Registration is now open for the 2014 Annual Rural Health Conference, which will be held at the Hotel Elegantè – October 16 & 17, 2014. The agenda is posted online for your review, and I'm sure you will find the conference engaging and thought-provoking.
On the agenda:
· The Landscape of Rural Health Policy - Maggie Elehwany, NRHA
· Courageous Leadership—An INside Job - Sandra Walston
· Rural Residency - Kim Marvel, CAFMR
· Community Paramedicine - Christopher Montera, Eagle County Paramedic Services
· The Business Side of Quality - Darlene Bainbridge
· Cold Spotting Colorado - Dr. Jack Westfall, Colorado HealthOP
· Future of HIE by Morgan Honea, CORHIO and Dick Thompson, Quality Health Network
· Culture Change…Are We There Yet - Michelle Rathman Batschke
To register, visit https://coruralhealth.org/product/annualmemberreg and please note that each attendee must register separately. To review conference details visit the main conference page at http://coruralhealth.org/events/annual-conference.
Should you have any questions or need assistance with registration, please contact Bridgette Olson at bo@coruralhealth.org or call 720.248.2746.
Thursday, September 25, 2014
Medicare Part B News-Jurisdiction H for September 23rd, 2014
The following information is provided by Novitas Solutions.
Other Part B Frequently Asked Question (FAQ) Topics
Ambulance FAQs are now available! These are located on the FAQ page of our website. You will find questions such as "What type of documentation is acceptable for ambulance mileage?" Please take time to review answers to this and other questions.
Medicare Learning Network (MLN) Articles from CMS
Revised:
MLN Connects Provider eNews for September 18th, 2014
In This Edition:
MLN Connects™ National Provider Calls
- Hospital Appeals Settlement Update — Registration Opening Soon
- Transitioning to ICD-10 — Registration Now Open
- New MLN Connects™ National Provider Call Audio Recording and Transcript
- ICD-10 Coordination and Maintenance Committee Meeting
- New Affordable Care Act Tools and Payment Models Deliver $372 Million in Savings, Improve Care
- HHS Provides Additional Flexibility for Certification of Electronic Health Record Technology
- Medicare EHR Incentive Program: October 3 Last Day for 1st-year EPs to Begin 2014 Reporting Period
- Mass Adjustments to IPF Claims with Teaching Adjustment Amounts Being Duplicated
MLN Educational Products
- "2014-2015 Influenza (Flu) Resources for Health Care Professionals" MLN Matters® Article — Released
- "Internet-based PECOS FAQs" Fact Sheet — Released
- "Safeguard Your Identity and Privacy Using PECOS" Fact Sheet — Released
- "Dual Eligible Beneficiaries Under the Medicare and Medicaid Programs" Fact Sheet — Revised
- "Health Professional Shortage Area (HPSA) Physician Bonus, HPSA Surgical Incentive Payment, and Primary Care Incentive Payment Programs" Fact Sheet — Revised
- MLN Products Available In Electronic Publication Format
Medicare Part A News-Jurisdiction H for September 23rd, 2014
The following information is provided by Novitas Solutions.
Medicare News
New Medicare Insights Weekly Podcasts Now Available
In this week's Medicare Insights Weekly podcast, we review the skilled nursing facility certification and recertification requirements (Part A) and the definition of Confined to Home and Home Health Face-to-Face Visits (Part B). Don't miss these important podcasts!
Other Part A Frequently Asked Question (FAQ) Topics
Ambulance FAQs are now available! These are located on the FAQ page of our website. You will find questions such as "What type of documentation is acceptable for ambulance mileage?" Please take time to review answers to this and other questions.
Novitas Solutions 2014 Medicare Symposium Registration
Join us for our upcoming symposium in Houston, TX on Thursday, October 23! This event will be held at the Crowne Plaza Houston NRG Stadium Hotel.
Time is fading fast! Now is your chance to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.
Registration is also open for the following events:
Medicare News
New Medicare Insights Weekly Podcasts Now Available
In this week's Medicare Insights Weekly podcast, we review the skilled nursing facility certification and recertification requirements (Part A) and the definition of Confined to Home and Home Health Face-to-Face Visits (Part B). Don't miss these important podcasts!
Other Part A Frequently Asked Question (FAQ) Topics
Ambulance FAQs are now available! These are located on the FAQ page of our website. You will find questions such as "What type of documentation is acceptable for ambulance mileage?" Please take time to review answers to this and other questions.
Novitas Solutions 2014 Medicare Symposium Registration
Join us for our upcoming symposium in Houston, TX on Thursday, October 23! This event will be held at the Crowne Plaza Houston NRG Stadium Hotel.
Time is fading fast! Now is your chance to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.
Registration is also open for the following events:
HQCC Fall Conference
HQCC is pleased to present:
Leading Change in Healthcare: Meeting the Triple Aim
Friday, October 24th, 2014
7:30am-4:00pm
University of Denver, Craig Hall
$80.00 HQCC Members
$80.00 when combined with $40.00 membership fee
$90.00 for Non-members
$30.00 for Students
Register at www.HQCC.org!
Leading Change in Healthcare: Meeting the Triple Aim
Friday, October 24th, 2014
7:30am-4:00pm
University of Denver, Craig Hall
$80.00 HQCC Members
$80.00 when combined with $40.00 membership fee
$90.00 for Non-members
$30.00 for Students
Register at www.HQCC.org!
Enroll for Novitasphere Portal Today!
Novitas Solutions is pleased to announce open enrollment of its Novitasphere Portal!
Novitasphere is our free, web-based portal that will allow you access to Eligibility, Claim Information and Remittance Advice, Claim Submission with File Status, Electronic Remittance Advice (ERA), Claim Correction, and a MailBox. Eliminate the need to call Novitas for this information, resulting in time savings for your office! Novitasphere is also a great alternative to using dial-up or Secure File Transfer Protocol (SFTP) for your EDI transactions.
If you are a Medicare JH Part B Provider in the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas/Indian Health Services (IHS), please visit our dedicated Novitasphere Portal center for information related to Novitasphere. This page will be your go-to resource for information on Novitasphere, technical requirements, the enrollment process, and contact information for Novitas as it relates to the portal. Please carefully review the information on this center before completing your Enrollment Form. Please note, we are not enrolling Veteran Affairs providers, Billing Services or Clearinghouses at this time.
You can find the Novitasphere Portal center on the left side of the JH Part B center of www.novitas-solutions.com or by visiting http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00081055.
It is important to note, when enrolling for Novitasphere, your existing submitter setup will not be affected and you will be asked to designate where your Electronic Remittance Advice (ERA) should go. This means you can keep your existing method of claim submission and ERA retrieval if you so choose.
Contacting Us
We will be hosting several webinars for Novitasphere over the next few weeks. Customers must register for an account through our new Novitas Medicare Learning Center in order to attend these events, if not already registered. Please visit our Novitas Medicare Learning Center page for more information, including how to create a Novitas Medicare Learning Center Training Account.
Please feel free to register for the upcoming webinars:
If you have any questions related to Novitasphere set-up, navigation, and password issues, please contact an EDI Analyst at 1-855-880-8424 from 8:00 AM-6:00 PM Eastern Time (ET), 7:00AM – 5:00PM CT. Questions regarding claim denials and other standard issues should still be directed to the Novitas Customer Service Center at 1-855-252-8782.
Novitasphere is our free, web-based portal that will allow you access to Eligibility, Claim Information and Remittance Advice, Claim Submission with File Status, Electronic Remittance Advice (ERA), Claim Correction, and a MailBox. Eliminate the need to call Novitas for this information, resulting in time savings for your office! Novitasphere is also a great alternative to using dial-up or Secure File Transfer Protocol (SFTP) for your EDI transactions.
If you are a Medicare JH Part B Provider in the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas/Indian Health Services (IHS), please visit our dedicated Novitasphere Portal center for information related to Novitasphere. This page will be your go-to resource for information on Novitasphere, technical requirements, the enrollment process, and contact information for Novitas as it relates to the portal. Please carefully review the information on this center before completing your Enrollment Form. Please note, we are not enrolling Veteran Affairs providers, Billing Services or Clearinghouses at this time.
You can find the Novitasphere Portal center on the left side of the JH Part B center of www.novitas-solutions.com or by visiting http://www.novitas-solutions.com/webcenter/spaces/MedicareJH/page/pagebyid?contentId=00081055.
It is important to note, when enrolling for Novitasphere, your existing submitter setup will not be affected and you will be asked to designate where your Electronic Remittance Advice (ERA) should go. This means you can keep your existing method of claim submission and ERA retrieval if you so choose.
Contacting Us
We will be hosting several webinars for Novitasphere over the next few weeks. Customers must register for an account through our new Novitas Medicare Learning Center in order to attend these events, if not already registered. Please visit our Novitas Medicare Learning Center page for more information, including how to create a Novitas Medicare Learning Center Training Account.
