Provider Advisory Groups

1. Preventive Medicine Chart
   • Greg explained to the provider’s that this is a quick reference guide for billing preventive medicine. Greg also pointed out that this chart includes the new billing procedures for diabetic and cardiovascular screening.
   • Provider’s had suggestions as to how this chart could best be used including:
     • Put handout on the website for easy access.
     • Use as a handout for various meetings and workshops.
        
2. OIG Fraud Release
   • Greg discussed this warning with the members. It was suggested that this be a topic in future enrollment workshops.
   • This information was also published on Medicare’s website and in January 2005 Provider Newsletter
      
3. Drug Administration Changes
   • Greg asked the provider’s if they had heard of any problems with the new Drug Administration Changes. No one had any questions on this subject. It was discussed that information about problems with recent changes be published on the web, in workshops, and in the newsletters. The MedLearn Matters articles were published on the Medicare Website December 27, 2004 with an update on January 12, 2005.
      
4. HPSA/Physician Specialty Bonus
   • A revision to the Health Professional Shortage Area (HPSA) Bonus Payment Processes was published on the website on September 27, 2004. Some providers have experienced problems because it requires the professional component to be split from the technical component when billing. All agreed that this needed to be covered in our workshops.
   • There has been a recent revision on this matter. Payment will be automatically made based on the zip code submitted on the claim. Providers are urged to visit the CMS website at: http://www.cms.hhs.gov/providers/bonuspayment to determine if you are eligible for the bonus, or if a zip code that is not on the list is still eligible for a bonus. It was recommended that we establish a link from the HPSA portion of our webpage to this page of the CMS website.
      
5. CMS Change Request 3376 Initiatives
   • Ask the Contractor Teleconference
     • This is a one-hour teleconference similar to the CMS Open Door calls, allowing providers to interact with representatives from various departments within Medicare.
     • The call is set up with 100 lines and will be on a first come first serve basis. Questions can be submitted in advance to be addressed during the conference. The flyer announcing this call was discussed.
     • Suggestions from the providers as to how to handle the teleconferences included:
       • It should be topic specific,
       • Have an agenda ahead of time.
       • It was also suggested that no cell phone use for these conference calls because it is hard to hear and understand the person when they are talking.
          
   • Customer Service Initiatives
     • We have moved to a three tiers of customer service representatives in order to better service providers in answering their questions. There were some complaints on this procedure from the providers that they are not able to get a correct answer when calling customer service without having it turn into a supervisor call. Pat Bonnette pointed out that new service representatives have been hired and are still training which may be the cause of this confusion. This process started in January 2005.
     • Also under this CR is the Interactive Voice System (IVR) that is not in effect at this moment. Providers will also be able to check beneficiary eligibility on this system also.|
        
   • Web Initiatives
     • We are urging providers to start using the internet to get answers for questions they may have about Medicare issues. There was a suggestion from the providers to show how to use the internet at workshop meetings to find answers, maybe use handouts or a PowerPoint presentation.
        
6. Web Based Training
   • Members will be notified via email at the beginning of the review period with instructions on how to access the training site and how to provide feedback. Most recently, they were asked to preview the course on Coverage Determination. There is a ten day to two-week window for providers to preview these courses.
      
7. 2005 Workshop Schedule
   • There will be a General Update Workshop and Fundamentals Workshop that will be given in various areas. Greg provided a schedule of the workshops for this year to the providers.
   • There was a handout given to show the confirmation letters that the providers should receive back from Medicare when they enroll into a workshop online or if mailing their registration form in to Medicare. Greg pointed out to the providers that when they register online that does not mean they have a definite seat for the workshop. The check must be received prior to workshop to insure a seat.
   • Members asked if it was possible to pay by credit/debit card on line. At this time, it is not but we’ll check to see if it would be possible in the future.
      
8. National Provider Identifier
   • This is part of the HIPAA initiative, National Provider Identifier, or NPI, was selected as the standard unique health identifier for healthcare providers. It was recommended that this be part of our General Update and Fundamentals as well as the Enrollment workshops. Several members said they would include information on their website. It was also suggested that this be included in the Hot Topics of our Ask the Contractor calls.
      
9. HIPAA
   • Kelly Vaughn told members that providers not filing electronically would be checked to see if they are following the guidelines for submitting paper claims.
   • Another issue that is not being followed by some providers is that they are not using the nine-digit provider number when billing claims. Kelly urges that you please do this when billing your claims if it applies to you.
   • Another concern with providers is the Medicare to MediPak crossover issues. There was a problem but that has been resolved and claims have been crossed if they should have crossed. Kelly also stated to providers that Medicare would not cross to MediPak if Medicare denies a claim.
   • Members recommended that information about crossovers be placed on the website.
      
10. Other Business
    • MSP representatives spoke about voluntary refunds. The providers were directed to the December 2004 Newsletter about this topic.

The meeting adjourned at 11:47 a.m.

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