Provider Outreach and Education Advisory Group (POE AG) Meeting Minutes - June 14, 2022

Roll Call

POEAG Member or Other (CMS) Attendees

Avery Malate, Chelsey Kekahuna-Kalaukoa, Cheryl Bradley, Greg Labow, Mitchel Kaye, Susan LaPadula, and Tameka Island

Noridian Attendees

Teresa Cirelli, Elizabeth Barton, Tammy Ewers, Tim Morrissey, Val Cavett, and Brittney Beck

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.
    5. 06/14: The reason codes are not on our website and Noridian will have an update by the September POEAG meeting.
  2. 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 were 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. 06/14: Teresa will work on finalizing this document based on the comments she has received. Once the new version is ready, it will be distributed to the POEAG members for final input.
  3. 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.
    3. 06/14: Tutorial sessions continue to be in development.
    4. 06/14: Tutorial sessions continue to be in development and we hope to begin publishing the individual tutorials that are part of the series and will provide an update on our progress in September.
  4. 03/08/2022. SMRC Requests.
    1. SMRC requests for documentation from Physical Therapy, Occupational Therapy, and Speech Language Therapy. 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.
    2. The Carrier Medical Director for SMRC reached out to the California Physical Therapy Association to answer questions and concerns discussed during the March POEAG meeting. The Outpatient Therapy project listed on the SMRC website, under the documentation requests, provides guidance regarding information requested. Only information that is applicable to the claim review, and available, would need to be provided. A written response was also sent to the American Physical Therapy Association regarding related questions submitted to the SMRC.
      1. A POEAG member indicated awareness of a new SMRC project and requests for MR documentation pertaining to the prior analysis of the OIG. The selection process is carving out the diagnosis. Providers had been familiar with receiving requests and now sites are receiving requests specific to schizophrenia. He noticed it is already published on the Noridian site and if Noridian could publish info to better advertise this project so providers know of resources that would be worthwhile.
  5. 03/08/2022. New Provider Packets
    1. 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.
    2. Members were unaware of these packets and suggested we have a packet mailed to each member for review.
      1. 06/14: Teresa will email the PDF of the information for POEAG feedback on the value of the content and the delivery method possibly migrating from postal to email delivery. Noridian staff shared we are working on an innovation in partnership with the Provider Enrollment education counterparts on a streamlined delivery approach. Susan asked if there could be an app using new technology to reach the masses we could develop for new providers (Android, Google, Phone-based App). Katie will take this to our Noridian Innovation team to explore.

New Agenda Items

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

  1. Request to add an additional webinar for Skilled Nursing Facilities (SNF) and a review of the waivers in place during the Public Health Emergency (PHE). Special Edition 20011 outlines the waivers for SNFs.
    • There is a webinar scheduled for June 16 - 1:00-2:30 CT or 11:00-12:30 PT. Registration: https://attendee.gotowebinar.com/register/3198987722446026768
    • POEAG members said "Big thank you" and "Thanks for doing this to provide information specifically for PHE." Will you be sending information out for training? Those who attend receive the presentation. Those who are unable to attend still receive the material. We do try to record our webinar sessions and will work to have this event made available as a recording. The requests we have received to have links to specific resources on each slide has been incorporated.
  2. A reminder was shared that sequestration adjustments have returned. April 1 through June 30, started with one percent adjustment. The full two percent adjustment returns July 1. This is based on date of service, not claim submission date.
  3. MAC Customer Experience (MCE) Satisfaction Survey Update: Surveys reflect the webinar presentation content is informative. Additional comments:
    • We are using the recommendations received through the survey as we plan 2023 webinars. We are hoping POEAG members share specific topic ideas for future webinars too.
    • Comments we have received in the survey pertained to staying within the advertised webinar duration and not going over the scheduled timeline.
    • Providers appreciate the polling questions offered to help engage attendees and help them focus on the presentation.
    • Technical difficulties during May resulted in re-scheduling the webinar or recording the webinar as a "Webinar on Demand". We are working to ensure the material is still made available.
  4. Two-Day Virtual Symposium Returns - Save the Date for September 21 and 22 will be posted in July. Guest speakers will include CMS, Contractor Medical Director, Provider Enrollment, Recovery Auditor, and DME. Additional webinar topics from Education are being finalized.
    • A POEAG member asked if we could add SMRC to the virtual symposium such as on the new review of schizophrenia? Teresa will reach out to the SMRC to see if they are available.