Please feel free to register for the upcoming webinars:
- Novitasphere Portal Overview – Tuesday, October 7, 2014 – 9:00 AM CT
- Novitasphere Portal Enrollment Overview – Tuesday, October 14, 2014 – 1:00 PM CT
- Novitasphere Direct Data Entry (DDE) Overview – Thursday, October 16, 2014 – 1:00 PM CT
If you have any questions related to Novitasphere set-up, navigation, and password issues, please contact an EDI Analyst at 1-855-880-8424 from 8:00 AM-6:00 PM Eastern Time (ET), 7:00AM – 5:00PM CT. Questions regarding claim denials and other standard issues should still be directed to the Novitas Customer Service Center at 1-855-252-8782.
National Farm Safety & Health Week
September 21–27 is National Farm Safety Week. NIOSH marks this year’s theme, Safety Counts: Protecting What Matters, by announcing the new Agriculture, Forestry, and Fishing directory page. This page is a one-stop entry point to NIOSH data, information, and resources for research and action in this sector. The web page is coordinated by the NIOSH Office of Agricultural Safety and Health.
As you know, workers in agriculture, forestry, and fishing experience the highest rates of fatal work-related injury of workers in any sector in the United States. The new directory page offers improved access to NIOSH data, topics and publications related to the health and safety of agriculture, forestry and commercial fishing workers. It also links to information about extramural programs and program goals, outcomes, and partnerships through the Agriculture, Forestry and Fishing Program Portfolio, National Occupational Research Agenda, and recent program review pages. Please visit the Agriculture, Forestry, and Fishing directory page and distribute the link among your networks.
As you know, workers in agriculture, forestry, and fishing experience the highest rates of fatal work-related injury of workers in any sector in the United States. The new directory page offers improved access to NIOSH data, topics and publications related to the health and safety of agriculture, forestry and commercial fishing workers. It also links to information about extramural programs and program goals, outcomes, and partnerships through the Agriculture, Forestry and Fishing Program Portfolio, National Occupational Research Agenda, and recent program review pages. Please visit the Agriculture, Forestry, and Fishing directory page and distribute the link among your networks.
Thursday, September 18, 2014
Medicare Part B News-Jurisdiction H for September 15th, 2014
The following information is provided by Novitas Solutions.
Internet-Based PECOS Signature Submissions
Please review clarifying information regarding the signature submissions for enrollment applications submitted via Internet-based PECOS
Novitas Medicare Learning Center Frequently Asked Questions (FAQs)
The Novitas Medicare Learning Center FAQ, How do I enroll in a teleconference?, has been updated. Check out the answer to this and other questions about the Novitas Medicare Learning Center.
Internet-Based PECOS Signature Submissions
Please review clarifying information regarding the signature submissions for enrollment applications submitted via Internet-based PECOS
Novitas Medicare Learning Center Frequently Asked Questions (FAQs)
The Novitas Medicare Learning Center FAQ, How do I enroll in a teleconference?, has been updated. Check out the answer to this and other questions about the Novitas Medicare Learning Center.
Medicare Part A and B News-Jurisdiction H for September 16th, 2014
The following information is provided by Novitas Solutions.
Medicare News
Novitasphere Portal Webinars
Have you attended our informative Novitasphere webinar series? Now is your chance!
Novitasphere is a free, secure web-based internet portal that features the ability for the provider to check patient’s benefits/eligibility, check claim status, submit claims, and so much more! The Novitasphere Portal Overview sessions will provide an overview of the features of Novitasphere, our Part B provider portal. The Novitasphere Provider Portal Enrollment Overview will review the required steps for enrolling in Novitasphere, including details of completing the IACS User ID process. The Novitasphere Direct Data Entry (DDE) Overview will review just the process of submitting claims and retrieving reports using the Direct Data Entry (DDE) function in Novitasphere. Enroll in an upcoming webinar today to find out what the Novitasphere Portal has to offer!
Upcoming events include:
9/17 – JH Novitasphere Provider Portal Enrollment Overview
9/18 – JH Novitasphere Direct Data Entry (DDE) Overview
Additional events are scheduled for October, November, and December! Visit the Events Calendar on our website for details!
Medicare News
Novitasphere Portal Webinars
Have you attended our informative Novitasphere webinar series? Now is your chance!
Novitasphere is a free, secure web-based internet portal that features the ability for the provider to check patient’s benefits/eligibility, check claim status, submit claims, and so much more! The Novitasphere Portal Overview sessions will provide an overview of the features of Novitasphere, our Part B provider portal. The Novitasphere Provider Portal Enrollment Overview will review the required steps for enrolling in Novitasphere, including details of completing the IACS User ID process. The Novitasphere Direct Data Entry (DDE) Overview will review just the process of submitting claims and retrieving reports using the Direct Data Entry (DDE) function in Novitasphere. Enroll in an upcoming webinar today to find out what the Novitasphere Portal has to offer!
Upcoming events include:
9/17 – JH Novitasphere Provider Portal Enrollment Overview
9/18 – JH Novitasphere Direct Data Entry (DDE) Overview
Additional events are scheduled for October, November, and December! Visit the Events Calendar on our website for details!
Medicare Part A and B News-Jurisdiction H for September 11th, 2014
The following information is provided by Novitas Solutions.
Medicare News
National Academy of Ambulance Coding (NAAC) CEUs Now Available for Educational Events
Novitas is pleased to announce a new partnership with the NAAC! Selected educational events are accepted by the NAAC for Continuing Education Units (CEUs) at a rate of one CEU per hour. Certified Ambulance Coders may now submit Novitas certificates of completion to the NAAC for approval. Please visit our Learning Center webpage for more information.
Provider Outreach & Education Advisory Group (POE AG) Meeting Minutes Now Available
Meeting minutes are now available from the August 21, 2014 Part B Provider Outreach & Education Advisory Group (POE AG) meeting! Please take a moment to review.
Medicare News
National Academy of Ambulance Coding (NAAC) CEUs Now Available for Educational Events
Novitas is pleased to announce a new partnership with the NAAC! Selected educational events are accepted by the NAAC for Continuing Education Units (CEUs) at a rate of one CEU per hour. Certified Ambulance Coders may now submit Novitas certificates of completion to the NAAC for approval. Please visit our Learning Center webpage for more information.
Provider Outreach & Education Advisory Group (POE AG) Meeting Minutes Now Available
Meeting minutes are now available from the August 21, 2014 Part B Provider Outreach & Education Advisory Group (POE AG) meeting! Please take a moment to review.
House passes NRHA-supported bill to delay rural hospital supervision requirements
The House on Tuesday passed legislation to delay enforcement of supervision requirements for outpatient therapeutic services in certain hospitals.
Passed by voice vote, the bill would prevent the Centers for Medicare and Medicaid Services (CMS) from requiring Critical Access Hospitals and small rural hospitals from needing a physician to supervise therapeutic services like drawing blood.
To read more, click here.
Passed by voice vote, the bill would prevent the Centers for Medicare and Medicaid Services (CMS) from requiring Critical Access Hospitals and small rural hospitals from needing a physician to supervise therapeutic services like drawing blood.
To read more, click here.
Medical Orders for Scope of Treatment Webinar
More About the MOST: Review and Update on the Medical Orders for Scope of Treatment
Webinar: Wednesday, September 24th 12:00pm-1:00pm MT
Hosted by the Center for Improving Value in Health Care
This webinar will recap the purpose, authority, and appropriate use of the Medical Orders for Scope of Treatment as a device to ensure continuity of care and communication between providers and facilities. Upcoming revisions to the form will also be introduced. Bring your questions and concerns for a lively discussion.
David Koets, MD, and Jennifer Ballentine, MA, are co-chairs of the Colorado Advance Directives Consortium, which launched the MOST program in Colorado in 2010.
Dr. Koets serves as Chief Medical Officer of The Denver Hospice and has enjoyed a long career in caring for Colorado's most vulnerable residents in long-term care and at the end of life. In 2012 he was honored with the Vesta Bowden award by the Colorado Health Care Association for his outstanding contributions to the field.
Ms. Ballentine is an educator, advocate, and analyst dedicated to improving quality in hospice and palliative care. She currently serves as Vice President of Hospice Analytics, and previously held positions as Executive Director of Life Quality Institute and Director of Programs for the Colorado Center for Hospice and Palliative Care.
Click Here for Free Registration
Webinar: Wednesday, September 24th 12:00pm-1:00pm MT
Hosted by the Center for Improving Value in Health Care
This webinar will recap the purpose, authority, and appropriate use of the Medical Orders for Scope of Treatment as a device to ensure continuity of care and communication between providers and facilities. Upcoming revisions to the form will also be introduced. Bring your questions and concerns for a lively discussion.
