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33
1 Medicare Updates 2020 American Association of Healthcare Administrative Management (AAHAM) Virtual Conference September 17, 2020 Presented By First Coast Service Options, Inc. Provider Outreach & Education Ursula Weaver Provider Relations Representative 1

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Page 1: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

1

Medicare Updates 2020

American Association of Healthcare Administrative Management (AAHAM)

Virtual Conference

September 17 2020

Presented By

First Coast Service Options Inc

Provider Outreach amp Education

Ursula Weaver

Provider Relations Representative

1

2

Disclaimer All Current Procedural Terminologyreg (CPTreg) only copyright 2019 American Medical Association (AMA) All rights reserved CPTreg is a registered trademark of the AMA Applicable Federal Acquisition RegulationDefense Federal Acquisition Regulation Supplement restrictions apply to government use Fee schedules relative value units conversion factors andor related components are not assigned by the AMA are not part of CPT and the AMA is not recommending their use The AMA does not directly or indirectly practice medicine or dispense medical services The AMA assumes no liability for data contained or not contained herein

The information enclosed was current at the time it was presented Medicare policy changes frequently links to the source documents have been provided within the document for your reference This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations Although every reasonable effort has been made to assure the accuracy of the information within these pages the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services

First Coast Service Options Inc employees agents and staff make no representation warranty or guarantee that this compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide This presentation is a general summary that explains certain aspects of the Medicare program but is not a legal document The official Medicare program provisions are contained in the relevant laws regulations and rulings

No portion or element of this presentation may be copied in whole or in part for profit-making purposes without the express written consent of First Coast Service Options Inc

First Coast Service Options Incs attendance at this event does not constitute or imply endorsement recommendation or favoring of any specific commercial products process or services by trade name trademark manufacturer or otherwise

2

Agenda Items

Coronavirus (COVID-19)

Medicare updates

One Medicare Learning Networkreg (MLNreg) Mattersreg (MM) articles one special edition (SE) articles

Prior authorization (PA) for certain outpatient department (OPD) services

Qualified Independent Contractor (QIC) Part A appeals East (PAE) demonstration

Online resources

3

3

Learning Objectives

At the conclusion of todays session youll be able to

bull Locate updates about COVID-19 bull Define Medicare changes and updates

that can have an impact on your facility bull Review requirements of PA for certain

OPD services bull Discuss and participate in the QIC

appeals demonstration bull Review online resources to be

proactive in your day-to-day operations

4

COVID-19 Updates

5

4

COVID-19

6

COVID-19 Resources

Update concerning the public health emergency (PHE) in response to the 2019 novel COVID-19 pandemic

COVID-19 Partner Toolkit

SE20011 Medicare Fee-for-Service (FFS) Response to the PHE on COVID-19

COVID-19 Frequently-asked Questions (FAQs) on Medicare FFS billing

Telehealth resources

Article COVID-19 Correctly billing telehealth and telephone-only service during the emergency

Medicare Learning Networkreg (MLNreg) video Medicare coverage and payment of virtual services

7

5

Claims Processing Issues

COVID Dear Clinician letter Diagnosis codes Z03818 Z20828 and Z1159

Allowing claims with Z diagnosis

codes Diagnosis codes Z03818 and Z1159 denied in error for claims

processed prior to July 17 2020

COVID-19 Correcting telehealth

services billed with place of service

(POS) 02 8

COVID-19 Testing Update

COVID-19 Allowances for laboratory

test codes U0001-U0004 0202U

0223U 0224U 0225U 0226U

86408 86409 87426 and 87635

9

6

COVID-19 Part A Updates

Cost reporting updates

Suspension of 2 sequestration for biweekly periodic interim payment (PIP) and pass-through payments

Suspended through 12312020

Medicare Graduate Medical Education (GME) Affiliation Agreement

Teaching hospitals have until 10012020 to submit new or amended Medicare GME affiliated group agreements

Page eight of 41

10

Medicare Updates

11

7

New mailing addresses for First Coast correspondence

12

Contact Center

Effective 09142020

For many areas including

Appeals

Claims

Congressional inquiries

Customer service

Debt recovery

Medical review

Provider audit and reimbursement

Provider Outreach and Education

Redeterminations

Forms updated with new addresses

Use current forms 13

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 2: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

