WPS Medicare J5 Provider Outreach & Education Advisory Group (POE AG) Minutes - Kansas and Missouri

June 4, 2009
10:00 AM - 11:30 AM
Teleconference

Members Present
Marion Regier, Hillsboro Community Medical Center (CAH)
Mike Metro, Salina Regional Health (H)
Larry Morris, Stormont-Vail HealthCare (H)
Stacy Cope, Lawrence Memorial (H)
Brenda Olson, Great Plains Health Alliance
Sandra Lindley, Ray County Memorial Hospital (CAH)
Vicki Caywood, Hutchinson Hospital (H)
Eldon Schumacher, Great Plains Health Alliance
Wesla Arambulo, Skilled Healthcare, LLC (SNF)
Tish Hollingsworth, Kansas Hospital Association
Gale Whitehair, Memorial Health System (H)
Heather Rouse, Sullivan County Memorial (CAH)
Karen Endicott-Coyan, Mercy Health Center (H)
Aileen Sigler, WPS Medicare

Meeting
The J5 Part A Provider Outreach and Education Advisory Group (POE AG) for Missouri and Kansas took place via teleconference on June 4, 2009. Aileen Sigler, Outreach Analyst, called the meeting to order at 10:00 a.m. Aileen began by reminding the group of the main purpose of the POE Advisory Group: to suggest training topics for future provider education. In addition to seminars, suggestions from the POE group can drive other educational activities such as "Ask the Contractor" (ACT) teleconference topics and Computer Based Training (CBT) subjects.

Suggested Seminar Topics

• Bi-annual or quarterly updates- coding, edits, Local Coverage Determinations (LCDs)

Suggested Seminar Locations

• No changes from February

Recommended Timeframes for Education

• No changes from February

Contractor Updates and Issues

• C-SNAP - Aileen informed the group about the benefits of using the CMS Secure Net Access Portal (C-SNAP), which is capable of accessing Medicare information, patient eligibility, and claim status information. It is available 24 hours a day 7 days a week at no cost.
• DDE Screen Changes - at this time, providers are unable to delete a line item within a claim. The functionality of the 'home' key is not working properly. Due to a FISS issue, the 'home' key is defaulting to the "SC" field instead of the "page" field. UPDATE: The Fiscal Intermediary Standard System (FISS) has created a workaround to delete lines on MAP1712 until the problem to the functionality of the 'home' key is corrected.

To delete a line on MAP1712:

1. Go to the revenue line you would like to delete.
2. Press the END key to remove the revenue code, and then press enter.
3. For providers that can not use the END key because the function is not mapped to their keyboard, press the DELETE key four times to remove the revenue code, then press enter.
4. Tab down to recalculate the 0001 total charge line and press PF9. The entire line will be deleted.

FISS will make the necessary corrections to the functionality of the 'home' key with an implementation date of July 6, 2009.

• Communiqué - June edition of the Communiqué is available on our Website. There is a lot of information contained in it.

Provider Education
We are in the planning stages for educational activities for the fourth quarter of Fiscal Year (FY) 2009. There will be 4 billing seminars for the J5 states of Missouri, Nebraska, Kansas, and Iowa. So far, a Critical Access Billing seminar has been planned for Des Moines, IA on August 27, 2009. Check the Education area of the Website for upcoming seminars and teleconferences. Contact the Outreach Analyst hosting the event for more information.

Member Issues
Q. Part B has had several Ask-the-Contractor Teleconferences (ACTs) on ambulance. At what point is Part A going to address education on ambulance?
A. There is no formal ambulance education planned at this time. If you have questions regarding ambulance billing, please contact our Customer Service area.

Q. Would it be possible to post encore versions of ACTs on the Part A Website?
A. Recordings of the J5 ACTs are posted to the WPS Medicare Website within the Training/Resources area.

Q. There is a lot of talk about Probe audits. What goals are set by WPS or CMS? What happens to a hospital if there are a lot of denials? If they have none or one, will they get off probes for a while? Do you have education on expected documentation?
A. The goal of the Medical Review program is to reduce the paid claim error rate by identifying and addressing billing errors concerning coverage and coding made by providers. When probe reviews verify that an error exists, the severity of the problem is assessed. We will then respond to the billing problem as appropriate and determine what steps need to be taken to correct the problem. There is a listing of suggested documentation to submit based on the service being reviewed. It is available on the WPS Medicare Website.

Q. Does your system have LCD and payment edits?
A. The FISS/DDE system has numerous edits in place for billing and coding errors based on CMS guidance as well as active LCDs.

Q. Are injections separately chargeable when given in the recovery room after a surgical procedure?
A. If the injection is an integral part of the procedure, it would not be separately payable, but part of the reimbursement for the procedure. If you have a specific example you would like us to look at, please contact our office.

Next Meeting
The next scheduled meeting will be held via teleconference on September 24, 2009 from 10:00-11:30 AM. This meeting will not take place if the National POE AG meeting is held at North Kansas City Hospital. Watch for more information.

Page Last Updated: Friday, 06-Nov-2009 14:04:54 CST