Provider Outreach and Education Advisory Group (POE AG) Meeting Minutes - June 9, 2020

Roll Call

Noridian Attendees

Reanna Doele, Tammy Ewers, Lu Newell, Jennifer Molly, Lori Weber, Tana Williams, Kim Graham, Naomi Umstot, Teresa Cirelli, Tim Morrisey, Elizabeth Barton, Julie Schroeder, Claire Anderson 

POEAG Member Attendance

Cheryl Bradley, Dawn Silva, Mitchel Kaye, Robert Risley, Susan LaPadula, Tameka Island, Wendy Alfaro, Wendy Alfaro, Greg Labow, Alexis Christian-Abbott (CMS)

POEAG Mission and Goals

During each meeting, the Mission and Goals are reviewed.

Prior Meeting Minutes

The prior meeting minutes were distributed to POEAG members and published to the website

JEA: https://med.noridianmedicare.com/web/jea/education/poe-advisory-group
JEB: https://med.noridianmedicare.com/web/jeb/education/poe-advisory-group

New Agenda Items

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

  1. Overpayment Results for Part A and Part B Users Now Available
    1. Overpayment Results inquiry is available for any user that already has access to the Financials tab within NMP. The Overpayment Results inquiry will provide information on claims that caused an overpayment and the steps being taken to satisfy that overpayment.
    2. Tutorial available on the Noridian Medicare Portal.
  2. Medicare Beneficiary Identifier (MBI) Disclosure - Future NMP Availability
    1. NMP lookup tool will extend the period providers can obtain a deceased beneficiary's MBI from 13-48-month period. Through the Noridian Provider Contact Center (PCC) representatives you may obtain the MBI over the phone for a span up to 48 months.
  3. Prior Authorization for Certain Outpatient Department (OPD) Hospital Services
    1. Viewed by Part A providers under Medical Review/Pre-Claim Review - Effective July 1, 2020 a prior authorization (PA) request must be submitted to the MAC before performing services. CMS has identified five (5) services that may be medically necessary instead of cosmetic: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation.
    2. Webinars are scheduled May-August detailing the PA process.
    3. Submission may begin on June 17th, current available methods are fax or mail.  The ability to submit through either the portal or esMD is set for a later date.  More info can be located on a newly created page under Medical review, claim review section All information will be found on this page. https://med.noridianmedicare.com/web/jeb/cert-reviews/pre-claim
  4. Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM)
    1. Original implementation omitted the need to enforce sequential billing for the variable per diem to pay correctly.  On or after implementation date October 5, 2020, Noridian will reprocess claims brought to their attention and that processed prior to 10/1/2020.
    2. View complete Medicare Learning Network (MLN) 11727 article https://www.cms.gov/files/document/mm11727.pdf for update to Medicare Claims Processing System (MCPS).
  5. Skilled Nursing Facility (SNF) COVID-19 Waivers
    1. COVID-19 Public Health Emergency (PHE) special circumstances for the additional SNF benefit days (100 days) without the 60-day break to the spell of illness (Blanket Waiver).
    2. Applies to any patient that has exhausted days after waiver has been implemented and has been affected by the PHE
    3. Matters Article Number: SE20011 Clarification for Using the "CR" Modifier and "DR" Condition Code. https://www.cms.gov/files/document/se20011.pdf
    4. SNF Waiver to Extend the Benefit Period article: https://med.noridianmedicare.com/web/jea/article-detail/-/view/10521/snf-pdpm-assessment-diagnosis-covid-19-icd-10-code-u07-1-and-snf-waiver-to-extend-benefit-period
  6. COVID-19:
    1. Check Related Articles Section and call the hotline
      JFA: https://med.noridianmedicare.com/web/jea/topics/emergencies-disasters
      JFB: https://med.noridianmedicare.com/web/jeb/topics/emergencies-disasters
    2. Additional telehealth webinar scheduled June 25, 2020
    3. We have presented several sessions in April and May.  All of our states were included we had an average of 300 or more attendees in each session
  7. Therapy Billing During COVID-19 - Telehealth Services
    1. Webinars were held in May and June 2020 with updated billing information for outpatient hospital, and independent therapists.
  8. Report Cards - Enrollment
    1. Provider Enrollment has an opportunity for all enrollments. Report Card are given to the enrollments regarding the applications they have submitted (Paper versus PECOS), request of additional information that is needed on the application, how many revalidations have been requested, and more. Please let us know if there are any enrollments you think would benefit from this. Email PEeducation@noridian.com to let us know.

Upcoming Events

Providers can view trainings and seminars available by visiting the “Education and Outreach/ Schedule of Events” section of our website.

Webinars

Part A: https://med.noridianmedicare.com/web/jea/education/training-events
Part B: https://med.noridianmedicare.com/web/jeb/education/training-events

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.

Provider input: The Provider Outreach and Education staff is doing a great job. Enjoying all the webinar presentations, especially on the coronavirus.

Provider input: Great education that has been released to the therapy community this past quarter, especially on COVID-19 coding and billing.

Suggestion: Any progress on Part A providers obtaining full remittance advices from the Noridian Medicare Portal. Part B has this functionality currently.

  • The portal improvement request was submitted in August 2019 to the Support team. It is still under consideration. This function of full remittance advices for Part A is more complex. 

Upcoming Meetings

Scheduled Meetings for 2020

All meeting times 3-4 PM CT

  • September 8
  • December 8

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

 

Last Updated Thu, 08 Oct 2020 13:29:14 +0000