrissey, Val Cavett, Julie Schroeder, Daylann Robertson, Brittney Beck, and Jennifer Joyce

POEAG Mission and Goals

The primary function of the POE Advisory Group is to assist Noridian in the creation, implementation and review of our provider education and training strategy and efforts. The input received from these groups will affect the way educational materials and correspondence are presented, the content contained in them and how Noridian can best provide resources for the provider community.

Prior Meeting Minutes

The prior meeting minutes were distributed to POEAG members and published to the website(s).

Prior POEAG Member Recommendations

Below are the POEAG member prior meeting recommendations and the progress or resolution for each item.

  1. 03/09/2021. Prior Authorization Training.
    1. 06/08: We have webinars scheduled for June, July, and August. We are recording Education on Demand tutorials. We will reach out to a member regarding their experience with our Prior Authorization process and responsiveness.
    2. 09/14: Webinars for Prior Authorization for Certain Hospital Outpatient Department Services wrapped up in August. We updated the presentation based on questions received during the webinars to improve our education each time it was delivered. In response to a request received, our Education and Call Center team members are working to add the applicable PA reason codes to the PA webpage.
    3. 12/14: Development to add the reason codes to the PA webpages has started. Plan to have webpages updated beginning of 2022.
    4. 03/08: The webpage updates continue to be in progress.
  2. 09/14/2021. Expand Noridian Medicare Portal (NMP).
    1. 09/14: Expand NMP to offer 120 days and/or last 100 ADR letters for providers to access on demand.
    2. 12/14: Sarah shared these are only the ADRs from Medical Review and there are CMS-defined timelines (45-days) for the providers to access and respond. When the timeline expires, they can no longer use the portal for the ADR. Due to this time-specific requirement, we are unable to offer ADRs for a longer timeline.
    3. 03/08: Additional questions: Where would a provider access an Additional Documentation Request (ADR) after the CMS defined 45-day timeframe? The claim would deny, and appeal rights would be available. The ADR would not be available. Understand when the timeframe expires, the provider can no longer use the portal for the ADR. However, where can the provider access ADR requests beyond the 45-days and what is the procedure for returning these documents? The ADR is in the portal for 45 calendar days and is also mailed to the facility. The calendar vs. business day source, CMS IOM Pub 100-08, Chapter 3, Section 3.2.3.3, will be clarified within the documentation chart resource.
  3. 09/14/2021. Pre and Post-pay Medical Review Chart for Part A and B.
    1. 09/14: Providers are looking for instructions on how to respond, what timelines they have, where should the data be submitted in a reasonable time for processing. A chart could be helpful.
    2. 12/14: Chart is in development.
    3. 03/08: Chart was included with the agenda. Open discussion to review. Should there be separate charts for Part A and B; separate Jurisdiction? Member requested to define pre- and post-payment review. Intro paragraph, offer hyperlink to JE or JF website for pre-payment or post-payment review. This is fabulous; it really is terrific and thank you to all who worked so hard on this resource. It would be helpful to provide a sample or template of what the letter looks like to help the provider locate the correspondence in their office if it was delivered internally to the wrong department. Specific courier addresses for return documents if there is a courier or signature service should be included. Another member suggested the value to include recoupment 935 letters to the resource.
  4. 12/14/2021. Back to Basics Tutorials.
    1. 12/14: Noridian will offer a tutorial series for new provider staff members to gain exposure and learn more about the basics of Medicare. Topics include beneficiary forms, claim submission, appeals, documentation, and locating information on websites.
    2. 03/08: Tutorial sessions are in development and will be available by early summer. POEAG suggested topics include over payments and options for providers, ADRs, Pre and Post Pay Medical Review. POEAG feedback: Wonderful. Thank you to the whole team. Unfortunately, our industry has a tremendous turnover so having it on-demand will be critical.
  5. 12/14/2021. Overpayments and Credit Balance Report.
    1. 12/14: Overpayments and credit balance reporting tutorial or event was recommended.
    2. 03/08: Website information is on our Credit Balance Report webpage, Jurisdiction E Part A (JEA) Credit Balance Reports. We have this statement on the Overlapping Claim Resolution Tips page, “To request assistance with resolving a billing dispute, call the Provider Contact Center. Be prepared to provide documentation as incomplete requests will not be processed. Your request will be processed within 45 calendar days of the date it was received and we will notify you of the outcome via phone. Your MAC may request additional documentation including call logs, letters, or bill attempts, and supporting medical records including transfer agreements, admission orders or discharge summaries.” JEA Overlapping Claim Resolution Tips
  6. 12/14/2021. Overlapping Services.
    1. 12/14: MAC involvement when there is a disagreement among overlapping services.
    2. 03/08: To request assistance with resolving a billing dispute, call the Provider Contact Center. Be prepared to provide documentation as incomplete requests will not be processed. Your request will be processed within 45 calendar days of the date it was received and we will notify you of the outcome via phone. Noridian may request additional documentation including call logs, letters, or bill attempts, and supporting medical records including transfer agreements, admission orders or discharge summaries. Overlapping Claim Resolution Tips - JE Part A - Noridian

New Agenda Items

Prior to the meeting, Noridian solicited agenda topics from members and evaluated significant program changes to discuss.