2

Disclaimer All Current Procedural Terminologyreg (CPTreg) only copyright 2019 American Medical Association (AMA) All rights reserved CPTreg is a registered trademark of the AMA Applicable Federal Acquisition RegulationDefense Federal Acquisition Regulation Supplement restrictions apply to government use Fee schedules relative value units conversion factors andor related components are not assigned by the AMA are not part of CPT and the AMA is not recommending their use The AMA does not directly or indirectly practice medicine or dispense medical services The AMA assumes no liability for data contained or not contained herein

The information enclosed was current at the time it was presented Medicare policy changes frequently links to the source documents have been provided within the document for your reference This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations Although every reasonable effort has been made to assure the accuracy of the information within these pages the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services

First Coast Service Options Inc employees agents and staff make no representation warranty or guarantee that this compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide This presentation is a general summary that explains certain aspects of the Medicare program but is not a legal document The official Medicare program provisions are contained in the relevant laws regulations and rulings

No portion or element of this presentation may be copied in whole or in part for profit-making purposes without the express written consent of First Coast Service Options Inc

First Coast Service Options Incs attendance at this event does not constitute or imply endorsement recommendation or favoring of any specific commercial products process or services by trade name trademark manufacturer or otherwise

2

Agenda Items

Coronavirus (COVID-19)

Medicare updates

One Medicare Learning Networkreg (MLNreg) Mattersreg (MM) articles one special edition (SE) articles

Prior authorization (PA) for certain outpatient department (OPD) services

Qualified Independent Contractor (QIC) Part A appeals East (PAE) demonstration

Online resources

3

3

Learning Objectives

At the conclusion of todays session youll be able to

bull Locate updates about COVID-19 bull Define Medicare changes and updates

that can have an impact on your facility bull Review requirements of PA for certain

OPD services bull Discuss and participate in the QIC

appeals demonstration bull Review online resources to be

proactive in your day-to-day operations

4

COVID-19 Updates

5

4

COVID-19

6

COVID-19 Resources

Update concerning the public health emergency (PHE) in response to the 2019 novel COVID-19 pandemic

COVID-19 Partner Toolkit

SE20011 Medicare Fee-for-Service (FFS) Response to the PHE on COVID-19

COVID-19 Frequently-asked Questions (FAQs) on Medicare FFS billing

Telehealth resources

Article COVID-19 Correctly billing telehealth and telephone-only service during the emergency

Medicare Learning Networkreg (MLNreg) video Medicare coverage and payment of virtual services

7

5

Claims Processing Issues

COVID Dear Clinician letter Diagnosis codes Z03818 Z20828 and Z1159

Allowing claims with Z diagnosis

codes Diagnosis codes Z03818 and Z1159 denied in error for claims

processed prior to July 17 2020

COVID-19 Correcting telehealth

services billed with place of service

(POS) 02 8

COVID-19 Testing Update

COVID-19 Allowances for laboratory

test codes U0001-U0004 0202U

0223U 0224U 0225U 0226U

86408 86409 87426 and 87635

9

6

COVID-19 Part A Updates

Cost reporting updates

Suspension of 2 sequestration for biweekly periodic interim payment (PIP) and pass-through payments

Suspended through 12312020

Medicare Graduate Medical Education (GME) Affiliation Agreement

Teaching hospitals have until 10012020 to submit new or amended Medicare GME affiliated group agreements

Page eight of 41

10

Medicare Updates

11

7

New mailing addresses for First Coast correspondence

12

Contact Center

Effective 09142020

For many areas including

Appeals

Claims

Congressional inquiries

Customer service

Debt recovery

Medical review

Provider audit and reimbursement

Provider Outreach and Education

Redeterminations

Forms updated with new addresses

Use current forms 13

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 3: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

3

Learning Objectives

At the conclusion of todays session youll be able to

bull Locate updates about COVID-19 bull Define Medicare changes and updates

that can have an impact on your facility bull Review requirements of PA for certain

OPD services bull Discuss and participate in the QIC

appeals demonstration bull Review online resources to be

proactive in your day-to-day operations

4

COVID-19 Updates

5

4

COVID-19

6

COVID-19 Resources

Update concerning the public health emergency (PHE) in response to the 2019 novel COVID-19 pandemic

COVID-19 Partner Toolkit

SE20011 Medicare Fee-for-Service (FFS) Response to the PHE on COVID-19

COVID-19 Frequently-asked Questions (FAQs) on Medicare FFS billing

Telehealth resources

Article COVID-19 Correctly billing telehealth and telephone-only service during the emergency

