Thursday, May 25, 2017
- Social Security Number Removal Initiative Reminder: Get Your Systems Ready
- 2018 Medicare Shared Savings Program: Submit Notice of Intent to Apply by May 31
- Quality Payment Program: Technical Assistance Resource Guide Available
- SNF QRP Quality Measure User’s Manual
- Administrative Simplification: Get the Basics
- May is National Osteoporosis Month
- National Partnership to Improve Dementia Care and QAPI Call — June 15
- CLIA Certificate of Provider-performed Microscopy Webcast — June 28
- CBR on Anesthesia Services for Lower Endoscopic Procedures Webinar — July 12
As you know, beginning in April 2018, CMS will start mailing Medicare cards with new Medicare Beneficiary Identifiers (MBIs) to all people with Medicare. The MBI will replace the Social Security Number (SSN)-based Health Insurance Claim Number for transactions like billing, eligibility status, and claim status after a transition period. Make sure your systems are ready:
- Visit our Social Security Number Removal Initiative (SSNRI) Home and Provider webpages for the latest details about the transition. Subscribe to the weekly MLN Connects newsletter for updates and new information.
- Verify your patients’ addresses. Your patients will not get a new card if their address is not correct. If the address you have on file is different than the Medicare address you get in electronic eligibility transaction responses, ask your patients to correct their address in Medicare’s records through Social Security. This may require coordination between your billing and office staff.
- Attend our quarterly calls to get more information. We will let you know when calls are scheduled in MLN Connects.
- Work with us to help your Medicare patients with the change to the MBI. This fall (2017), we will be in touch with ways to help.
- Get ready to use the new MBI Format. Ask your billing and office staff if your system will be ready to accept the 11 digit alpha numeric MBI. If you use vendors to bill Medicare, ask them about their MBI practice management system changes and make sure they are ready for the change. Make and internally test changes to your practice management systems and business processes by April 2018, before we mail the new Medicare cards.
- If you are a vendor who partners with Medicare providers to bill Medicare, communicate with them about your system readiness and what they should expect to see from you beginning April 2018.
There are only a few days left to submit a Notice of Intent to Apply (NOIA) for the January 1, 2018, start date. You must submit a NOIA if you intend to apply to the Medicare Shared Savings Program, Skilled Nursing Facility 3-Day Rule Waiver, and/or the Medicare Accountable Care Organization Track 1+ Model. The NOIA submissions are due no later than May 31, 2017, at noon ET. A NOIA submission does not bind your organization to submit an application; however, you must submit a NOIA to be eligible to apply in July.
Please note: You may not submit more than one NOIA. If you are an initial applicant to the Medicare Shared Savings Program and have not decided whether to submit a NOIA for Track 1; Track 1, including the Track 1+ Model; Track 2; or Track 3, submit a NOIA for any one of the available tracks. You can change your Track selection or any other NOIA information during the application submission period in July. See the NOIA Guidance Document (PDF) and How to Apply webpage for detailed instructions on the NOIA submission process.
The Technical Assistance Resource Guide concisely highlights all of the support that is available to clinicians participating in the Quality Payment Program. It contains brief summaries on each branch of technical assistance, contact information, and maps to illustrate coverage areas. Visit the Quality Payment Program website for more information.
The new Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Measure Calculations and Reporting User’s Manual (PDF) presents methods used to calculate quality measures, including quality measure definitions; inclusion and exclusion criteria; and measure calculation specifications. For information on calculating measures for the Nursing Home Quality Initiative, see the MDS 3.0 Quality Measures User's Manual (PDF).
HIPAA Administrative Simplification rules can save time and costs across the health care system through adopted standards, operating rules, unique identifiers, and code sets. Get the basics with our new fact sheet (PDF) and infographic (PDF).
“Break Free from Osteoporosis.” The chance of having osteoporosis increases with age but making lifestyle changes can build strong bones for life. Talk to your Medicare patients about their risk factors and recommend Bone Mass Measurement if appropriate.
For More Information:
- Medicare Preventive Services Educational Tool
- Centers for Disease Control and Prevention Osteoporosis webpage
- National Osteoporosis Foundation website
Visit the Preventive Services website to learn more about Medicare-covered services.
Ambulance suppliers often submit Medicare claims for Advanced Life Support (ALS) ambulance services which lack sufficient medical record documentation. The 2015 Comprehensive Error Rate Testing (CERT) Report states that the improper payment rate for ALS services was 14.5 percent with improper payments projected at $226 million. The most frequent errors occur when documentation:
- Does not support the medical necessity of the ALS level of service
- Lacks the patient’s signature authorizing the supplier to bill Medicare for the service.
Use the following resources to avoid documentation errors:
- Medicare Ambulance Transports (PDF) Booklet
- 42 Code of Federal Regulations 424.36 - Signature Requirements
- April 2016 Medicare Quarterly Provider Compliance Newsletter (PDF), Pages 1 through 3
- Ambulance Fee Schedule (PDF) Fact Sheet
- Medicare Claims Processing Manual (PDF), Chapter 15
Thursday, June 15 from 1:30 to 3 pm ET
To register or for more information, visit MLN Connects® Event Registration.
During this call, learn about appropriate assessment and evaluation for the accurate diagnosis of schizophrenia and other mental disorders. Also, find out about the work of the Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) and how their efforts align with the National Partnership and Quality Assurance and Performance Improvement (QAPI). Additionally, CMS experts share updates on the progress of the National Partnership to Improve Dementia Care in Nursing Homes and Quality Assurance and Performance Improvement. A question and answer session follows the presentations.
- Dr. Susan Levy, Medical Director/Consultant
- Kaylie Doyle, Telligen
- Kelly O’Neill, Stratis Health
- Michele Laughman and Debbie Lyons, CMS
Target Audience: Consumer and advocacy groups, nursing home providers, surveyor community, prescribers, professional associations, and other interested stakeholders.
Wednesday, June 28 from 1:30 to 3 pm ET
To register or for more information, visit MLN Connects Event Registration.
During this webcast, learn about the Clinical Laboratory Improvement Amendments (CLIA) requirements for Provider-performed Microscopy (PPM) testing. Participants should review PPM Procedures: A Focus on Quality prior to the webcast.
CLIA established quality standards to ensure accuracy and reliability of patients’ test results regardless of where the test is performed. The CLIA Certificate for PPM procedures is issued to laboratories where physicians, mid-level practitioners or dentists perform specific microscopic examinations during the course of the patients’ visit.
Target Audience: Physicians, mid-level practitioners, dentists, pathologists, laboratory directors, laboratories managers, point-of care testing coordinators, clinical laboratory scientists, and medical laboratories technicians.
Wednesday, July 12 from 3 to 4 pm ET
Join us for an informative discussion of the Comparative Billing Report (CBR) on Anesthesia Services for Lower Endoscopic Procedures (CBR201705), an educational tool for Medicare Part B providers with allowed service claims using Current Procedural Terminology code 00810 for lower endoscopic procedures. During the webinar, interact directly with content specialists and submit questions about the report. See the announcement for more information and find out how to participate.
The revised ABCs of the Initial Preventive Physical Examination (IPPE) Educational Tool is available. Learn about:
- Components of the IPPE
- Coding, diagnosis, and billing
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