  1. The SMRC requests for documentation are being sent out to PT/OT/SLP private practice offices. In California, the CA PT Association and our POE AG member have received 100 private practice provider contact regarding the SMRC letters which are requesting information on 19 items to provide for therapy services. The concern surrounds items being requested by the SMRC are not Medicare requirements (i.e., physician order or referral per policy manual) and other instances where information is being requested for one date of service on the evaluation but up to 30-40 different patients for one provider.
    • The POE AG member requested the SMRC be asked to a) modify their letter, b) reduce the items being requested, and c) provide an explanation on the requests. The PT Association is working with the SMRC on their concerns with the requests.
    • Noridian will work with our leadership and the POE AG member to assist with the concerns received.
  2. Noridian New Provider packets are mailed out each month to newly enrolled Part B solo-practice practitioners that have recently enrolled in Medicare. We are looking for feedback if providers would prefer these packets via email vs mail. These are a basic introduction for schedule of events, EDI, Noridian Medicare Portal. In prior months there were 500 packets mailed so Noridian is looking for ways to deliver to the intended recipient sooner in the process. Do people see a need to have this emailed instead of postal mailed? How do we emphasize the importance for new providers to fill out that email address while they are enrolling? We do have one email already occurring but if we could replace the postal mailing with emailed attachments may help.
    • Are these mainly new doctors? Is this anything that could shadow with the Medicare and You Handbook or if there is proprietary information a contact could be offered? Perhaps a webpage to provide the welcome pack. Could this occur through the portal or website?
    • Suggestion: Have Noridian send the Welcome New Provider Pack material to each POEAG member. This will allow each member to view the materials to have more insight on why we are trying to entice providers to go to our website by mailing them introductory educational material.
  3. CMS and Noridian want to remind Part B providers that Cognitive Assessment & Care Plan Service or CACP is also available to perform via Telehealth. In January 2021, CMS introduced a Medicare-covered, possible additional visit to assess a beneficiary that meets the requirements. For example, if a physician, or other clinician, that’s eligible to bill an Evaluation and Management (E/M) or Annual Wellness Visit (AWV), finds a patient is showing signs of cognitive impairment during that routine visit, Medicare now covers a separate visit (CPT 99483) to thoroughly assess that patient’s cognitive function and develop a written care plan.
  4. Sequestration adjustments will be returning in phases. April 1 through June 30, there will be a one percent adjustment. The full two percent adjustment returns July 1.
  5. MAC Customer Experience (MCE) Satisfaction Survey Update. Results for surveys collected in January and February continues to show participants find the Noridian webinars informative. We frequently receive requests to include more examples during webinars, however, many of the topics would be determined by individual patient documentation and the complete history. A wide variety of suggested topics are suggested with webinars planned for most of the recommendations.
  6. Recorded webinars are now available. Webinars on Demand will be posted on the website for two months. This allows the information to be removed without becoming out-of-date.

Upcoming Education and Training Events

Providers can view Ask the Contractor Teleconferences (ACTs), webinars, and related training opportunities by visiting the “Education and Outreach/ Schedule of Events” section of our website.

Webinars and Schedule of Events

2022 ACTs

CMS requires quarterly ACTs. Noridian offers a question and answer portion within each webinar to help streamline applicable topics, audience, and questions for experts. Please share recommendations for any timing, frequency, size, topics, and provider type(s) for the 2022 ACT schedule.

  • March 23 (Part A), April 20 (Part B), September 28 (Part A), and October 19 (Part B) from 3-4 p.m. CT.
  • Submit questions in advance through the Pre-Question Process on our website

Provider Contact Center Training

CMS approves training for Customer Service Representatives (CSRs) for up to eight hours per month. The training improves consistency and accuracy, understanding of issues, and knowledge retention. POE participates in training Customer Service Representatives each month. POEAG member recommendations for PCC training topic or related recommendations are welcome.

Electronic Mailing List (Listserv)

Noridian’s email list is routinely distributed Friday mornings with a CMS-authored MLN Connect sent out each Thursday. Noridian’s providers benefit by seeing outreach opportunities with an ability to register as those events are made available.

New POEAG Suggestions and Recommendations

During each meeting, all POEAG members are asked to provide suggestions on ways to increase education, improve training methods, or elaborate on topics discussed during the meeting.

  1. Compliments regarding the Pre and Post-pay Medical Review Chart document were shared indicating, “Thank you for preparing this as it will be a great resource” and “The resource document that had been shared was timely, looks good, and I was able to use that draft document to answer a QIO-related question.”

  2. The SMRC request offers a phone number allowing extensions and allow multiple extensions for providers with challenges pulling their documentation together. The member is happy to see that option for the contact and ability to extend due dates.

  3. Thank you for the POEAG leadership and the details you bring to the meetings.

Upcoming Meetings

Scheduled Meetings for 2022

When: All meeting times 3-4 P.M. CT/1-2 P.M. PT

  • June 14
  • September 13
  • December 13

Thank you for attending today’s meeting. We look forward to working with all of you again.

 

Last Updated Fri, 08 Apr 2022 17:37:05 +0000