Medicare Learning Networkreg (MLNreg) video Medicare coverage and payment of virtual services

7

5

Claims Processing Issues

COVID Dear Clinician letter Diagnosis codes Z03818 Z20828 and Z1159

Allowing claims with Z diagnosis

codes Diagnosis codes Z03818 and Z1159 denied in error for claims

processed prior to July 17 2020

COVID-19 Correcting telehealth

services billed with place of service

(POS) 02 8

COVID-19 Testing Update

COVID-19 Allowances for laboratory

test codes U0001-U0004 0202U

0223U 0224U 0225U 0226U

86408 86409 87426 and 87635

9

6

COVID-19 Part A Updates

Cost reporting updates

Suspension of 2 sequestration for biweekly periodic interim payment (PIP) and pass-through payments

Suspended through 12312020

Medicare Graduate Medical Education (GME) Affiliation Agreement

Teaching hospitals have until 10012020 to submit new or amended Medicare GME affiliated group agreements

Page eight of 41

10

Medicare Updates

11

7

New mailing addresses for First Coast correspondence

12

Contact Center

Effective 09142020

For many areas including

Appeals

Claims

Congressional inquiries

Customer service

Debt recovery

Medical review

Provider audit and reimbursement

Provider Outreach and Education

Redeterminations

Forms updated with new addresses

Use current forms 13

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 4: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

4

COVID-19

6

COVID-19 Resources

Update concerning the public health emergency (PHE) in response to the 2019 novel COVID-19 pandemic

COVID-19 Partner Toolkit

SE20011 Medicare Fee-for-Service (FFS) Response to the PHE on COVID-19

COVID-19 Frequently-asked Questions (FAQs) on Medicare FFS billing

Telehealth resources

Article COVID-19 Correctly billing telehealth and telephone-only service during the emergency

Medicare Learning Networkreg (MLNreg) video Medicare coverage and payment of virtual services

7

5

Claims Processing Issues

COVID Dear Clinician letter Diagnosis codes Z03818 Z20828 and Z1159

Allowing claims with Z diagnosis

codes Diagnosis codes Z03818 and Z1159 denied in error for claims

processed prior to July 17 2020

COVID-19 Correcting telehealth

services billed with place of service

(POS) 02 8

COVID-19 Testing Update

COVID-19 Allowances for laboratory

test codes U0001-U0004 0202U

0223U 0224U 0225U 0226U

86408 86409 87426 and 87635

9

6

COVID-19 Part A Updates

Cost reporting updates

Suspension of 2 sequestration for biweekly periodic interim payment (PIP) and pass-through payments

Suspended through 12312020

Medicare Graduate Medical Education (GME) Affiliation Agreement

Teaching hospitals have until 10012020 to submit new or amended Medicare GME affiliated group agreements

Page eight of 41

10

Medicare Updates

11

7

New mailing addresses for First Coast correspondence

12

Contact Center

Effective 09142020

For many areas including

Appeals

Claims

Congressional inquiries

Customer service

Debt recovery

Medical review

Provider audit and reimbursement

Provider Outreach and Education

Redeterminations

Forms updated with new addresses

Use current forms 13

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 5: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

5

Claims Processing Issues

COVID Dear Clinician letter Diagnosis codes Z03818 Z20828 and Z1159

Allowing claims with Z diagnosis

codes Diagnosis codes Z03818 and Z1159 denied in error for claims

processed prior to July 17 2020

COVID-19 Correcting telehealth

services billed with place of service

(POS) 02 8

COVID-19 Testing Update

COVID-19 Allowances for laboratory

test codes U0001-U0004 0202U

0223U 0224U 0225U 0226U

86408 86409 87426 and 87635

9

6

COVID-19 Part A Updates

Cost reporting updates

Suspension of 2 sequestration for biweekly periodic interim payment (PIP) and pass-through payments

Suspended through 12312020

Medicare Graduate Medical Education (GME) Affiliation Agreement

Teaching hospitals have until 10012020 to submit new or amended Medicare GME affiliated group agreements

Page eight of 41

10

Medicare Updates

11

7

New mailing addresses for First Coast correspondence

12

Contact Center

Effective 09142020

For many areas including

Appeals

Claims

Congressional inquiries

Customer service

Debt recovery

Medical review

Provider audit and reimbursement

Provider Outreach and Education

Redeterminations

Forms updated with new addresses

Use current forms 13

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 6: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