David Koets, MD, and Jennifer Ballentine, MA, are co-chairs of the Colorado Advance Directives Consortium, which launched the MOST program in Colorado in 2010.
Dr. Koets serves as Chief Medical Officer of The Denver Hospice and has enjoyed a long career in caring for Colorado's most vulnerable residents in long-term care and at the end of life. In 2012 he was honored with the Vesta Bowden award by the Colorado Health Care Association for his outstanding contributions to the field.
Ms. Ballentine is an educator, advocate, and analyst dedicated to improving quality in hospice and palliative care. She currently serves as Vice President of Hospice Analytics, and previously held positions as Executive Director of Life Quality Institute and Director of Programs for the Colorado Center for Hospice and Palliative Care.
Click Here for Free Registration
COAW: Diabetes Self-Management Program
A message from the Consortium for Older Adult Wellness:
Or are you more interested in the Diabetes Self-Management Program? Then you will be excited to learn we are hosting a two day cross-training for current leaders trained in Healthier Living Colorado (the Chronic Disease Self-Management Program). Join us Wednesday, October 1 through Tuesday, October 2, 2014 in Broomfield, Colorado. The cost is just $325 and includes snacks and lunch both days. And check out the new discounts for multiple registrations from your organization!
If you have any questions on your eligibility for discounts or scholarships please contact Pam Allen, 303-984-1845, 888-900-2629, or Pam@COAW.org.
Enroll now by clicking here: COAW.org
CEU's are available. COAW is an authorized IACET Provider, offering CEU’s for programs that qualify under the ANSI/IACET Standard.
CMS Offers RAC Settlement Option to Hospitals
CMS Offers RAC Settlement Option to Hospitals
The Centers for Medicare & Medicaid Services will provide any acute care or critical access hospital willing to withdraw their pending recovery audit appeal of claims with a "timely partial payment" of 68 percent of the disputed claims' net allowable amount. The CMS Office of Medicare Hearings and Appeals has a significant backlog of hospital inpatient claims appeals, and the agency is encouraging hospitals to "make use of this administrative agreement mechanism to alleviate the administrative burden of current appeals on both the hospital and Medicare system." The eligible claims, according to CMS, are appeals pending for inpatient-status claim denials by Medicare contractors on the basis that services may have been reasonable and necessary, but treatment on an inpatient basis was not, with dates of admissions prior to Oct. 1, 2013. Hospitals that wish to appeal should do so by Oct. 31, 2014, or request an extension. CMS will review the spreadsheets of claims and appeals submitted by hospitals, then the hospitals will review any discrepancies and resubmit spreadsheets as needed, and finally the appeals will be dismissed and the hospitals will be paid.
The Centers for Medicare & Medicaid Services will provide any acute care or critical access hospital willing to withdraw their pending recovery audit appeal of claims with a "timely partial payment" of 68 percent of the disputed claims' net allowable amount. The CMS Office of Medicare Hearings and Appeals has a significant backlog of hospital inpatient claims appeals, and the agency is encouraging hospitals to "make use of this administrative agreement mechanism to alleviate the administrative burden of current appeals on both the hospital and Medicare system." The eligible claims, according to CMS, are appeals pending for inpatient-status claim denials by Medicare contractors on the basis that services may have been reasonable and necessary, but treatment on an inpatient basis was not, with dates of admissions prior to Oct. 1, 2013. Hospitals that wish to appeal should do so by Oct. 31, 2014, or request an extension. CMS will review the spreadsheets of claims and appeals submitted by hospitals, then the hospitals will review any discrepancies and resubmit spreadsheets as needed, and finally the appeals will be dismissed and the hospitals will be paid.
MLN Connects for September 11th, 2014
View this edition as a PDF
In This Edition:
MLN Connects™ National Provider Calls
Announcements
Claims, Pricers, and Codes
MLN Educational Products
In This Edition:
MLN Connects™ National Provider Calls
- PQRS: How to Avoid 2016 Negative Payment Adjustments for CMS Medicare Quality Reporting Programs — Last Chance to Register
Announcements
- Hospitals Appeals Settlement FAQs
- National Cholesterol Education Month — Medicare Preventive Services for Cardiovascular Disease
- New Release of PEPPER for Short-term Acute Care Hospitals
- EHR Incentive Programs: Learn More about Patient Electronic Access Requirements
- EHR Incentive Programs: Exclusions and Hardship Exceptions for Broadband Access
Claims, Pricers, and Codes
- Incarcerated Beneficiary Update
- Updated Information on Preventive Services Paid Based on the RHC or FQHC All-Inclusive Rate
- October 2014 Average Sales Price Files Now Available
MLN Educational Products
- "HIPAA Privacy and Security Basics for Providers" Fact Sheet — Released
- "The CMS Physician Quality Reporting System (PQRS) Program: What Medicare Eligible Professionals Need to Know in 2014" Web-Based Training Course — Released
- "The CMS Value-Based Payment Modifier: What Medicare Eligible Professionals Need to Know in 2014" Web-Based Training Course — Released
- "The Medicare and Medicaid EHR Incentive Programs: What Medicare and Medicaid Providers Need to Know in 2014" Web-Based Training Course — Released
- "Examining the Difference between a National Provider Identifier (NPI) and a Provider Transaction Access Number (PTAN)" MLN Matters®Article — Revised
- "Scenarios and Coding Instructions for Submitting Requests to Reopen Claims that are Beyond the Claim Filing Timeframes – Companion Information to MM8581: Automation of the Request for Reopening Claims Process" MLN Matters® Article — Revised
- New MLN Topic of the Month
Education Credits Now Available for Three CMS Quality Program Webinars
Education credits are now available for the three web-based trainings that were posted on YouTube by MLN Connects in June 2014. To see a listing of all available courses, go to the Web-Based Training Course listing.
"The CMS Physician Quality Reporting System (PQRS) Program: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training Course — Released
The “The CMS Physician Quality Reporting System (PQRS) Program: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training (WBT) Course was released and is now available. This WBT is designed to provide an overview of the requirements of the Medicare PQRS program, so that all eligible professionals can participate to earn the incentives that are available in 2014 for successfully participating in the program, as well as to avoid the payment adjustment in 2016 for not reporting this year. This presentation educates healthcare professionals on a variety of topics that are essential to the CMS PQRS program. Continuing education credits are available to learners who successfully complete this course. See course description for more information.
To access the WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.
"The CMS Value-Based Payment Modifier: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training Course — Released
The “The CMS Value-Based Payment Modifier: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training (WBT) Course was released and is now available. This WBT is designed to provide an overview of the value-based payment modifier, and how it relates to the Physician Quality Reporting System (PQRS) program, so that all Medicare physicians will understand how the value modifier can effect Medicare reimbursement starting in 2015. This presentation educates healthcare professionals on a variety of topics that are essential to the value-based payment modifier.Continuing education credits are available to learners who successfully complete this course. See course description for more information.
To access the WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.
"The Medicare and Medicaid EHR Incentive Programs: What Medicare and Medicaid Providers Need to Know in 2014” Web-Based Training Course — Released
The “The Medicare and Medicaid EHR Incentive Programs: What Medicare and Medicaid Providers Need to Know in 2014” Web-Based Training (WBT) Course was released and is now available. This WBT is designed to provide an overview of the requirements of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, so that providers can participate to earn the incentives that are available in 2014 for successfully attesting the meaningful use objectives and clinical quality measures, as well as to avoid the payment adjustment in 2016 for not reporting this year. This presentation educates healthcare professionals on a variety of topics that are essential to the EHR Incentive Programs. Continuing education credits are available to learners who successfully complete this course. See course description for more information.
To access the WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.
"The CMS Physician Quality Reporting System (PQRS) Program: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training Course — Released
The “The CMS Physician Quality Reporting System (PQRS) Program: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training (WBT) Course was released and is now available. This WBT is designed to provide an overview of the requirements of the Medicare PQRS program, so that all eligible professionals can participate to earn the incentives that are available in 2014 for successfully participating in the program, as well as to avoid the payment adjustment in 2016 for not reporting this year. This presentation educates healthcare professionals on a variety of topics that are essential to the CMS PQRS program. Continuing education credits are available to learners who successfully complete this course. See course description for more information.
To access the WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.
"The CMS Value-Based Payment Modifier: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training Course — Released
The “The CMS Value-Based Payment Modifier: What Medicare Eligible Professionals Need to Know in 2014” Web-Based Training (WBT) Course was released and is now available. This WBT is designed to provide an overview of the value-based payment modifier, and how it relates to the Physician Quality Reporting System (PQRS) program, so that all Medicare physicians will understand how the value modifier can effect Medicare reimbursement starting in 2015. This presentation educates healthcare professionals on a variety of topics that are essential to the value-based payment modifier.Continuing education credits are available to learners who successfully complete this course. See course description for more information.
To access the WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.
