Provider Outreach and Education Advisory Group (POEAG) Meeting - September 13, 2022

Roll Call

POEAG Member or Other (CMS) Attendees

Angela Amey, Candice Kahue-Antone, Cheryl Bradley, Greg Labow, Mitchel Kaye, Rob Sikorski (Susan Albaitis), Susan LaPadula, Tameka Island, and Wendy Alfaro

Noridian Attendees

Teresa Cirelli, Elizabeth Barton, Becky Paluch, Cheryl Hanson, Danie Aasen, Erin Swaidner, Jan Ervin, Katie Wik, Reanna Doele, Tammy Ewers, Tim Morrissey, Val Cavett, Julie Schroeder, 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.
    5. 09/13: Reason codes have been added to the website on 8/31/2022. If CMS expands this program in the future, we will communicate with our providers. An example of the new webpage is provided within the minutes. Reason Code Guidance - JE Part A - Noridian (noridianmedicare.com)
  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: A chart is in development.
    3. 03/08: The chart was shared with the members and discussed during the meeting. Members suggested there should be separate charts for Part A and B and a member requested Noridian to define pre- and post-payment review. The introductory paragraph should hyperlink to the pre-payment or post-payment review webpages. A member shared, "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 within the resource.
    4. 09/13: Updates to the chart are in process. The final version with comments received in March will be emailed to POEAG members. Members will be asked to review the modified version with feedback incorporated prior to publishing this to our website. Maintenance can continue as feedback is received.
  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. 09/13: The Medicare basic curriculum will be developed into a two-day Symposium being planned in 2023 - March into Medicare. Members were asked to share topic suggestions for this symposium which are welcome through poeag@noridian.com or during a future POEAG meeting.
  4. 03/08/2022. SMRC Requests.
    1. SMRC requests for documentation from Physical Therapy, Occupational Therapy, and Speech Language Therapy were discussed as an area of concern. The POEAG 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 Contractor Medical Director for the 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 sent to the American Physical Therapy Association regarding related questions submitted to the SMRC.
    3. 09/13: Members were encouraged to register for the SMRC educational webinar session during Noridian's September Symposium.
  5. 03/08/2022. New Provider Packets
    1. Noridian had notified members that Welcome New Provider packets had been mailed each month to newly enrolled Part B solo-practice practitioners that have recently enrolled in Medicare. Noridian requested feedback from members who had received the materials. Members were unaware of these packets and suggested we have a packet mailed to each member for review.
    2. 09/13: This process is being revamped within Noridian with the material and delivery being transferred from POE to Provider Enrollment to send the new provider packets.
    3. A member shared the change is logical and it makes sense for Provider Enrollment to send out the material.

