Provider Outreach and Education Advisory Group (POE AG) Meeting Minutes - September 14, 2021

Roll Call

POEAG Member or Other (CMS) Attendees

Kimi Shintani, Mitchel Kaye, Susan LaPadula, Tameka Island, and Wendy Alfaro

Noridian Attendees

Teresa Cirelli, Elizabeth Barton, Reanna Doele, Tim Morrissey, Karlotta Dixon, Val Cavett, Julie Schroeder, Alicia Mahle, Tammy Ewers, Jan Ervin, Lu Newell, and Cindy White

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 Suggestions and Recommendations

The POEAG meeting recommendations and/or suggestions from the prior event with updates are reflected below.

Suggestion Date Description Resolution
09/10/19 Noridian Medicare Portal
  1. Part A full remittance advice functionality added
  2. Portal survey
06/08/2021: NMP’s Part A Full Remittance Advice Expansion: A version of the Part A remittance advice was previously offered on the portal for those providers who received the Standard Paper Remittance Advice (SPRA).
09/14: a) Effective July 2021, the portal now offers full remittance advices for providers receiving Electronic Remittance Advices (ERAs). As of July 30, Part A claim status inquiry reason codes provide guidance of denials or edits for each line of the claim. Hyperlinks are provided to the reason code narrative. b) Survey results were emailed to all POEAG members on August 6. JE providers liked the accuracy and functionality provided but shared concerns about Portal stability. Two suggestions were forwarded: 1) Provider would like to talk directly to Medical Policy. Noridian’s call center tracks all incoming calls and triages issues that need additional information. 2) Requested current 45-day timeline to allow a longer time frame, maybe 180 days, to respond to documentation requests. This has been forwarded to Medical Review.
03/09/21 Prior Authorization Training 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.
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.
06/08/21 Part B Additional Documentation Request (ADR) responsiveness 06/08: The group requested more insight on provider types involved and creation of ADR Part A and Part B educational resource containing ADR pay-to and billing address information obtained during provider’s enrollment, importance of identifying requests received and internal office timely routing, portal status and submission features, CMS guidance, Noridian recommendations, and other pre- and post-pay activities occurring.
09/14: ADR webinars will be presented on 9/21, 10/14 and 10/28, 11/2, 11/12 and 11/17. We would encourage you and other staff members to join one of these sessions. The address used to send ADR letters is pulled from the pay-to address indicated in the provider enrollment record.
06/08/21 Provider enrollment letters 06/08: Noridian asked if any members have concerns regarding communication from the Enrollment team (i.e., outbound notification letters or requests for information)? Last year in September of 2020, the format of the notification letters changed to be specific to reflect the type of application submitted. The letters are in line with all Medicare Administrative Contractors and have been successful in moving forward. There have been a few cases when the team has received positive feedback on the information sent out, so the change has been a successful transition.
09/14: A member asked questions on when a provider enrolls in private practice, when can they begin treating Medicare patients. Could an existing enrolled provider in the same office sign medical records while the provider waits for enrollment to finalize? The member indicated CSRs have stated claims could be held if they treat patients before their enrollment is finalized and active. They were told a 30–45-day period may exist, and they can only back-date 30 days. Julie from Provider Enrollment provided a response. If a provider starts seeing a patient before their application is completed, enrollment may not be able to grant the effective date indicated on the enrollment form (additional information needed, license not valid on date of request). We recommend providers not see patients until after they receive their Medicare enrollment finalized letter. A provider may take a risk to see patients early; but if there is a challenge experienced during enrollment this may affect the effective date. There is currently a waiver situation allowing 90-days to backdate. There have also been providers without state license completed prior to their enrollment with Medicare. Enrollment will follow-up with the member to discuss in further detail.

 

New Agenda Items

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

  1. Pre-pay and Post Medical Review for Part A and B Providers
    1. 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. Expand Noridian Medicare Portal (NMP) to offer 120 days and/or last 100 ADR letters for providers to access on demand.
    1. The Noridian Medicare Portal ability to view more ADRs and allow an extended period to ensure providers receive the data in the ADR. The pay-to address for large providers is an accounting or corporate office for financials and is not the clinical location where care is given and charted.
    2. There may be time sensitive requirements on how long providers have to reply which may drive how long ADR letters can be visible in the portal. Noridian MR, Portal, Appeals and POE will research what options we can offer for this more complex request.
    3. The pause with the pandemic and large volume of requests for records is being anticipated from providers. Noridian is offering webinars and will be discussing how those record requests will be received.
  3. Beneficiary Notices Initiative (BNI) or Advance Beneficiary Notice (ABN)
    1. Providers need clear clarification. Perhaps a chart with specific notices for Fee for Service (FFS) and Medicare Advantage (MA).
    2. Some notices are for all Medicare beneficiaries; other notices are for both FFS and Medicare Advantage (MA).
    3. New as of October 14, 2021, changes will occur for ABN notices as defined in the CMS Change Request 12242. There is a CMS Beneficiary Noticies Initiative (BNI) website Noridian looks to CMS to update with the changes for providers to access. The changes focus on Liability Perspective, Signature refusal procedures, and video explanation of the letter with clear instructions for the beneficiary and family explaining options and consequences.
      • Noridian has submitted BNI suggestions CMS review and consideration.
  4. Continuing Education Units (CEUs) Eligibility Changes Effective October 1, 2021
    1. Noridian will be changing the process for webinar participants to earn American Academy of Professional Coder (AAPC) CEUs. The attendees must be logged into GoToWebinar for the entire presentation to earn the CEU. Attendance is tracked through the webinar platform to indicate logged in and out times. The CEU will only be provided following the webinar and no longer provided as a handout during the event.
  5. 2022 ACT Date and Topic Recommendations
    1. Recommend topic specific POEAG meetings
    2. Members will share any suggestions regarding topics and frequency with Noridian’s POEAG leader; poeag@noridian.com.
  6. POEAG Meeting Frequency: Once every three or every four months
    1. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/com109c06.pdf, Section 20.6.1, “The POE AG shall generally convene quarterly but, at a minimum, shall meet three times per year.”
    2. Members prefer quarterly, as it is currently scheduled. Meeting four times per year allows proactive information sharing and recaps.

Upcoming 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

2021 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.

  • January 20 (Part A), March 10 (E/M), April 14 (Part B), September 15 (Part A), and October 13 (Part B) from 1-2 ET / 3-4 CT.

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.

During the upcoming round robin portion of the agenda, members were encouraged to share what recommendations they have for CSR training topics.

Electronic Mailing List (Listserv)

Noridian’s email list is routinely distributed Tuesday and Friday mornings with a CMS-authored MLNConnect 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 requested Noridian consider recordings of webinars be made available. Noridian shared we are researching solutions beyond our current recorded presentation to have those live event recordings to supplement Education on Demand tutorials.
  • Portal performance and stability is an update the group would like to discuss during the December meeting.

Upcoming Meeting

Scheduled Meetings for 2021

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

  • December 14

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

 

Last Updated Tue, 12 Oct 2021 19:00:04 +0000