"The Medicare and Medicaid EHR Incentive Programs: What Medicare and Medicaid Providers Need to Know in 2014” Web-Based Training Course — Released
The “The Medicare and Medicaid EHR Incentive Programs: What Medicare and Medicaid Providers Need to Know in 2014” Web-Based Training (WBT) Course was released and is now available. This WBT is designed to provide an overview of the requirements of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, so that providers can participate to earn the incentives that are available in 2014 for successfully attesting the meaningful use objectives and clinical quality measures, as well as to avoid the payment adjustment in 2016 for not reporting this year. This presentation educates healthcare professionals on a variety of topics that are essential to the EHR Incentive Programs. Continuing education credits are available to learners who successfully complete this course. See course description for more information.
To access the WBTs, go to MLN Products and click on “Web-Based Training Courses” under “Related Links” at the bottom of the web page.
Wednesday, September 10, 2014
2014 Annual Rural Health Conference Registration Open!
Registration is now open for the 2014 Annual Rural Health Conference, which will be held at the Hotel Elegantè – October 16 & 17, 2014. The agenda is posted online for your review, and I'm sure you will find the conference engaging and thought-provoking. Make sure to take advantage of the Early Bird Rate and register by September 24, 2014. Rates increase $50.00 after September 24.
On the agenda:
· The Landscape of Rural Health Policy - Maggie Elehwany, NRHA
· Courageous Leadership—An INside Job - Sandra Walston
· Rural Residency - Kim Marvel, CAFMR
· Community Paramedicine - Christopher Montera, Eagle County Paramedic Services
· The Business Side of Quality - Darlene Bainbridge
· Cold Spotting Colorado - Dr. Jack Westfall, Colorado HealthOP
· Future of HIE by Morgan Honea, CORHIO and Dick Thompson, Quality Health Network
· Culture Change…Are We There Yet - Michelle Rathman Batschke
To register, visit https://coruralhealth.org/product/annualmemberreg and please note that each attendee must register separately. To review conference details visit the main conference page at http://coruralhealth.org/events/annual-conference.
Should you have any questions or need assistance with registration, please contact Bridgette Olson at bo@coruralhealth.org or call 720.248.2746.
On the agenda:
· The Landscape of Rural Health Policy - Maggie Elehwany, NRHA
· Courageous Leadership—An INside Job - Sandra Walston
· Rural Residency - Kim Marvel, CAFMR
· Community Paramedicine - Christopher Montera, Eagle County Paramedic Services
· The Business Side of Quality - Darlene Bainbridge
· Cold Spotting Colorado - Dr. Jack Westfall, Colorado HealthOP
· Future of HIE by Morgan Honea, CORHIO and Dick Thompson, Quality Health Network
· Culture Change…Are We There Yet - Michelle Rathman Batschke
To register, visit https://coruralhealth.org/product/annualmemberreg and please note that each attendee must register separately. To review conference details visit the main conference page at http://coruralhealth.org/events/annual-conference.
Should you have any questions or need assistance with registration, please contact Bridgette Olson at bo@coruralhealth.org or call 720.248.2746.
Webinar: ICD-10 Coding for CAHs and Rural PPS Hospitals, Training #10
Please join
us on Tuesday, September 16, 2014, from 12:00pm - 1:30 pm for
the last webinar in this series of coding for CAHs and Rural PPS
hospitals -- so you and your small rural hospital will be ready
for ICD-10 implementation.
During
this live webinar we will receive training on "Overview of ICD-10-CM
Concept Additions: Part 2". So, this webinar is
also appropriate for clinics!!!
This
webinar will consist of 1 hour of training by an AHIMA certified trainer.
This
educational activity is geared towards clinicians and billing & coding
staff at rural hospitals and CAHs. All healthcare providers, particularly
physicians, are invited to attend.
This webinar series
is free to hospitals participating in the FY2013 SHIP grant program and CRHC
members. All other facilities will be invoiced $49 following the webinar.
Click here to register!
Telehealth Webinar: Mid-Year Rural Health Policy Roundup
The Arizona Telemedicine Program invites you to participate in a telehealth webinar, "2014 Mid-Year Rural Health Policy Roundup" on September 17th at 1:00pm.
The objectives for this webinar is to:
The objectives for this webinar is to:
- Obtain current information on Congressional Initiatives that impact rural health care
- Learn the status of the rural health care initiatives at committee and administrative levels
- Gain the latest information about any new governmental administrative rulings that impact rural health care along with positions taken by NRHA
For more information and registration instructions go to: http://www.telemedicine.arizona.edu/distant-education/upcoming-workshops
Credentialing Network Webinar Series, Part 3
The next webinar in the Credentialing Network Webinar Series will take place on September 24th at 11:00am. These quarterly webinars will be interactive and informative, providing insight on credentialing needs.
The webinars can be purchased individually at $99 for CRHC members or $149 for CRHC non-Members. You will be invoiced following the webinar. Or save by purchasing all four webinars through a Credentialing Network Membership, which is $250 for CRHC Members and $375 for CRHC non-members – for information about purchasing a Credentialing Network Membership, contact Liz Kelman at lk@coruralhealth.org.
To register, click on the hyperlinks above.
Virtual Credit Card Payment Resources
The following article is included in the Colorado Medical Society's newsletter Livewire.
Learn more about virtual credit card payments with resource and webinar
An increasingly common payment method among health insurers offers these companies significant financial rewards while sticking physicians with all the associated fees and extra work. But physicians are fighting back as the American Medical Association, MGMA and other health care associations take the issue to the federal government, the AMA reports.
Many insurers are choosing to use virtual credit cards for claims payments to physicians, instead of sending paper checks or paying via the electronic funds transfer (EFT) standard transaction. When paying via virtual credit card, insurers send single-use credit card payment information and instructions to physicians via mail, fax or email. The physician's office staff then processes the payment as they would a patient's credit card.
For each of these payments, physicians are charged fees that typically amount to 3-5 percent of the total payment, the AMA explained in recent testimony (log in required) to the National Committee on Vital and Health Statistics, an advisory board to the secretary of the U.S. Department of Health and Human Services (HHS).
That adds up. If a physician contractually is owed $5,000, for instance, he or she could have to shell out up to $250 in fees.
In addition, physicians' practices are forced to devote more time to processing these payments, having to manually enter information, correct any entry errors and manually reconcile the payment with the separate claims remittance advice.
Insurers, on the other hand, often receive cash-back incentives for making virtual card payments, including a portion of the fees the physician paid.
The AMA is urging HHS to issue additional guidance on this issue. In a letter (log in) sent last week to HHS Secretary Sylvia Burwell, the AMA, MGMA and two other leading organizations called on the agency to prohibit insurers from forcing physicians to accept this payment method. They also urged the agency to require insurers to give full upfront disclosures of associated fees, obtain physician authorization before implementing virtual card payments and ensure an easy opt-out process if a physician later chooses not to accept this form of payment.
Physicians instead can request insurers to pay via the EFT standard transaction, which works like direct deposit and can cut down the time spent on processing paper checks.
A free continuing medical education webinar, "Stop paying to get paid: Effective electronic payments," will take place at 10 a.m. MT Sept. 16. Click here to register. The AMA has created a resource that explains your rights concerning acceptance of virtual credit card payments. Click here to read more.
Learn more about virtual credit card payments with resource and webinar
An increasingly common payment method among health insurers offers these companies significant financial rewards while sticking physicians with all the associated fees and extra work. But physicians are fighting back as the American Medical Association, MGMA and other health care associations take the issue to the federal government, the AMA reports.
Many insurers are choosing to use virtual credit cards for claims payments to physicians, instead of sending paper checks or paying via the electronic funds transfer (EFT) standard transaction. When paying via virtual credit card, insurers send single-use credit card payment information and instructions to physicians via mail, fax or email. The physician's office staff then processes the payment as they would a patient's credit card.
For each of these payments, physicians are charged fees that typically amount to 3-5 percent of the total payment, the AMA explained in recent testimony (log in required) to the National Committee on Vital and Health Statistics, an advisory board to the secretary of the U.S. Department of Health and Human Services (HHS).
That adds up. If a physician contractually is owed $5,000, for instance, he or she could have to shell out up to $250 in fees.
In addition, physicians' practices are forced to devote more time to processing these payments, having to manually enter information, correct any entry errors and manually reconcile the payment with the separate claims remittance advice.
Insurers, on the other hand, often receive cash-back incentives for making virtual card payments, including a portion of the fees the physician paid.
The AMA is urging HHS to issue additional guidance on this issue. In a letter (log in) sent last week to HHS Secretary Sylvia Burwell, the AMA, MGMA and two other leading organizations called on the agency to prohibit insurers from forcing physicians to accept this payment method. They also urged the agency to require insurers to give full upfront disclosures of associated fees, obtain physician authorization before implementing virtual card payments and ensure an easy opt-out process if a physician later chooses not to accept this form of payment.