New Agenda Items

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

  1. Skilled Nursing Facility (SNF) demand bill education. This topic was not conducted in previous SNF Noridian education and outreach. Noridian will work to educate on the regulatory privileges for all Medicare beneficiaries, include the right to demand a bill to be sent to Medicare.
    • Noridian is producing an Education-on-Demand tutorial that is planned to be available by the end of 2022.
    • A member shared CMS is co-authoring a letter with the collection of bad debts for nursing homes. Many times, Medicare patients and family members want the letter delivered immediately to not accrue an unpaid bill. This was a surprise to providers in the industry to see the government is seeing consumers are not being treated properly according to debt guidelines.
  2. Webinar on Demand Recordings Access Timeline - Providers are asking for longer than the current 60-day time period. POEAG members shared three-to-six months would be more ideal as there are changes with Medicaid in California that impacts in 2023. Education to new practices is occurring. There is a workforce shortage in healthcare.
    • Noridian's powerpoint recording tutorials are available on our YouTube channel. The live event Webinars-on-Demand recordings are currently limited to 60-days.
  3. Canceled overlapping claims alert reported in April 2022
    • The fix was implemented in the system in the middle of August. All claims have been reprocessed. The member shared this had been resolved at the end of August so the outcome should be visible to providers soon.
  4. Noridian Medicare Portal (NMP) to be expanded to offer all levels of appeal for Part A, Part B and DME.
    • Currently, the NMP offers Level 1 for Part A, Part B and DME and Level 2 for Part A only. The Level 2 for Part A was part of a CMS "Pilot" program allowing providers to upload their Reconsiderations. This required special access that was granted to the Medicare contractors. To allow Level 2 appeals through the portal for Part B and DME, Medicare contractors would need to obtain access into the different review entities systems. Currently, there has not been any direction from CMS to expand the appeals submission for a Level 2 for Part B or DME.
    • The request was shared with the Noridian Medicare Portal team. With the different contractors involved at different levels of appeals, Only Par A allows the second level of appeals (reconsiderations) at this time. This would be a long-term project beyond what POE can accomplish. We will add this as a new topic to a future agenda when progress on expanding NMP to accommodate more level of appeal efforts begin.
  5. SMRC request consideration for extension during a natural disaster pursuant to the CMS special circumstances regulations.
    • The provider has 45 days to respond to the initial request and 14 days to request a discussion and education period. Following the discussion, final results would be provided in 7 days.
  6. Noridian's team members who work on Comprehensive Error Rate Testing (CERT) activities have been actively contacting providers this summer that did not respond to requests for medical records. August 22 was the deadline to submit records for the 2022 CERT review. Additional information on CERT can be found on these websites:
  7. MAC Customer Experience (MCE) Satisfaction Survey Update: Satisfaction surveys are collected through provider interaction with our website, tutorials, webpages, portals and multiple Noridian team services. It is our goal to make changes and be responsive to the requests received. Responses below are from POE webinar surveys and reflect the webinar presentation content is informative as reflected below. Noridian requested POEAG members share the training topics or new webinars they would like Noridian to pursue as we establish our webinar schedule for 2023.
    • Participants appreciate the knowledge they receive from our events.
    • Providers have sent technical issue concerns to Noridian which resulted in Webinar-on-Demand recordings being pursued and published.
    • Webinar-on-Demand recordings are appreciated and allow additional access to listen to our educational recordings.
    • Opportunities to consider included expanding webinar topics, access questions and answers after the webinar, and awareness of content overload for the timeframe scheduled.
    • POEAG member input for 2023 specific webinar topics are requested to avoid the "repurposed" webinars each year.
    • Please know we truly value each survey completed as every survey and their comments are reviewed by reps, leadership, management. This is for webinars, webpages, tutorials, event recordings. Your voice drives our education plan.
  8. Two-Day Virtual Symposium Returns - POEAG members were encouraged to register for the September 21 and 22 webinar series. Guest speakers will included CMS, Carrier Medical Director, Provider Enrollment, RAC, SMRC, and DME. Additional topics from Education Representatives will be presented. We shared our excitement to have the SMRC hosting one of the sessions in our event as we recognize JE POEAG members have historically shared concerns they had with projects the SMRC was processing.
    • How will providers know when the recording is available?
    • Noridian has a process to notify anyone who registered that the presentation recording has been published. Noridian will ensure we notify POEAG members when the recordings are available
    • JEA - Symposium Events
    • JEB - Symposium Events

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.

  • A member shared they are always happy to see the Back to Basics are coming back. "I'm a huge fan of that module."
  • A member asked if the symposium presentations would be available at another time. Noridian shared each session will be recorded; however, it will not be hosted a second time.
  • Remote Therapy Monitoring (RTM) had been a June POEAG discussion item. Noridian's team member has been researching this topic and looking to associations for additional information on the topic to best support this request. A presentation from the provider/FDA approved application had produced educational material but we are awaiting guidance from CMS. We have reached out to the other AB MACs and are running into challenges as well. We do want to provide the documentation and guidelines and have those responsibilities documented and how a web app would work. Therapists have questions and vendor companies indicate their equipment is meeting criteria; difficult when there is no published material.
  • A member shared they appreciate Noridian's consistent outreach. For on-demand-webinars; we understand how quickly guides change when material is out too long. The suggestion was made for Noridian to keep the recordings published and available for three months instead of two months.
  • A member shared their, "boast of gratitude for all that Noridian does; thank you so much."

Upcoming Meetings

Scheduled Meetings for 2022

When: All meeting times 3-4 p.m. CT/1-2 p.m. PT

  • December 13

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

 

Last Updated Tue, 08 Nov 2022 17:59:22 +0000