1. COB REMINDERS -Ask the patient questions to determine MSP status - Use the MSP questionnaire - Use resources to verify information provided matches information given by patient - Have beneficiary notify Benefits Coordination Recovery Center (BCRC) if MSP Questionnaire is inconsistent with CWF/HIQA

2. COB REMINDERS -Verifying MSP Status CMS Secure Net Access Portal (C-SNAP) Interactive Voice Response System (IVR) HIPPA Eligibility Transaction System (HETS) Common Working File (CWF) Health Insurance Query Access (HIQA)

3. COB REMINDERS - When to contact the BCRC To report employment changes, or any other insurance coverage information To report a liability, auto/no-fault, or workers’ compensation case To ask a general MSP question To ask a question regarding the MSP letters and questionnaires

4. COB REMINDERS - Steps to Assist a Provider in Updating MSP Records When beneficiary is in office - Can be made via telephone one time only - Subsequent updates must be made in writing: Fax or mail proof of information on the insurer or employer’s company letterhead, OR Contact the insurer or employer organization that last updated the record When beneficiary is NOT in office no update will be made from a phone call

5. COB REMINDERS - Provider update for deceased beneficiary - A SINGLE update can be made by ONE provider – subsequent updates need to be handled by a family member with documentation (death certification)

6. COB REMINDERS - Updating the Common Working File (CWF) - Contact the BCRC at the Customer Call Center 855.798.2627 - BCRC Webpage: https://www.cms.gov/Medicare/Coordination- of-Benefits-and-Recovery/Coordination-of- Benefits-and-Recovery-Overview/Coordination- of-Benefits/Coordination-of-Benefits.html https://www.cms.gov/Medicare/Coordination

7. COB REMINDERS - Fax: 405.869.3307 - Mailing Address: Medicare – MSP General Correspondence P.O. Box 138897 Oklahoma City, OK 73113-8897

8. JULY UPDATES Medicare Advantage

9. CARE IMPROVEMENT - There are no new updates.

10. UNITEDHEALTHCARE - Monthly Bulletin - Communication Effectiveness Survey(Pg. 3) - New prior authorization effective Oct. 1 st : L6026 (Pg. 5) - Evaluation & Management Reimbursement Policy will be published Sept. 2016 (Pg. 21) - MA plans will no longer cover non- emergentambulance trips from a physician’s office to SNF (Pg. 21) - Medical Policy Updates

11. HUMANA -Availity Humana is transition to Availity Web Portal for providers to check eligibility and benefits, submit referrals and authorizations, and manage claims. - Go to www.availity.com to register and obtain access.www.availity.com - Changes to Unauthorized Inpatient Stay https://www.humana.com/provider/medical- providers/education/whats-new/changes-to-unauthorized- inpatient-services - Compliance Requirements for Providers

12. AETNA - Quarterly newsletter http://www.aetna.com/healthcare- professionals/assets/documents/OLU-SE- June2016.pdf - Digital ID cards (Pg. 6) - Inpatient notification requirement reminder within 1 business day (Pg. 7) - Medicare Compliance Requirements (Pg. 11)

13. THANK YOU!!! - Email: Leanne_layne@yahoo.com Leanne_layne@yahoo.com - Phone: 706.318.5302