Physicians instead can request insurers to pay via the EFT standard transaction, which works like direct deposit and can cut down the time spent on processing paper checks.
A free continuing medical education webinar, "Stop paying to get paid: Effective electronic payments," will take place at 10 a.m. MT Sept. 16. Click here to register. The AMA has created a resource that explains your rights concerning acceptance of virtual credit card payments. Click here to read more.
MLN Articles-Revised
Medicare Learning Network (MLN) Articles from CMS
Revised:
Revised:
- MM8506 – Pub 100-03, Chapter 1, Language-only Update
- MM8581 – Automation of the Request for Reopening Claims Process
- MM8758 – Cardiac Rehabilitation Programs for Chronic Heart Failure
- MM8890 – Influenza Vaccine Payment Allowances - Annual Update for 2014-2015 Season
- SE1216 – Examining the Difference between a National Provider Identifier (NPI) and a Provider Transaction Access Number (PTAN)
- SE1426 – Scenarios and Coding Instructions for Submitting Requests to Reopen Claims that are Beyond the Claim Filing Timeframes – Companion Information to MM8581: “Automation of the Request for Reopening Claims Process”
Medicare Part A News-Jurisdiction H for September 9th, 2014
The following information is provided by Novitas Solutions.
August 2014 Medicare Part A Newsletter
The August 2014 Medicare Part A Newsletter is now available! Please take a moment to review.
August 2014 Medicare Part A Newsletter
The August 2014 Medicare Part A Newsletter is now available! Please take a moment to review.
Update to Novitas Bad Debt Policy involving timeliness of patient billing
Please be aware that effective April 2014, Novitas is no longer using the 180 day standard for timeliness of billing coinsurance/ deductible. The following should be used:
Please be aware that effective April 2014, Novitas is no longer using the 180 day standard for timeliness of billing coinsurance/ deductible. The following should be used:
- Providers must issue the first bill within ninety days of the last processed Medicare remit.
- When secondary insurance is involved, providers must issue the first bill to the beneficiary within two months of receiving the remittance advice from the secondary insurance.
Instructions for Denied Polysomnography Services Claims
Please disregard demand letters for Polysomnography services associated with the Office of Inspector General (OIG) report OEI-05-12-00340. Activities are underway to re-examine these denials. Please do not submit appeals for these overpayments as all denials will be reversed. Any monies collected to date will be refunded, including interest.
Please disregard demand letters for Polysomnography services associated with the Office of Inspector General (OIG) report OEI-05-12-00340. Activities are underway to re-examine these denials. Please do not submit appeals for these overpayments as all denials will be reversed. Any monies collected to date will be refunded, including interest.
Medicare Part A and B News-Jurisdiction H for September 8th, 2014
The following information is provided by Novitas Solutions.
New Enrollment Podcasts Now Available
In this week's Medicare Insights Weekly podcast, we continue our Enrollment series with the Electronic Funds Authorization Agreement form, CMS-588. Learn how to complete this important form. Listen today!
Part A Top Claim Submission Errors
The Top Claim Submission Errors and resolutions for August 2014 are now available. Please take time to review these errors and avoid them on future claims.
Medicare Learning Network (MLN) Articles from CMS
New:
New Enrollment Podcasts Now Available
In this week's Medicare Insights Weekly podcast, we continue our Enrollment series with the Electronic Funds Authorization Agreement form, CMS-588. Learn how to complete this important form. Listen today!
Part A Top Claim Submission Errors
The Top Claim Submission Errors and resolutions for August 2014 are now available. Please take time to review these errors and avoid them on future claims.
Medicare Learning Network (MLN) Articles from CMS
New:
- Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy
- Sample Collection Fee Adjustment for Clinical Laboratory Fee Schedule and Laboratory Services
- Annual Clotting Factor Furnishing Fee Update 2015
- Ambulance Inflation Factor for CY 2015 and Productivity Adjustment
QHi Back to Basics Webinar
The following event has been added to PiHQ: Partners in Healthcare Quality:
Event: QHi Back to Basics
Location: Webinar
Event: QHi Back to Basics
Location: Webinar
Starts At: 2014-09-24 14:00
Ends At: 2014-09-24 15:00
Information: All QHi users are invited to join us on Wednesday, September 24 from 2:00 to 3:00 Central Time for our next QHi Back to Basics session. We will review the fundamentals of participation including selecting measures, adding users, entering data (CART upload review), and take a deep dive into running reports. Following the session we will open the lines for discussion, so bring questions for your peers. All QHi users are invited to attend this free webinar. Please register here: https://cc.readytalk.com/r/wh5y91heukbz&eom.
Ends At: 2014-09-24 15:00
Information: All QHi users are invited to join us on Wednesday, September 24 from 2:00 to 3:00 Central Time for our next QHi Back to Basics session. We will review the fundamentals of participation including selecting measures, adding users, entering data (CART upload review), and take a deep dive into running reports. Following the session we will open the lines for discussion, so bring questions for your peers. All QHi users are invited to attend this free webinar. Please register here: https://cc.readytalk.com/r/wh5y91heukbz&eom.
Medicare Part B News-Jurisdiction H for September 9th, 2014
The following information is provided by Novitas Solutions.
Immediate Action Needed for Groups with 10 or More Eligible Professionals to Avoid Automatic Medicare Payment Reductions in CY 2016
The deadline for groups to register to participate in the 2014 Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) is September 30, 2014, 11:59 pm EDT. Groups with 10 or more eligible professionals can avoid the automatic negative two percent (-2.0%) Value Modifier payment adjustment in CY 2016 by participating in the PQRS GPRO in CY 2014 and meeting the satisfactory reporting criteria to avoid the CY 2016 PQRS payment adjustment. If these group practices do not participate in the PQRS GPRO in CY 2014, then they can avoid the automatic -2.0% Value Modifier payment adjustment in CY 2016 if the eligible professionals in the group participate in the PQRS as individuals and at least 50% of the eligible professionals meet the requirements to avoid the CY 2016 PQRS payment adjustment. Additional information about these requirements can be found at: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Self-Nomination-Registration.html.
Instructions for Denied Polysomnography Services Claims
Please disregard demand letters for Polysomnography services associated with the Office of Inspector General (OIG) report OEI-05-12-00340. Activities are underway to re-examine these denials. Please do not submit appeals for these overpayments as all denials will be reversed. Any monies collected to date will be refunded, including interest.
September 2014 Part B Medicare Report
The September 2014 Part B Medicare Report is now available. Please take a few moments to review.
Webinar: Health Insurance Literacy
You are invited to the following event:
Coverage to Care - A Webinar About Health Insurance Literacy
Event to be held at the following time and date:
Thursday, September 18, 2014 from 10:00 AM to 11:00 AM (MDT)
Millions of Americans – including thousands in YOUR community – now have the health insurance coverage they need, but could not afford before. This includes people with new private plans, individuals on Medicaid, kids in CHIP programs, and people newly eligible for Medicare.
But many of these people don’t understand how their new coverage works, and this can jeopardize the goals of improving Americans’ health, and cutting health care costs we all pay. That’s why the Centers for Medicare & Medicaid Services has launched “From Coverage to Care,” a national initiative to help people understand their benefits, and connect to the primary care and preventive services they need for a long and healthy life.
This webinar, intended for Marketplace assistors*, providers, community and advocacy groups, and stakeholders throughout Region 8 (CO, MT, ND, SD, UT, and WY) is a roadmap to provide useful information in an easy-to-use format, including issues such as:
· How to read and understand an insurance card, and the terms it contains
· How to find a provider, and be prepared for the first visit with him or her
· What to do after the visit, and where to go if questions arise
We hope you can join us for an informative and educational presentation, which will include time for your questions.
Attend Event
(*)=While this webinar will be of great value to Navigators and Certified Assistance Counselors (CACs), it is not part of the certification process, and cannot substitute for official certification training.
Coverage to Care - A Webinar About Health Insurance Literacy
Event to be held at the following time and date:
Thursday, September 18, 2014 from 10:00 AM to 11:00 AM (MDT)
Millions of Americans – including thousands in YOUR community – now have the health insurance coverage they need, but could not afford before. This includes people with new private plans, individuals on Medicaid, kids in CHIP programs, and people newly eligible for Medicare.
But many of these people don’t understand how their new coverage works, and this can jeopardize the goals of improving Americans’ health, and cutting health care costs we all pay. That’s why the Centers for Medicare & Medicaid Services has launched “From Coverage to Care,” a national initiative to help people understand their benefits, and connect to the primary care and preventive services they need for a long and healthy life.
This webinar, intended for Marketplace assistors*, providers, community and advocacy groups, and stakeholders throughout Region 8 (CO, MT, ND, SD, UT, and WY) is a roadmap to provide useful information in an easy-to-use format, including issues such as:
· How to read and understand an insurance card, and the terms it contains
· How to find a provider, and be prepared for the first visit with him or her
· What to do after the visit, and where to go if questions arise
We hope you can join us for an informative and educational presentation, which will include time for your questions.
