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Provider Outreach and Education Advisory Group (POE-AG) Minutes: January 12, 2021


Facilitator
Wendy Weary, POE Supervisor

Palmetto GBA Members
Belinda Marin, POE Manager
Areka Freeman, POE Senior Provider Relations Representative
Marlene Frierson, POE Senior Provider Relations Representative
Judy Brown, Senior Provider Education Consultant
Tionna Washington, Senior Provider Education Consultant
Tamika Woodard, Senior Provider Education Consultant

Palmetto GBA Welcomed POE-AG Members

 Name  Company
David Sweet Cape Fear Valley Medical Center
Debbie Lee Mary Washington Healthcare
Drucilla Boddie Sentara Halifix
Jill Fountain Carilion Clinic
Matilda Jarrett-Davis Sentara Health
Fred Jones S.C. Department of Mental Health
Kathryn Mustard Princeton Community Hospital
Michael Womack Lexington Medical Center
Nakia Jones Cape Fear Valley Medical Center
Quiana Anderson S.C. Department of Mental Health
Natalie Hefner Mercury/Mary Washington Hospital
Samuel Clark N.C. Health Care Facilities Association
Stephanie Elliott Sentara Halifax Regional
Tammy Brown Kershaw Health
Tom Giambry Davita, Inc.

Welcome

Review of Goals and Purpose
Part A POE-AG Charter

Old Business: Prior POE-AG Suggestions/Recommendations

Feedback
Members had no further feedback.

New Business: POE-AG Education Suggestions and Recommendations

Feedback
A member suggested additional outpatient prior authorization education concerning when specific UTNs are not available for multiple providers.

A member would like further eServices education regarding one administrator for multiple facilities. For example, what steps the administrator would take to grant the access to the eServices portal and how to limit functions.

Website Enhancements

  • eServices
    1. Do You Have a Question Regarding eServices? We Can Help! Re-listserved 12/18, 12/22, 12/30.
    2. Do You Know Who Your eServices Administrator Is? Tool added to portal on 12/21.
    3. This tool allows providers to look up their portal administrators
    4. Access TPE Letters Electronically Job Aid added on 12/10
    5. eServices Data Availability. Re-listserved on 12/31.
    6. How do I change my password? Re-listserved on 12/11.
  • New Self-Service Tools
    1. Appeals Overview for Providers Module added on 12/21
    2. IPPS Billing for Cost Outlier Module added on 12/9
  • Revised Self-Service Tools

1. Interactive UB-04 revised on 12/16
2. Reason Code C7715 added to Claim Submission Error Help tool on 12/30
3. Claim Submission Error help tool added Reason Code C7800 added on 12/1
4. Satisfying an Overpayment Through Offset module revised on 12/3

Web Based Trainings (WBTs): The most viewed WBTs

DecemberFirstSecond

JM Part A

A/B Rebilling Module —
68 views
Basics of Provider Level Balance (PLB) Reason Codes Module — 40 views

JJ Part A

EDI Enrollment Instructions Guide Module — 138 views Appeals Overview for Providers Module — 54 views

Feedback
Members had no further feedback.

Upcoming Part A Education Events

  • 1-13 Left Atrial Appendage Closure (LAAC) webinar at 11 a.m.
  • 1-25 Part A Covid-19 Vaccine & Monoclonal Antibody Infusion Therapy Enrollment at 11 a.m.
  • 2-10 Ask the Contractor Teleconference (ACT) at 11 a.m.
  • 3-17 JJ/JM Part A Quarterly Medicare Updates webinar at 11 a.m.
     

CMS Initiatives

MLN Matters Articles

FAQs on the 3-Day Payment Window for Services Provided to Outpatients Who Later Are Admitted as Inpatients
CMS issued a new MLN Matters Special Edition Article SE20024 on
FAQs on the 3-Day Payment Window for Services Provided to Outpatients Who Later Are Admitted as Inpatients (PDF, 295.92 KB). Learn about procedures and resources to avoid billing errors.

New & Expanded Flexibilities for RHCs & FQHCs during the COVID-19 PHE
CMS revised MLN Matters Special Edition Article SE20016 on
New & Expanded Flexibilities for RHCs & FQHCs during the COVID-19 PHE (PDF, 264.19 KB) to provide additional guidance on cost-sharing for telehealth services.

Publications
Major Joint Replacement (Hip or Knee)
CMS revised the MLN booklet,
Major Joint Replacement (Hip or Knee). Learn about:

  • Documentation
  • Coverage requirements
  • Coding

Medicare Preventive Services
CMS revised the MLN educational tool,
Medicare Preventive Services. Learn about:

  • Coding
  • Coverage
  • Copayment/coinsurance and deductible

Medicare Provider Enrollment
CMS revised the MLN educational tool,
Medicare Provider Enrollment. Learn about:

  • Eligibility and process
  • Application fee for institutional providers
  • Revalidation
  • Provider Enrollment, Chain and Ownership System (PECOS)

Opioid Treatment Programs (OTPs) Medicare Billing and Payment
CMS revised MLN fact sheet,
Opioid Treatment Programs (OTPs) Medicare Billing and Payment. Learn about:

  • Covered services
  • Coding and submitting claims
  • Payment and remittance advice

Opioid Treatment Programs (OTPs) Medicare Enrollment
CMS revised MLN fact sheet,
Opioid Treatment Programs (OTPs) Medicare Enrollment. Learn about:

  • Completing and submitting your application
  • What to expect

Provider Compliance Tips
CMS revised the following MLN fact sheets with provider compliance tips. Learn about coverage and documentation requirements to prevent claim denials.

Provider Compliance Tips for Tracheostomy Supplies
CMS revised the MLN fact sheet,
Provider Compliance Tips for Tracheostomy Supplies. Learn about:

  • Coverage criteria
  • Refill requirements
  • How to prevent denials

Web-based Training
Diagnosis Coding: Using the ICD-10-CM Web-Based Training Course
A revised Diagnosis Coding: Using the ICD-10-CM Web-Based Training (WBT) course is available through the
MLN Learning Management System. Learn how to:

  • Recognize features
  • Find correct codes
  • Identify structure and format

Procedure Coding: Using the ICD-10-PCS Web-Based Training Course
A revised Procedure Coding: Using the ICD-10-PCS Web-Based Training (WBT) course is available through the
MLN Learning Management System. Learn how to:

  • Recognize features
  • Find correct codes
  • Identify structure and format

CERT A/B MAC Outreach & Education Task Force Education Resources

Feedback
Members had no further feedback.

Open Discussion
A member suggested joint Part A/B education regarding the importance of physicians keeping their PECOS information up to date, especially taxonomy and specialties. Facilities validate certifications with this data and often it is too generic.

Next JM Part A POE-AG teleconference is April 13, 2021, at 10 a.m.


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Last Updated: 01/21/2021