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

Roll Call

POEAG Member or Other (CMS) Attendees

Dawn Davidson, Jamie Neill, and Trisha Anderson

Noridian Attendees

Teresa Cirelli, Elizabeth Barton, Katie Hove, Reanna Doele, Tim Morrissey, Jameson Groth, Julie Schroeder, Val Cavett, Jan Ervin, and Mark Ternes

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

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

Suggestion Date Description Resolution
11/16/20 Educate on Inpatient Transfers vs Leave of Absence 09/14: Noridian is producing an Education on Demand tutorial on “Transfers, Interrupted Stays and Leave of Absence” that is expected to be available the end of October.
12/10/20 Add more information on how to bill unlisted codes 09/14: A member requested to have more visibility to the internal listing the call center uses for unlisted codes. POE continues working with the call center and our claim processing teams on this possibility. A webpage is under development to assist with unlisted codes and is anticipated to be published early-2022. This topic will be shared with our Contact Center as a possible Customer Service Respresnetative (CSR) education opportunity so they may avoid referencing internal-only resources.
03/09/21 Publish an Overlapping Facility Request for Assistance Form 06/08: Our contact center leadership is evaluating other MAC Dispute Request for Assistance forms and our current workload. We are working with other departments to determine if adding a dispute form to our website is feasible. We are aware providers may feel a 45-business day written correspondence response timeline is less customer-service focused than the current processes which allows telephone inquiries.
09/14: A member shared a) the form would be trackable and provide clear documentation, b) would confirm discharge location with the patient, and c) have Noridian recoup payment from other facility to track correction to discharge patient status code. The feedback received has been shared with Provider Contact Center (PCC) leadership for discussion and consideration.
06/08/21 Nurse Practitioner (NP) and Physician Assistant (PA) Edits 06/08: Providers are experiencing a large volume of claim denials and appeals surrounding NP and PA services occurring a) on the same day as another NP or PA service or b) as a new patient visit in a three-year period when the beneficiary is seen by another NP or PA in the same group. Noridian listened to providers, evaluated data for these situations, and we are reviewing options.
09/14: Noridian has scheduled n internal project to review system edits. A member indicated they contacted Noridian’s PCC and were informed the PA would need a different specialty; however, there isn’t a different specialty they can receive. PCC leadership will research this topic as a PCC CSR training opportunity.
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)? 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. No additional feedback received from POEAG members. This is now closed.
06/08/21 Noridian Medicare Portal (NMP)
  1. Remittance Advice Expansion
  2. Portal Survey
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. JF providers liked the ability to perform first level appeals. The members requested the ability to reopen items currently only available by phone or mail. This was shared internally with the reopening and NMP group for review.
06/08/21 Targeted Probe and Educate (TPE) 09/14: TPE has resumed following Change Request 10249 published in 2019. TPE webinars started on 9/10 with additional sessions offered on 9/23 and 10/14. Additional information can be found on Noridian’s JF Part B (JFB) Targeted Probe and Educate (TPE) website.
06/08/21 Prior Authorization Updates 09/14: The webinar series for Prior Authorization for Certain Hospital Outpatient Department Services was completed in August. Based on frequently asked questions during the webinars, the presentation was updated throughout the summer. One suggestion was to add the reason codes to the PA webpages; this is in the works with the Provider Contact Center.
06/08/21 Medicare Diabetes Prevention Program (MDPP) 06/08: Education rep shared how the MDPP program was developed. One POEAG member shared challenges that were experienced. A rep will reach out to the provider group.
09/14: Noridian’s MDPP expert reached out and provided great information. There were not any additional questions at received. A Provider enrollment webinar is scheduled on 09/29. This is now closed
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 internally routing in a timely manner, using the portal status and submission features, understanding CMS guidance, accessing Noridian recommendations, and understanding other pre- and post-payment activities that are 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 to join one of these sessions. The address used to send ADR letters is retrieved from the pay-to address indicated in the provider enrollment record.

 

New Agenda Items

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

  1. Beneficiary Notices Initiative (BNI) or Advance Beneficiary Notice (ABN)
    1. New October 14, 2021 changes forthcoming for ABN notices.
      • Notifiers are entities who issue ABNs
      • Defines ABN triggering events
      • Effective period for non-covered care
      • When an ABN is mandatory vs optional
      • ABNs can be used for providers, suppliers, ambulance, and facilities.
    2. Resources
  2. Continuing Education Units (CEUs) 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.
  3. MAC Customer Experience (MCE) Satisfaction Survey Update
    1. Results for surveys collected June through August indicate providers appreciate visual examples. Opportunities identified a longer question and answer portion of events may assist with future training. Some attendees feel the presenters are reading every slide and others feel more information was verbally provided than what was included on the slides.
  4. 2022 Ask the Contractor Teleconference (ACT) Date and Topic Recommendations
    1. Noridian fulfills the CMS required by hosting quarterly ACTs. We have expanded the minimal expectation and have hosted special events, such as an Evaluation and Management ACT during 2021 based on the high number of questions received.
    2. Members were encouraged to share their recommend topic-specific POEAG meetings and any recommendated dates.
    3. Two members shared they will share suggestions that may develop after discussing with their constituents. Members will email their suggestions to POEAG@noridian.com.
  5. 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. Two members shared once every four months (three times a year) will work for them.
    3. Noridian has been meeting every three months (four times a year) the past few years.

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

MS 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 2021 ACT schedule.

  • January 20 (Part A), March 10 (E/M), April 14 (Part B), September 15 (Part A), and October 13 (Part B) from 3-4 p.m. 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 shared the following recommendations for CSR training topics.

  1. Physician Assistant (PA) specialty and claim processing is on potential topic
  2. Unlisted code denials should refer to resources available to the public, not internal only.

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 will benefit by seeing outreach opportunities and 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.

  • Group member suggested global education for zero pay claims submitted when the primary is paid in full and the secondary is being billed as a no-pay (131) and condition code 77 or 78. When the claim gets to Medicare, they are (130) rejected claims. Is there documentation or research on the claims that can occur?
  • Date of Death lag time is an issue they are experiencing but they know they are following the process and understand there is nothing additional needed or that can be done at this time.
  • Is there a go-live date for the provider-based billing address exact match with the claim and PECOS address? There is not a date at this time that has been shared for the implementation of the practice address requirements as of today. We will educate as soon as we receive that guidance.
  • Global education for donor claim denials would be a good resource for Noridian’s website.
  • High interest from critical care providers to see how the MACs will provide guidance on the critical care guidelines with global surgeries that are outlined in the proposed 2022 Medicare Physician Fee Schedule. Can Noridian clarify how they are interpreting the global guidelines for patients that need critical care? Proposed rule indicates this may be a bundled service and may negatively impact critical care physicians that oversee post-surgical cases.

Upcoming Meetings

Scheduled Meetings for 2021

All meeting times 1 - 2 P.M. CT

  • 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 20:11:34 +0000