Attend Event
(*)=While this webinar will be of great value to Navigators and Certified Assistance Counselors (CACs), it is not part of the certification process, and cannot substitute for official certification training.
RHC Technical Assistance Call
The next RHC TA call has been scheduled for September 18th at 3:00pm EASTERN. The topic will be “Billing for RHC and Non-RHC services.” Our speaker will be Janet Lytton.
If you have any questions or subjects you would like Janet to try to cover during her presentation, please send them to info@narhc.org and put RHC TA Question in the subject line.
The call-in information for that call is:
Phone: 888-603-9640
Passcode: 9854323
Please note that we are in the process of scheduling an RHC TA call entitled, “Ask the Experts” where we intend to have several RHC consultants available just to answer your questions so if there is something we can’t get to on the call on the 18th, there will be an opportunity to get to additional questions during the “Ask the Experts” call.
Another message will be sent with the link to the slides that Janet will be using during her presentation.
We look forward to having you participate in the call on the 18th.
Please feel free to share this announcement with anyone you think might benefit from listening to this presentation. There is no charge to participate and it is not necessary to sign up in advance.
If you have any questions or subjects you would like Janet to try to cover during her presentation, please send them to info@narhc.org and put RHC TA Question in the subject line.
The call-in information for that call is:
Phone: 888-603-9640
Passcode: 9854323
Please note that we are in the process of scheduling an RHC TA call entitled, “Ask the Experts” where we intend to have several RHC consultants available just to answer your questions so if there is something we can’t get to on the call on the 18th, there will be an opportunity to get to additional questions during the “Ask the Experts” call.
Another message will be sent with the link to the slides that Janet will be using during her presentation.
We look forward to having you participate in the call on the 18th.
Please feel free to share this announcement with anyone you think might benefit from listening to this presentation. There is no charge to participate and it is not necessary to sign up in advance.
Thursday, September 4, 2014
Medicare Part A and B News-Jurisdiction H for September 3rd, 2014
The following information is provided by Novitas Solutions.
Medicare Learning Network (MLN) Articles from CMS
New:
Medicare Learning Network (MLN) Articles from CMS
New:
- MM8893 – Annual Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcement
- MM8735 – Claim Status Category and Claim Status Codes Update
- MM8788 – Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2015
- MM8808 – New Manual Correction for Extracorporeal Photopheresis
- MM8838 – Implement Operating Rules - Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) Rule - Update from CAQH CORE
- MM8866 – Healthcare Provider Taxonomy Codes (HPTC) Update, October 2014
- MM8888 – October Update to the CY 2014 Medicare Physician Fee Schedule Database (MPFSDB)
- MM8889 – Update-Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Fiscal Year (FY) 2015
- MM8890 – Influenza Vaccine Payment Allowances - Annual Update for 2014-2015 Season
Medicare Part A and B News-Jurisdiction H for September 2nd, 2014
The following information is provided by Novitas Solutions.
Medicare News
CMS MLN Connects™ Provider eNews Special Edition for August 29, 2014
CMS Offers Settlement to Acute Care Hospitals and CAHs to Resolve Appeals of Patient Status Denials
MLN Connects™ National Provider Call: Tuesday, September 9; 1-2pm ET
To more quickly reduce the volume of patient status claim denials pending in the appeals process, CMS is offering an administrative agreement to any acute care hospital or critical access hospital (CAH) willing to resolve their pending appeals (or waive their right to request an appeal) in exchange for timely partial payment (68% of the net payable amount). CMS encourages hospitals with patient status claim denials currently in the appeals process to make use of this administrative agreement to alleviate the burden of current appeals on both the hospital and Medicare system.
More details about the providers and claims eligible for an administrative agreement, as well as the documents needed to request such an agreement, can be found on the CMS Inpatient Hospital Reviews web page.
Details:
Email any questions to MedicareSettlementFAQs@cms.hhs.gov. These questions will be answered on the MLN Connects Call and will be used to create frequently asked questions and answers that will be posted to the Inpatient Hospital Reviews web page. Watch future editions of the eNews for additional updates on this topic.
Symposium Registration Now Open!
Join us for our upcoming symposium in Baton Rouge, LA on Wednesday, September 10! This event will be held at the Belle of Baton Rouge Hotel.
Time is slipping away to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.
Not sure how to register? Watch our Symposium Registration Tutorial video for a step-by-step guide on how to successfully register for the events you wish to attend.
Registration is also open for the following events:
New Short-Term (ST) Acute Care Program for Evaluating Payment Patterns Electronic Report (PEPPER) now available
A new release of the Short-Term (ST) Acute Care Program for Evaluating Payment Patterns Electronic Report (PEPPER), with statistics through the second quarter of fiscal year 2014, is available for short-term acute care hospitals nationwide.
Medicare News
CMS MLN Connects™ Provider eNews Special Edition for August 29, 2014
CMS Offers Settlement to Acute Care Hospitals and CAHs to Resolve Appeals of Patient Status Denials
MLN Connects™ National Provider Call: Tuesday, September 9; 1-2pm ET
To more quickly reduce the volume of patient status claim denials pending in the appeals process, CMS is offering an administrative agreement to any acute care hospital or critical access hospital (CAH) willing to resolve their pending appeals (or waive their right to request an appeal) in exchange for timely partial payment (68% of the net payable amount). CMS encourages hospitals with patient status claim denials currently in the appeals process to make use of this administrative agreement to alleviate the burden of current appeals on both the hospital and Medicare system.
More details about the providers and claims eligible for an administrative agreement, as well as the documents needed to request such an agreement, can be found on the CMS Inpatient Hospital Reviews web page.
Details:
- Attend the MLN Connects Call. Registration opening soon at MLN Connects™ Upcoming Calls.
- The administrative agreement covers admissions prior to October 1, 2013
- Administrative agreement requests are due to CMS by October 31, 2014
Email any questions to MedicareSettlementFAQs@cms.hhs.gov. These questions will be answered on the MLN Connects Call and will be used to create frequently asked questions and answers that will be posted to the Inpatient Hospital Reviews web page. Watch future editions of the eNews for additional updates on this topic.
Symposium Registration Now Open!
Join us for our upcoming symposium in Baton Rouge, LA on Wednesday, September 10! This event will be held at the Belle of Baton Rouge Hotel.
Time is slipping away to register and attend our free 2014 Medicare Symposiums with the Provider Outreach and Education team. We offer a wide variety of class topics including Evaluation and Management Services, Two-Midnight Rule, claim form overviews, and Medicare basics. Don’t miss this golden opportunity to get the latest updates and changes to the Medicare program brought to you live and in-person.
Not sure how to register? Watch our Symposium Registration Tutorial video for a step-by-step guide on how to successfully register for the events you wish to attend.
Registration is also open for the following events:
A new release of the Short-Term (ST) Acute Care Program for Evaluating Payment Patterns Electronic Report (PEPPER), with statistics through the second quarter of fiscal year 2014, is available for short-term acute care hospitals nationwide.
National Rural Health Association Newsletter
NRHA Today contains many informative articles about rural health across the county. Check out the articles below.
In this issue:
• NRHA makes Modern Healthcare’s list of top influencers
• Critical access hospitals at a crossroads; NRHA cited
• “Why are there so few doctors in rural America?” asks the Atlantic
• Rural health facilities provide quality care
• Rural hospitals struggle to keep doors open
• 12 days left: NRHA seeks nominations for volunteer leaders
• 35 years and 500 doctors: Program matches physicians with jobs in rural Wisconsin
• ORHP quality improvement funding available
• California Rural Health Association becomes active after funding lapse
• NRHA to host free webinar Tuesday: ACA and rural minority communities
• NRHA, SNHPA to host free 340B roundtable following RHC, CAH event
• CMS updates preventive service Medicare payments for RHCs, FQHCs
• Telemedicine expands services to rural areas
• Freestanding ERs target suburbs, rural panel told
• Partners offer webinars on OEM contracts, leveraging data
• Multicultural conference moves; call for presentations now open
• NRHA makes Modern Healthcare’s list of top influencers
• Critical access hospitals at a crossroads; NRHA cited
• “Why are there so few doctors in rural America?” asks the Atlantic
• Rural health facilities provide quality care
• Rural hospitals struggle to keep doors open
• 12 days left: NRHA seeks nominations for volunteer leaders
• 35 years and 500 doctors: Program matches physicians with jobs in rural Wisconsin
• ORHP quality improvement funding available
• California Rural Health Association becomes active after funding lapse
• NRHA to host free webinar Tuesday: ACA and rural minority communities
• NRHA, SNHPA to host free 340B roundtable following RHC, CAH event
• CMS updates preventive service Medicare payments for RHCs, FQHCs
• Telemedicine expands services to rural areas
• Freestanding ERs target suburbs, rural panel told
• Partners offer webinars on OEM contracts, leveraging data
• Multicultural conference moves; call for presentations now open
Telemedicine Article: Northern Arizona’s Sara Gibson, MD: A Telepsychiatry Pioneer
From the Arizona Telemedicine Program...