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. A member thought it would be nice to have a report of the SMRC findings. The recent round requested charts from Physical Therapy (PT) and Occupational Therapy (OT). Providers are receiving response letters, but they would like overall finding letters to learn of areas that need general improvements. Teresa understands the requests and relates it to what CERT publishes. The results would be helpful for Education to include in future webinar materials too.
    1. SMRC "Completed Projects" for therapy review was published to the SMRC website: https://www.noridiansmrc.com/completed-projects/01-044/
  2. The MCE rejections where CMS uploaded MCE code editor and some of the ICD10 codes are not following PPTM MAC file/Tool, like unspecified diagnosis or unacceptable diagnosis. This issue may be by region; however, other Jurisdictions seem to be having the same issue. Education on how to correct the claims is what is being requested. MPS adjustment or edit a claim? This is for Part A SNF claims. The edit is based on IPPS but disconnects for PDPM side. This had occurred back in April and there is a list of unspecified diagnoses, that are acceptable.
  3. Therapist providers would like in-person education on audits within Noridian and the process. Noridian offers education and requests for specific education can be submitted.  Therapists always appreciate education from Enrollment and their newly licensed, certified providers. In the past there could have been a one-day opportunity with two to four topics offered. Will Noridian be traveling at venues around our Jurisdiction where providers register.
    1. Teresa will share our collaborative guest speaker and individual provider education forms. We tailor toward our audience at this time. Katie shared we try to accommodate requests received while reaching as many people as we can when we do travel. We are not currently scheduling in-person seminar/hotel-style conferences at this time as our travel is now beginning to open up following the pandemic.
    2. If a training request is being accommodated, knowing the types of topics that may be available would be helpful so she could know what to request. Noridian indicated if providers share their pain points or areas of concern in their education request, the education team will internally locate the right team(s) to participate and represent Noridian to walk through the questions or areas of concern.
  4. A request was received to include echocardiography in our webinar topic planning.
  5. Noridian allows second round appeals via the portal, are there plans in place to allow all level of appeals to be available on the portal? With increased remote work, the availability of faxing entire documents becomes more difficult, faxing and getting thru in general is difficult as well.
    1. Noridian explained as MACs migrate to the Medicare Appeals System for redeterminations into reconsiderations, that allows the single appeal data source to be accessed by portals. As Part B and DME migrate to MAS, that opens the door for portal reconsideration access. As far as Administrative Law Judge and higher appeal levels, that will be researched with the Noridian Medicare Portal (NMP) team.
  6. A request for educational offering on RTM (Remote Therapeutic Monitoring)
    1. Teresa researching if it is part of the current plan as she feels she has seen this.
  7. SNF demand bills were not covered in the prior year. Noridian staff asked if this could be a good fit for a tutorial instead of a webinar. The member indicated "the sooner the better" as beneficiaries have the right to request the demand bill and proper completion is important. The tutorial may be the fastest solution of creation and delivery.
  8. Does the SMRC have disaster waivers? As the Noridian MAC, we are unsure what guidance they have received. Decision and Education session within 14 days.
  9. Is there a different phone number as people are waiting one hour with no call backs?
    833 860 4133 –
    1. This is the same phone number as the SMRC has published on their website for their contact center. Katie will have someone in the SMRC reach out to the POEAG member to discuss his concerns.

Upcoming Meetings

Scheduled Meetings for 2022

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

  • September 13
  • December 13

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

 

Last Updated Dec 09 , 2023