Railroad Medicare Provider News for Tuesday 2/20/18

CMS National Provider Enrollment Conference – April 24 and 25, 2018

The CMS National Provider Enrollment Conference will be held on April 24 and 25, 2018 at the San Diego Convention Center. Take advantage of this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts.

Medicare Secondary Payer Inquiry Form

As a reminder, A Medicare Secondary Payer Inquiry Form is available in the Medicare Secondary Payer forms section of our website. To ensure timely processing of your request, this form should be used for any Medicare Secondary Payer (MSP) request pertaining to Primary or Secondary payment of claims. Please share with appropriate staff.

Get to Know KEPRO Your BFCC-QIO Webcast: March 14

Palmetto GBA will host an informative ‘Get to Know KEPRO Your BFCC-QIO’ webcast on March 14, 2018 at 10 am ET. KEPRO is the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for over 30 states. You will learn more about the services that they offer to Medicare beneficiaries and their families concerning beneficiary complaints, discharge appeals and immediate advocacy. Please plan to attend.


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Jurisdiction J Part B News for Tuesday 2/20/18

Part B Claims Payment/Processing Issues Log Webcast: March 6

Palmetto GBA will host a JJ/JM Part B Claims Payment/Processing Issues Log (CPIL) webcast on March 6, 2018 at 11 am, ET. This 60-minute Webcast is designed to provide an overview of the CPIL available on the Part B Palmetto GBA websites. The live webcast will include a question and answer period for questions related to accessing and using the CPIL. This webcast will include: how to access the CPIL, types of issues included on the log, and how to sign up for email notification when an individual CPIL is updated. Please plan to attend.

Part B Quarterly Updates Webcast: March 14

Palmetto GBA will host the Medicare Administrative Contractor March Part B Quarterly Updates, Changes and Reminders Webcast on March 14, 2018 at 10 am. ET. These updates, changes and reminders include any new billing regulations, hot topics that impact provider billing, and a Q & A segment for questions on covered material. Please plan to attend.


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Jurisdiction J Part A News for Tuesday 2/20/18

CMS National Provider Enrollment Conference – April 24 and 25, 2018

The CMS National Provider Enrollment Conference will be held on April 24 and 25, 2018 at the San Diego Convention Center. Take advantage of this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts.

Medicare Secondary Payer Inquiry Form

As a reminder, A Medicare Secondary Payer Inquiry Form is available in the Medicare Secondary Payer forms section of our website. To ensure timely processing of your request, this form should be used for any Medicare Secondary Payer (MSP) request pertaining to Primary or Secondary payment of claims. Please share with appropriate staff.

Part B Claims Payment/Processing Issues Log Webcast: March 6

Palmetto GBA will host a JJ/JM Part B Claims Payment/Processing Issues Log (CPIL) webcast on March 6, 2018 at 11 am, ET. This 60-minute Webcast is designed to provide an overview of the CPIL available on the Part B Palmetto GBA websites. The live webcast will include a question and answer period for questions related to accessing and using the CPIL. This webcast will include: how to access the CPIL, types of issues included on the log, and how to sign up for email notification when an individual CPIL is updated. Please plan to attend.

Get to Know KEPRO Your BFCC-QIO Webcast: March 14

Palmetto GBA will host an informative ‘Get to Know KEPRO Your BFCC-QIO’ webcast on March 14, 2018 at 10 am ET. KEPRO is the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for over 30 states. You will learn more about the services that they offer to Medicare beneficiaries and their families concerning beneficiary complaints, discharge appeals and immediate advocacy. Please plan to attend.

Part B Quarterly Updates Webcast: March 14

Palmetto GBA will host the Medicare Administrative Contractor March Part B Quarterly Updates, Changes and Reminders Webcast on March 14, 2018 at 10 am. ET. These updates, changes and reminders include any new billing regulations, hot topics that impact provider billing, and a Q & A segment for questions on covered material. Please plan to attend.


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Jurisdiction M Home Health & Hospice News for Tuesday 2/20/18

CMS National Provider Enrollment Conference – April 24 and 25, 2018

The CMS National Provider Enrollment Conference will be held on April 24 and 25, 2018 at the San Diego Convention Center. Take advantage of this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts.