In Arizona, Sara Gibson, MD, a psychiatrist with Northern Arizona Regional Behavioral Health Authority in Flagstaff, was the first to practice psychiatry via telemedicine.
It was November 1996, and Gibson had just returned to work after being on maternity leave. “I was covering Apache County, on the New Mexico border, where there are only two towns, St. Johns and Springerville,” she recalls.
“Travel is always an issue – and it was even more so after the birth of my son. My husband is a physician who’s on call a lot. And so NARBHA approached me and said, ‘This is totally new, would you be willing to pilot this?’”
The entire state of Arizona is a federally designated "mental health professionals shortage area." Gibson saw telemedicine as a way to bridge the gap between her and many of her patients.
It was November 1996, and Gibson had just returned to work after being on maternity leave. “I was covering Apache County, on the New Mexico border, where there are only two towns, St. Johns and Springerville,” she recalls.
“Travel is always an issue – and it was even more so after the birth of my son. My husband is a physician who’s on call a lot. And so NARBHA approached me and said, ‘This is totally new, would you be willing to pilot this?’”
The entire state of Arizona is a federally designated "mental health professionals shortage area." Gibson saw telemedicine as a way to bridge the gap between her and many of her patients.
To read more, click here.
Telemedicine & Telehealth Service Provider Showcase (SPS), early bird pricing ends soon!
**SPS Early Bird pricing ends Friday, September 5th!
Don’t Wait Register Now to save $100 off the full Conference Registration price!
Please share with your telehealth and healthcare colleagues!
Telemedicine and telehealth services reduce barriers to care, improve patient access to specialists, help medical practitioners expand their practice reach, and save patients from having to travel or be transported to receive expert specialty care.
The Telemedicine and Telehealth Service Provider Showcase (SPS™) is a national meeting that will focus on building partnerships for bringing high quality, telemedicine- and telehealth-enabled medical specialty services directly into hospitals, clinics, private practices and patients’ homes. The goals are to improve patient care and outcomes and to increase market share for both healthcare providers and the telehealth service providers they partner with.
Telemedicine and telehealth specialty services have come into their own as technology has become more affordable and as competition among healthcare companies increases. The market for commercial services is exploding. Decision-makers are challenged to select the most appropriate distant services and providers to meet the needs of their communities.
Offering an expo hall with an array of tele-medical specialty services and supporting technologies, SPS will provide a forum for seeing and discussing the latest trends in clinical telehealth. Attendees also will receive a wealth of practical information for both healthcare providers and best-of-breed telehealth service vendors.
Don’t Wait Register Now to save $100 off the full Conference Registration price!
Please share with your telehealth and healthcare colleagues!
Telemedicine & Telehealth Service Provider Showcase (SPS)
ADVANCING TELEHEALTH PARTNERSHIPS
October 6-7, 2014 ~ Hyatt Regency ~ Phoenix, AZ
Telemedicine and telehealth services reduce barriers to care, improve patient access to specialists, help medical practitioners expand their practice reach, and save patients from having to travel or be transported to receive expert specialty care.
The Telemedicine and Telehealth Service Provider Showcase (SPS™) is a national meeting that will focus on building partnerships for bringing high quality, telemedicine- and telehealth-enabled medical specialty services directly into hospitals, clinics, private practices and patients’ homes. The goals are to improve patient care and outcomes and to increase market share for both healthcare providers and the telehealth service providers they partner with.
Telemedicine and telehealth specialty services have come into their own as technology has become more affordable and as competition among healthcare companies increases. The market for commercial services is exploding. Decision-makers are challenged to select the most appropriate distant services and providers to meet the needs of their communities.
Offering an expo hall with an array of tele-medical specialty services and supporting technologies, SPS will provide a forum for seeing and discussing the latest trends in clinical telehealth. Attendees also will receive a wealth of practical information for both healthcare providers and best-of-breed telehealth service vendors.
Frontier Focus: CMS Offers Settlement to Acute Care Hospitals and CAHs for Resolving Patient Status Denials: Registration Now Open
MLN Connects™ National Provider Call: CMS Offers Settlement to Acute Care Hospitals and CAHs for Resolving Patient Status Denials — Registration Now Open
Tuesday, September 9; 1-2pm ET
To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.
This MLN Connects™ National Provider Call will provide details of the administrative agreement for acute care hospitals and critical access hospitals (CAHs) to expediently resolve patient status denials. To more quickly reduce the volume of patient status claim denials currently pending in the appeals process, CMS is offering an administrative agreement to any acute care hospital or CAH willing to withdraw their pending appeals (or waive their right to request an appeal) in exchange for timely partial payment (68% of the net payable amount). CMS encourages hospitals to make use of this administrative agreement mechanism to alleviate the burden of current appeals on both the hospital and Medicare system. The administrative agreement covers admissions prior to October 1, 2013. Administrative agreement requests are due to CMS by October 31, 2014. For details about the providers and claims eligible for administrative agreement, as well as the documents needed to request such an agreement, visit the Inpatient Hospital Reviews web page.
CMS encourages interested parties to submit questions in advance of the call. Submitted questions may be addressed on the call or may be used to create frequently asked questions (FAQs) that will be posted to the CMS website.
Agenda:
• Background
• Which providers are eligible
• What is the administrative agreement
• How to submit a settlement request
• Next steps
• Answers to pre-submitted questions
• Live Q&A
Target Audience: Acute care hospitals, including those paid via the prospective payment system, periodic interim payments, and the Maryland waiver; and CAHs. A full definition of each of these facility types can be found at §1886(d) or §1820(c) of the Social Security Act.
Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.
Tuesday, September 9; 1-2pm ET
To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.
This MLN Connects™ National Provider Call will provide details of the administrative agreement for acute care hospitals and critical access hospitals (CAHs) to expediently resolve patient status denials. To more quickly reduce the volume of patient status claim denials currently pending in the appeals process, CMS is offering an administrative agreement to any acute care hospital or CAH willing to withdraw their pending appeals (or waive their right to request an appeal) in exchange for timely partial payment (68% of the net payable amount). CMS encourages hospitals to make use of this administrative agreement mechanism to alleviate the burden of current appeals on both the hospital and Medicare system. The administrative agreement covers admissions prior to October 1, 2013. Administrative agreement requests are due to CMS by October 31, 2014. For details about the providers and claims eligible for administrative agreement, as well as the documents needed to request such an agreement, visit the Inpatient Hospital Reviews web page.
CMS encourages interested parties to submit questions in advance of the call. Submitted questions may be addressed on the call or may be used to create frequently asked questions (FAQs) that will be posted to the CMS website.
Agenda:
• Background
• Which providers are eligible
• What is the administrative agreement
• How to submit a settlement request
• Next steps
• Answers to pre-submitted questions
• Live Q&A
Target Audience: Acute care hospitals, including those paid via the prospective payment system, periodic interim payments, and the Maryland waiver; and CAHs. A full definition of each of these facility types can be found at §1886(d) or §1820(c) of the Social Security Act.
Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.
Webinar: Coverage to Care, Health Insurance Literacy
Coverage to Care - A Webinar About Health Insurance Literacy
Event to be held at the following time and date:
Thursday, September 18, 2014 from 10:00 AM to 11:00 AM (MDT)
Register for the Event
Millions of Americans – including thousands in YOUR community – now have the health insurance coverage they need, but could not afford before. This includes people with new private plans, individuals on Medicaid, kids in CHIP programs, and people newly eligible for Medicare.
But many of these people don’t understand how their new coverage works, and this can jeopardize the goals of improving Americans’ health, and cutting health care costs we all pay. That’s why the Centers for Medicare & Medicaid Services has launched “From Coverage to Care,” a national initiative to help people understand their benefits, and connect to the primary care and preventive services they need for a long and healthy life.
This webinar, intended for Marketplace assistors*, providers, community and advocacy groups, and stakeholders throughout Region 8 (CO, MT, ND, SD, UT, and WY) is a roadmap to provide useful information in an easy-to-use format, including issues such as:
• How to read and understand an insurance card, and the terms it contains
• How to find a provider, and be prepared for the first visit with him or her
• What to do after the visit, and where to go if questions arise
We hope you can join us for an informative and educational presentation, which will include time for your questions.
(*)=While this webinar will be of great value to Navigators and Certified Assistance Counselors (CACs), it is not part of the certification process, and cannot substitute for official certification training.
