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

Amber Krueger, Lisa Davies, Mindy Gale, 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

JFA: https://med.noridianmedicare.com/web/jfa/education/poe-advisory-group
JFB: https://med.noridianmedicare.com/web/jfb/education/poe-advisory-group

Here are the POEAG meeting recommendations and/or suggestions from the prior event.

Suggestion Date Description Resolution
March 10, 2020 Provider suggestion: The Noridian Medicare Portal (NMP) should include the Additional Development Request (ADR) actual findings like it does on Direct Data Entry (DDE). ADR decisions are viewable in the portal on the ADR Inquiry and would be viewable on the remittance advice. NMP example below.

 

Partial view of ADR Inquiry on the Noridian Medicare Portal (NMP)

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/jfb/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. COVID-19:
    1. Check Related Articles Section and call the hotline
      JFA: https://med.noridianmedicare.com/web/jfa/topics/emergencies-disasters
      JFB: https://med.noridianmedicare.com/web/jfb/topics/emergencies-disasters
    2. Additional telehealth webinar scheduled June 25, 2020
    3. We have presented several sessions in April and May. All our states were included with an average of 300 or more attendees in each session
  6. 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.
  7. 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/jfa/education/training-events
Part B: https://med.noridianmedicare.com/web/jfb/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: Expressed everyone has been doing a good job keeping up with all the fast and furious changes occurring. Noridian has been trying to stay as current as possible going through all the COVID 19 materials.

Suggestion: Host education on the upcoming evaluation and management changes before January 1, 2021. Also consider having more than one educational session.

  • Noridian plans educational opportunity in the fall of 2020 in collaboration with Medical review. Noridian registration is limited to 500 and will consider multiple training on this topic.

Suggestion: Provide training for credit balance reporting, since there are some issues with faxed information not being readable. The faxed form required for reporting usually ends up in a phone call from Noridian. Can this additional step be resolved?

  • Noridian will take this into consideration

Suggestion: Provide submission of the credit balance reports through the Noridian Medicare Portal.

  • Noridian will make a recommendation to the take this into consideration.

Suggestion: Appeals training.

  • Appeals training is offered quarterly or semi-annually.

Question: When are the updates to the new telehealth codes effective?

  • The updates are scheduled for the July 7, 2020 quarterly release.

Question: Is there going to be a time limit on the use of DR condition code or CR modifier? Will there be a mass adjustment based on the July 2020 quarterly release?

  • Clarification of the DR condition code and CR modifier related to waivers located in SE20011. Mass adjustments information will be issued through the Quarterly Medicare Updates - AB webinar (July 2020).

Upcoming Meetings

Scheduled Meetings for 2020

All meeting times 1-2 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 13:31:54 +0000