6

COVID-19 Part A Updates

Cost reporting updates

Suspension of 2 sequestration for biweekly periodic interim payment (PIP) and pass-through payments

Suspended through 12312020

Medicare Graduate Medical Education (GME) Affiliation Agreement

Teaching hospitals have until 10012020 to submit new or amended Medicare GME affiliated group agreements

Page eight of 41

10

Medicare Updates

11

7

New mailing addresses for First Coast correspondence

12

Contact Center

Effective 09142020

For many areas including

Appeals

Claims

Congressional inquiries

Customer service

Debt recovery

Medical review

Provider audit and reimbursement

Provider Outreach and Education

Redeterminations

Forms updated with new addresses

Use current forms 13

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 7: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

7

New mailing addresses for First Coast correspondence

12

Contact Center

Effective 09142020

For many areas including

Appeals

Claims

Congressional inquiries

Customer service

Debt recovery

Medical review

Provider audit and reimbursement

Provider Outreach and Education

Redeterminations

Forms updated with new addresses

Use current forms 13

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 8: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

8

MM11882

Influenza Vaccine Payment Allowances -- Annual Update for 2020-2021 Season

Effective 08012020 Implementation 10012020

Approved payment allowances for influenza vaccines are posted to Centers for Medicare amp Medicaid Services (CMS) Seasonal Influenza Vaccines Pricing website

Effective 08012020-07312021

Medicare Administrative Contractors (MACs) will determine allowance for Healthcare Common Procedure Coding System (HCPCS) Q2039

First Coast will reprocess any flu vaccine claims priced with allowances other than these by 11012020

Full code descriptors and payment allowances found on website

Coinsurance and deductible do not apply 14

Post-payment Reviews Resumed

Effective 08172020

Specific ItemsServices

Service-specific reviews currently in

effect

15

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 9: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

9

CERT Reviews Resumed

Effective 08112020 Resumed

Mailing documentation request letters

Conducting phone calls

Mailed subsequent additional documentation requests (ADRs) that were active on March 27

Mailed subsequent ADRs identified but not yet sent during the temporary suspension

16

PA for Certain OPD Services Overview

17

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 10: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

10

OPD Program Overview

Nationwide program - implementation effective June 17 2020 for dates of service (DOS) on or after July 1 2020

Program will include hospital OPDs that provide certain OPD services and are enrolled in Medicare FFS program

For services reported on a type of bill (TOB) 13x

PA program does not change Medicare benefit or coverage requirements nor does it create new documentation requirements

CMS Prior Authorization for Certain Hospital OPD Services

18

OPD Services

As a condition of payment for DOS on or after July 1 2020 a prior authorization request (PAR) is required for the following hospital OPD services

Blepharoplasty Eyelid Surgery Brow Lift and Related Services

Botulinum toxin injections

Panniculectomy - Excision of Excess Skin and Subcutaneous Tissue (Including Lipectomy) and Related Services

Rhinoplasty and Related Services

Vein ablation and Related Services

CMS provides a list of the HCPCS codes included in the OPD PA program

19

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 11: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

11

PAR

20

PAR Submission Requirements

Hospital OPD provider must submit a PAR before

bull Providing services to Medicare beneficiaries

bull Submitting claims for payment

bull Note Physiciansproviders may complete the request on behalf of the hospital OPD

PAR must include

bull All documentation necessary to demonstrate the service meets applicable Medicare coverage coding and payment rules

bull Certain data elements to avoid potential delays in processing of the initial submission documents

bull First Coast will deny claims that require PA if provider has not received affirmation of coverage

21

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 12: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

12

PAR-related Terms

MBI = patientrsquos Medicare Beneficiary Identifier

NPI = National Provider Identifier

UTN = Unique Tracking Number ndash assigned to each PAR

CMS certification number also referred to as the PTAN (Provider Transaction Access Number) or plainly provider number

22

Potential PAR Responses

Prov isional affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are met

Prov isional partial affirmation

bull Issued to the provider when one or more service(s) on the PAR received provisional affirmation decision and one or more service(s) received a non-affirmation decision

Non-affirmation

bull Issued to the provider if applicable Medicare coverage coding and payment rules are not met

bull Detailed information about missing requirements and non-compliant information will be provided via fax mail or the Secure Provider Online Tool (SPOT)

23

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 13: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

13

Subsequent submission of PAR to correct an error or omission identified during a PA decision