Event to be held at the following time and date:
Thursday, September 18, 2014 from 10:00 AM to 11:00 AM (MDT)
Register for the Event
|
|
But many of these people don’t understand how their new coverage works, and this can jeopardize the goals of improving Americans’ health, and cutting health care costs we all pay. That’s why the Centers for Medicare & Medicaid Services has launched “From Coverage to Care,” a national initiative to help people understand their benefits, and connect to the primary care and preventive services they need for a long and healthy life.
This webinar, intended for Marketplace assistors*, providers, community and advocacy groups, and stakeholders throughout Region 8 (CO, MT, ND, SD, UT, and WY) is a roadmap to provide useful information in an easy-to-use format, including issues such as:
• How to read and understand an insurance card, and the terms it contains
• How to find a provider, and be prepared for the first visit with him or her
• What to do after the visit, and where to go if questions arise
We hope you can join us for an informative and educational presentation, which will include time for your questions.
(*)=While this webinar will be of great value to Navigators and Certified Assistance Counselors (CACs), it is not part of the certification process, and cannot substitute for official certification training.
CMS Meaningful Use Final Ruling
The Centers for Medicare & Medicaid Services and Office of the National Coordinator for Health Information Technology late Friday August 29 released the final rule providing several options for achieving meaningful use in 2014.
This final rule essentially maintains the content of the notice of proposed rulemaking that was released in May of this year. We discussed this at several of our consortium webinars during that time.
Essentially the rule allows the use of a 2011 Version of A certified EHR with the 2013 meaningful use objectives and measures. It also provides the ability to combine 2011 and 2014 certified versions or simply if you are ready use the 2014 version and meaningful use objectives and measures. However it does allow organizations who are required to reach stage 2 and have implemented a 2014 certified EHR the option to choose to attest to stage one meaningful use objectives and measures albeit these must be based upon the 2014 criteria.
Several minor changes are also included to provide CQM exemptions for low-volume situations which may be applicable to some of our critical access hospitals that have very very few discharges during a quarter. Some of these changes also extend to the transitions of care referrals as well as methods for calculating the electronic Exchange of laboratory results to community physicians.
At our next consortium webinar we will incorporate a short recap of this final rule.
Additionally the final rule provides needed to guidance regarding what would constitute an appropriate reason for not attesting with a 2014 certified version. This guidance discusses the basis for considering a vendor delay as the reason. We want to remind everybody that it is essential to maintain written documentation along with evidence to support the use of the vendor delay reason. As many of you have already witnessed during a follow-up meaningful use audit documentation that can be produced is critical.
This too will be covered both at our next consortium webinar and the upcoming annual meeting in October.
If you have any questions regarding Final rule please send them to our meaningful use team.
This final rule essentially maintains the content of the notice of proposed rulemaking that was released in May of this year. We discussed this at several of our consortium webinars during that time.
Essentially the rule allows the use of a 2011 Version of A certified EHR with the 2013 meaningful use objectives and measures. It also provides the ability to combine 2011 and 2014 certified versions or simply if you are ready use the 2014 version and meaningful use objectives and measures. However it does allow organizations who are required to reach stage 2 and have implemented a 2014 certified EHR the option to choose to attest to stage one meaningful use objectives and measures albeit these must be based upon the 2014 criteria.
Several minor changes are also included to provide CQM exemptions for low-volume situations which may be applicable to some of our critical access hospitals that have very very few discharges during a quarter. Some of these changes also extend to the transitions of care referrals as well as methods for calculating the electronic Exchange of laboratory results to community physicians.
At our next consortium webinar we will incorporate a short recap of this final rule.
Additionally the final rule provides needed to guidance regarding what would constitute an appropriate reason for not attesting with a 2014 certified version. This guidance discusses the basis for considering a vendor delay as the reason. We want to remind everybody that it is essential to maintain written documentation along with evidence to support the use of the vendor delay reason. As many of you have already witnessed during a follow-up meaningful use audit documentation that can be produced is critical.
This too will be covered both at our next consortium webinar and the upcoming annual meeting in October.
If you have any questions regarding Final rule please send them to our meaningful use team.
CPHQ Review and Study
The Certified Professional in Healthcare Quality (CPHQ) program is fully accredited by the Healthcare Quality Certification Board (HQCB). This course contains 7.5 Credit hours.
September 5, Friday 7:30-4
Register Online at HQCC.org OR Mail registration and payment to:
Healthcare Quality Coalition of Colorado
(HQCC) 13918 E. Mississippi Ave., Ste. 484
Aurora, CO 80012
Registration Fees:
HQCC Members: $80.00
Early Bird Special: $80.00 if registering before September 1, 2014
$90.00 after Sept. 1, 2014
This one day workshop is designed to help those who are planning to take the Certified Professional in Healthcare Quality (CPHQ) examination. The course will follow the exam matrix and will help you focus your study efforts. Participants should come to the workshop with functional knowledge in areas identified in the CPHQ exam outline, which may be obtained at www.cphq.org.
The course will present information on healthcare quality methods, information management, strategy and leadership, change management and innovation, continuous readiness, and patient safety.
Q-Solutions: Essential Resources for the Healthcare Quality Professional, Second Edition, is recommended for the course and is available for purchase from the NAHQ Online Store at www.nahq.org.
Completion of this course does not guarantee a passing grade on the examination. HQCC reserves the right to cancel this event if minimum enrollment figures are not met by the established deadline.
September 5, Friday 7:30-4
Register Online at HQCC.org OR Mail registration and payment to:
Healthcare Quality Coalition of Colorado
(HQCC) 13918 E. Mississippi Ave., Ste. 484
Aurora, CO 80012
Registration Fees:
HQCC Members: $80.00
Early Bird Special: $80.00 if registering before September 1, 2014
$90.00 after Sept. 1, 2014
This one day workshop is designed to help those who are planning to take the Certified Professional in Healthcare Quality (CPHQ) examination. The course will follow the exam matrix and will help you focus your study efforts. Participants should come to the workshop with functional knowledge in areas identified in the CPHQ exam outline, which may be obtained at www.cphq.org.
The course will present information on healthcare quality methods, information management, strategy and leadership, change management and innovation, continuous readiness, and patient safety.
Q-Solutions: Essential Resources for the Healthcare Quality Professional, Second Edition, is recommended for the course and is available for purchase from the NAHQ Online Store at www.nahq.org.
Completion of this course does not guarantee a passing grade on the examination. HQCC reserves the right to cancel this event if minimum enrollment figures are not met by the established deadline.
MLN Connects Provider eNews
Click here to view MLN Connects Provider eNews for Thursday, August 28th, 2014
In This Edition:
MLN Connects™ National Provider Calls
MLN Educational Products
In This Edition:
MLN Connects™ National Provider Calls
- PQRS: How to Avoid 2016 Negative Payment Adjustments for CMS Medicare Quality Reporting Programs — Register Now
- Overview of the 2013 Quality and Resource Use Reports — Registration Opening Soon
- New MLN Connects™ National Provider Call Video Slideshow, Audio Recording, and Transcript
- NIST EHR Randomizer Tool: Provider User Guide Available
- Review New FAQs for the EHR Incentive Programs
- Update to Preventive Services Paid Based on the RHC or FQHC All-inclusive Rate
- Adjustment of Some Home Health Claims
- FY 2014 HH PPS PC Pricer Updated
MLN Educational Products
- “International Classification of Diseases, 10th Revision (ICD-10) Testing - Acknowledgement Testing with Providers” MLN Matters® Article — Released
- “ICD-10-CM/PCS Billing and Payment Frequently Asked Questions” Fact Sheet — Revised
- “ICD-10-CM/PCS Myths and Facts” Fact Sheet — Revised
- “ICD-10-CM Classification Enhancements” Fact Sheet — Revised
- “General Equivalence Mappings Frequently Asked Questions” Booklet — Revised
- “New Physician Specialty Code for Interventional Cardiology” MLN Matters® Article — Released
- “Scenarios and Coding Instructions for Submitting Requests to Reopen Claims that are Beyond the Claim Filing Timeframes – Companion Information to MM8581: Automation of the Request for Reopening Claims Process” MLN Matters® Article — Released
- “Fingerprint-based Background Check Begins August 6, 2014” MLN Matters® Article — Released
- “Comprehensive Error Rate Testing (CERT): Skilled Nursing Facility (SNF) Certifications and Recertifications” MLN Matters® Article — Released
- “MLN Suite of Products & Resources for Rural Health Providers” Educational Tool — Revised
- New MLN Educational Web Guides Fast Fact
- MLN Products Available in Electronic Publication Format
At a Glance Newsletter
Please find the link to the August edition of At a Glance below. This Department of Health Care Policy and Financing publication provides information on major initiatives including policy changes and program updates. Please feel free to share it with your colleagues. You will notice the link below brings you to our new website; to access the August edition of At a Glance, simply click the plus sign to the left of this text:
Subscribe to:
Posts (Atom)