Medicare Secondary Payer Inquiry Form

As a reminder, A Medicare Secondary Payer Inquiry Form is available in the Medicare Secondary Payer forms section of our website. To ensure timely processing of your request, this form should be used for any Medicare Secondary Payer (MSP) request pertaining to Primary or Secondary payment of claims. Please share with appropriate staff.

Get to Know KEPRO Your BFCC-QIO Webcast: March 14

Palmetto GBA will host an informative ‘Get to Know KEPRO Your BFCC-QIO’ webcast on March 14, 2018 at 10 am ET. KEPRO is the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for over 30 states. You will learn more about the services that they offer to Medicare beneficiaries and their families concerning beneficiary complaints, discharge appeals and immediate advocacy. Please plan to attend.

Understanding Reason Code 37253 on Home Health Claims

Effective with claims received on or after October 6, 2017, when a corresponding Outcome and Assessment Information Set (OASIS) is not found, the claim will be Returned to the Provider (RTP) for correction. A claim that is RTP cannot be appealed. Providers must make the necessary corrections as outlined in this article and retransmit the claim. For claims that were received and denied prior to October 6, 2017, providers have the right to appeal the denial. Please share with appropriate staff.


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This post applies to: JM HHH

Jurisdiction M Part B News for Tuesday 2/20/18

CMS National Provider Enrollment Conference – April 24 and 25, 2018

The CMS National Provider Enrollment Conference will be held on April 24 and 25, 2018 at the San Diego Convention Center. Take advantage of this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts.

Medicare Secondary Payer Inquiry Form

As a reminder, A Medicare Secondary Payer Inquiry Form is available in the Medicare Secondary Payer forms section of our website. To ensure timely processing of your request, this form should be used for any Medicare Secondary Payer (MSP) request pertaining to Primary or Secondary payment of claims. Please share with appropriate staff.

Part B Claims Payment/Processing Issues Log Webcast: March 6

Palmetto GBA will host a JJ/JM Part B Claims Payment/Processing Issues Log (CPIL) webcast on March 6, 2018 at 11 am, ET. This 60-minute Webcast is designed to provide an overview of the CPIL available on the Part B Palmetto GBA websites. The live webcast will include a question and answer period for questions related to accessing and using the CPIL. This webcast will include: how to access the CPIL, types of issues included on the log, and how to sign up for email notification when an individual CPIL is updated. Please plan to attend.

Get to Know KEPRO Your BFCC-QIO Webcast: March 14

Palmetto GBA will host an informative ‘Get to Know KEPRO Your BFCC-QIO’ webcast on March 14, 2018 at 10 am ET. KEPRO is the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for over 30 states. You will learn more about the services that they offer to Medicare beneficiaries and their families concerning beneficiary complaints, discharge appeals and immediate advocacy. Please plan to attend.

Part B Quarterly Updates Webcast: March 14

Palmetto GBA will host the Medicare Administrative Contractor March Part B Quarterly Updates, Changes and Reminders Webcast on March 14, 2018 at 10 am. ET. These updates, changes and reminders include any new billing regulations, hot topics that impact provider billing, and a Q & A segment for questions on covered material. Please plan to attend.

Did you know you can view your latest electronic Comparative Billing Report (eCBR) in eServices?

Did you know you can view your latest electronic Comparative Billing Report (eCBR) in eServices? Be sure to check them out today!

eServices makes it easy to monitor the use of your NPI!

eUtilization reports provide rendering providers and ordering and referring providers access to their personal data. Check them out today.


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Jurisdiction M Part A News for Tuesday 2/20/18

CMS National Provider Enrollment Conference – April 24 and 25, 2018

The CMS National Provider Enrollment Conference will be held on April 24 and 25, 2018 at the San Diego Convention Center. Take advantage of this opportunity to interact directly with CMS and Medicare Administrative Contractor provider enrollment experts.

Medicare Secondary Payer Inquiry Form

As a reminder, A Medicare Secondary Payer Inquiry Form is available in the Medicare Secondary Payer forms section of our website. To ensure timely processing of your request, this form should be used for any Medicare Secondary Payer (MSP) request pertaining to Primary or Secondary payment of claims. Please share with appropriate staff.