Resubmission should include initial PAR information

Exact match of beneficiaryrsquos first name last name date of birth to the previous submission

UTN associated with previous submission

Provider may resubmit PAR with additional supporting information upon receipt of non-affirmation as many times as necessary to achieve an affirmation decision

UTN will be assigned to each resubmission request

24

Resubmission

Submitting PAR

Mail

bull First Coast Service Options Inc bull JN Prior Authorization bull 2020 Technology Parkway

bull PO Box 3033 bull Mechanicsburg PA 17055-1804

Fax bull 1-855-815-3065

esMD bull content type 85

Portal bull SPOT

25

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 14: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

14

Priority mail

First Coast Service Options Inc

Attention JN Prior Authorization

2020 Technology Parkway

Suite 100

Mechanicsburg PA 17050

Phone 1-855-340-5975 (Prior Auth Customer Service)

26

Additional PAR Options

PA submitted (or re-submitted) to First Coast

Within 10 business days medical determination is made

For provisional affirmation

Date 1 of 120 begins on the day the decision is made

UTN and date range of authorization are specified on approval notice

Service MUST be performed within 120 days

If DOS outside of 120 days = prior authorization does not apply (UTN no longer valid - a new PAR will be needed)

Existing claim timely filing guidelines apply (within one year)

27

PA Timeframes

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 15: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

15

Providers may submit claims for PARs that have received provisional affirmation

TOB 13X

UTN from the decision letter must be reported

If all Medicare coverage coding and payment requirements are met claim will likely be paid

First Coast will deny claims submitted when PAR has received a non-affirmed PA decision

Claims submitted to First Coast without PA decision on file will automatically deny

Associated or related services also denied including but not limited to

Physician and facility services

Anesthesiology 28

Claims

Reporting the UTN

Electronic claims

Submit UTN in the 2300 - Service Line loop in the Prior Authorization reference (REF) segment

REF01 = G1 qualifier and REF02 = UTN

Meets requirements of ASC X12 837 Technical Report 3 (TR3)

Direct data entry (DDE)

Enter UTN in Treatment Authorization field on DDE Page 05 (MAP1715)

Uniform bill (UB)-04

Submit UTN in Form Locator 63

Report UTN on the same line (A B C) that Medicare is shown in Form Locator 50 (Payer Line A B C)

UTN should begin in position 1 of Form Locator 63 29

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 16: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

16

Following claim types are excluded

from the PA program unless

otherwise specified Veterans Affairs

Indian Health Services

Medicare Advantage

Part A and Part B Demonstration

Medicare Advantage sub-category indirect medical education (IME) only claims

Part AB rebilling

30

Claim Exclusions

Timeframes have not accounted for

COVID testing PA received within 10 days ndash COVID testing may cause further

delay

Valid for 120 days ndash COVID testing must be completed

31

Consider COVID

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 17: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

17

Points to Remember

Authorization needed for services in

OPD = hospital needs authorization Claims related to or associated with services that require PA as

condition of payment will not be paid if the service requiring PA is not also paid (ie anesthesiology physician or facility services)

PA applies to certain OPD services

billed on TOB 13X PA does not apply to ambulatory surgical centers (ASCs) or office

visit services

Applies to POS 22

32

Points to Remember (Cont)

PAR has required elements ndash if not

completed in full will be dismissed Ensure PAR being sent to correct MAC

Addresses are needed

UTN only has number lsquo0rsquo ndash not letter

lsquoOrsquo (ie 0HA0000000XXXX)

33

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 18: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

18

Prior Authorizations Page

Prior authorization coversheet instructions

Access the OPD prior authorization coversheet

View general documentation requirements

For all five categories of service ndash with codes included

Hospital outpatient department (HOPD) services PA calculator

Learning On Demand

34

CMS Resources

Prior Authorization for Certain HOPD

Services OPD Frequently Asked Questions

OPD Operational Guide

Final list of outpatient services that

require prior authorization

35

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 19: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

19

QIC Part A Appeals Demonstration

36

Appeals Demonstration

Background January 1 2016 CMS implemented telephone discussion and

reopening process demonstration for Durable Medical Equipment (DME)

Originally limited to oxygen and glucose diabetic testing supplies in two jurisdictions

Now includes all four DME MAC Jurisdictions and most claim types

April 1 2019 Demonstration expanded to include appeals in the PAE QIC jurisdiction

Demonstration currently extended to December 31 2021

Participation in the appeals demonstration is voluntary

37

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 20: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

20

Two Parts of Demonstration

PAE Appeals Demonstration

Telephone Discussions

Discussions with decision maker on incoming

reconsiderations before decision is rendered

Reopening Process

Appeals pending at ALJ on which C2C is

conducting analysis to potentially resolve

favorably

38

Benefits of Participation

Telephone discussion Engage in discussion of appealed claims prior to issuance of

reconsideration decision

C2C health care professionals have opportunity to educate providers on complex medical necessity documentation requirements for specific services

Provider has until 14 days after discussion to submit any missing or critical documentation needed to secure payment

Goal of discussion is for providers to have enhanced understanding of Medicare requirements for their medically necessary services and improve future claim submissions

39

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 21: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

21

Telephone Discussion Process

Prior to telephone discussion C2C conducts cursory review of case

Mails out scheduling letter

Date and time of scheduled call

If missing documentation is identified C2C will notify you in scheduling letter

Choosing to participate Contact form needs to be returned to C2C within 14 days

Name of person who will participate in telephone discussion

Telephone number for them to be contacted

40

Telephone Discussion Process2

Participation

Allows QIC 120 days to process reconsideration rather than existing 60 days

You do not lose your appeal rights

If appeal denied after telephone discussion you still have ability to appeal to next level

Providers who use third party to

handle appeals Reach out to Ademofeedbackc2cinccom

41

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 22: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

22

Reopening Process

Provider actions Providers notified in writing if appeal is identified as potential

reopening along with missing or insufficient documentation required to allow payment

Providers have 30 days from date of the letter to return requested documentation

If requested documentation is not received C2C will not proceed with the reopening

Providers may submit a request for a potential reopening on the reconsideration request form

42

Reopening Process2

Upon receipt of requested documentation C2C will confirm if documents support a favorable decision

If documentation supports favorable decision upon receipt of the remand from Office of Medicare Hearings and Appeals (OMHA) C2C will reopen and render favorable decision

If favorable decision cannot be rendered provider will be notified in writing and appeal will remain at OMHA

Appeal does not lose placement at the Administrative Law Judge (ALJ)

43

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 23: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

23

How Can I Participate

Telephone discussion You may indicate your interest in participating in a discussion on

your reconsideration request that is mailed to C2C

For more information visit

wwwc2cinccom

For general comments or questions

Ademofeedbackc2cinccom

C2C Innovative Solutions Inc--Part A East Appeals Demonstration

904-224-7371 (phone)

904-224-2732 (fax)

44

Tips to Help Improve

Claim Decisions

45

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 24: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

24

First Coast Tips

Familiarize yourself with Information about services you provide

Contained in local coverage determinations (LCDs) and national coverage determinations (NCDs)

Do you know the indications and limitations of coverage

Have you met coding guidelines

Did you follow the documentation requirements

Utilize self-service tools Documentation checklists

Specialty pages

Medical policy articles

46

QIC Tips

How to prepare for a telephone

discussion Make sure address on reconsideration request is address you

want correspondence mailed to

Make sure you are available at time of scheduled call

Have documents pertaining to case available to you during the call

Have questions concerns and verbal testimony prepared

Be prepared to provide additional medical documentation if documentation already provided is missing or insufficient to meet coverage criteria

47

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 25: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

25

Online Resources

48

First Coast Provider Website

English or Spanish

49

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 26: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

26

First Coast Resources

Join eNews

Events calendar

Billing news

Institutional provider web page

50

New Online Learning Modules

Announcing eight

new online

learning modules

First Coast University course catalog (B)

First Coast University course catalog (A)

51

Title CEUs

Chiropractic serv ices (B)

1

Drugs amp Biologicals (A)

1

Drugs amp Biologicals (B)

1

Incident-to serv ices (B)

1

Medicare cov erage policies (AB)

1

NCCI program ov erv iew (AB)

1

SNF consolidated billing (A)

1

Spiltshared serv ices (B)

1

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 27: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

27

Provider Enrollment Education

Informational videos

Short three-to-five-minute videos on top inquiries and application development reasons

How do I complete and submit the CMS-588 electronic funds transfer (EFT) form

Understanding billing gaps

Avoid mismatched names when completing Medicare enrollment forms

Difference between sole owner and sole proprietor

More videos coming soon

Provider Enrollment Chain and Ownership System (PECOS) Identity amp Access (IampA) Management System Final adverse legal actions Revised CMS-855R and Revalidation