Get to Know KEPRO Your BFCC-QIO Webcast: March 14

Palmetto GBA will host an informative ‘Get to Know KEPRO Your BFCC-QIO’ webcast on March 14, 2018 at 10 am ET. KEPRO is the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for over 30 states. You will learn more about the services that they offer to Medicare beneficiaries and their families concerning beneficiary complaints, discharge appeals and immediate advocacy. Please plan to attend.


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Railroad Medicare Provider News for Monday 2/19/18

Revised Partial January 2018 Ambulatory Surgical Center (ASC) Payment Rates

CMS has identified and corrected a payment rate error in the January 2018 Ambulatory Surgical Center (ASC) Payment Rates for Covered Surgical and Ancillary Services File (ASCFS) for two CPT codes. Palmetto GBA will adjust claims received prior to the implementation of the new ASCFS file. Please share with appropriate staff.

Low Volume Appeals Settlement (LVA) Process

On February 5, 2018, CMS started accepting Expressions of Interest for its low volume appeals settlement (LVA) process. The LVA settlement option is for providers, physicians, and suppliers (appellants) with fewer than 500 appeals pending at the Office of Medicare Hearing and Appeals (OMHA) and the Medicare Appeals Council (Council) at the Departmental Appeals Board, combined, as of November 3, 2017, with a total billed amount of $9,000 or less per appeal. Be sure to visit the website in this article for more details.


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Jurisdiction J Part A News for Monday 2/19/18

Providers Can Submit Electronic Claims Adjustments VIA Direct Data Entry (DDE)

The Direct Data Entry (DDE) User Guide, Section 5 provides Claims Correction instructions. The information in this article is required on Adjustment and Cancel claims. This is not an all-inclusive list, subsequently additional data elements may be required when adjusting or cancelling your claims. Please share with appropriate staff.

Only Providers With a Valid Administrative Simplification Compliance Act (ASCA) Waiver Can Submit Paper Claims

The Administrative Simplification Compliance Act (ASCA) prohibits payment of services or supplies that a provider did not bill to Medicare electronically. This article lists some situations when this electronic billing requirement could be waived for some or all claims, but a provider must obtain Medicare pre-approval to submit paper claims in these situations. Please share with appropriate staff.

Past Due Credit Balance Reports

Credit Balance reports for the quarter ending December 31, 2017 are past due. Late letters were issued to providers who had not submitted their reports on February 14, 2018. In order to avoid penalty suspension, reports must be submitted by February 28, 2018. The fastest way to submit your report is through the eService portal at www.palmettogba.com/eservices.


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Jurisdiction M Home Health & Hospice News for Monday 2/19/18

Past Due Credit Balance Reports

Credit Balance reports for the quarter ending December 31, 2017 are past due. Late letters were issued to providers who had not submitted their reports on February 14, 2018. In order to avoid penalty suspension, reports must be submitted by February 28, 2018. The fastest way to submit your report is through the eService portal at www.palmettogba.com/eservices.


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This post applies to: JM HHH

Jurisdiction M Part B News for Monday 2/19/18

Revised Partial January 2018 Ambulatory Surgical Center (ASC) Payment Rates

CMS has identified and corrected a payment rate error in the January 2018 Ambulatory Surgical Center (ASC) Payment Rates for Covered Surgical and Ancillary Services File (ASCFS) for two CPT codes. Palmetto GBA will adjust claims received prior to the implementation of the new ASCFS file. Please share with appropriate staff.

Low Volume Appeals Settlement (LVA) Process

On February 5, 2018, CMS started accepting Expressions of Interest for its low volume appeals settlement (LVA) process. The LVA settlement option is for providers, physicians, and suppliers (appellants) with fewer than 500 appeals pending at the Office of Medicare Hearing and Appeals (OMHA) and the Medicare Appeals Council (Council) at the Departmental Appeals Board, combined, as of November 3, 2017, with a total billed amount of $9,000 or less per appeal. Be sure to visit the website in this article for more details.


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