52

SPOT

SPOT updates SPOT applications average processing time is about 5 days

MBI lookup retrieve an MBI for a beneficiary up to four years from the beneficiarys date of death

Request for pre-approval for certain outpatient procedures available as of June 17

Second level of appeals requestreconsideration currently in development 2021

53

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 28: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

28

CMS

54

CMS Resources

Transmittals

Internet-only manual (IOM)

55

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 29: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

29

Summary of Todays Topics

Today we Located updates about COVID-19

Defined Medicare changes and updates that can have an impact on your facility

Reviewed requirements of PA for certain OPD services

Discussed and learned how to participate in the QIC appeals demonstration

Reviewed online resources to be proactive in your day-to-day operations

56

Question and Answer Session

What questions do you have

57

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 30: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

30

Thank You for Participating

First Coast values your feedback Please complete your evaluation form and return via email

58

Acronym List

AAHAM American Association of Healthcare Administrative Management

ADR Additional documentation request

ALJ Administrative Law Judge

AMA American Medical Association

ASC Ambulatory surgical center

CMS Center for Medicare amp Medicaid Services

COVID Coronavirus

CPT Current Procedural Terminology

DDE Direct data entry

DME Durable medical equipment

DOS Date of service

59

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 31: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

31

Acronym List 2

EFT Electronic funds transfer

esMD Electronic submission of medical documentation

FAQ Frequently asked question

FFS Fee-for-service

GME Graduate Medical Education

HCPCS Healthcare Common Procedure Coding System

HOPD Hospital outpatient department

IampA Identity amp Access

IME Indirect Medical Education

IOM Internet-only manual

LCD Local coverage determination

MAC Medicare Administrative Contractor

60

Acronym List 3

MBI Medicare beneficiary identifier

MLNreg Medicare Learning Networkreg

NCD National coverage determination

NPI National Provider Identifier

OMHA Office of Hearings and Appeals

OPD Outpatient department

POS Place of service

PA Prior authorization

PAE Part A East

PAR Prior Authorization Request

PECOS Provider Enrollment Chain and Ownership System

PHE Public Health Emergency

PIP Periodic interim payment 61

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 32: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

32

Acronym List 4

PTAN Provider Transaction Access Number

QIC Qualified Independent Contractor

SPOT Secure Provider Online Tool

TOB Type of bill

UB Uniform bill

UTN Unique tracking number

SPOT Secure Provider Online Tool

62

What is the Florida Sunshine Chapter AAHAM

Florida Sunshine Chapter AAHAM is a networking group of Healthcare Rev enue Cy cle

Management prof essionals throughout Florida Florida Sunshine Chapterrsquos mission is to

provide education certification networking career guidance and opportunities and

advocacy for all healthcare revenue cycle professionals

AAHAM is dedicated to giv ing y ou the inside intelligence y ou need to thriv e prof essionally As

a member y ou hav e access to inf ormation on critical topics like education and adv ocacy in the

areas of reimbursement admitting and registration data management medical records

patient relations and so much more

For more information on benefits and to join online v isit wwwf loridaaahamcom

Interested in joining FL AAHAM Email us at membershipf loridaaahamcom

Follow us on LinkedIn httpswwwlinkedincomcompany florida-sunshine-chapter-aaham

Join us on Facebook httpswwwf acebookcomf loridasunshineaaham

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable

Page 33: Medicare Updates 2020...Effective 09/14/2020 For many areas including Appeals Claims Congressional inquiries Customer service Debt recovery Medical review Provider audit and reimbursement

33

AAHAM Florida Sunshine Chapter 2020 Corporate Partners

Platinum

OSGDiamond Healthcare Solutions

Gold Partners

Change Healthcare

Gulf Coast Collection Bureau Inc

Silver Partners

C3 Revenue Cycle Solutions

Penn Credit Corporation

SNS Recovery Inc

Bronze Partners

Bacen amp Jordan PA

DECO LLC

EnableComp

Firm Revenue Cycle

Health Pay 24

MSCB Inc

MyCare Finance

NobleBiz

OVAG International

Sage Law Offices

W e w ould like to thank all of our Corporate Sponsors for making a financial commitment to our Chapter and w e ask that all members make a special effort to

thank them for their continued support and include them in evaluation of needs andor RFP process w hen applicable