2018 CMS ITU Albuquerque, NM April 24, 2018.

2018 CMS ITU Albuquerque, NM April 24, 2018

Disclaimer All Current Procedural Terminology (CPT) only are copyright 2017 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable Federal Acquisition Regulation/ Defense Federal Acquisition Regulation (FARS/DFARS) Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. The information enclosed was current at the time it was presented. Medicare policy changes frequently; links to the source documents have been provided within the document for your reference. This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations. Although every reasonable effort has been made to assure the accuracy of the information within these pages, the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services. Novitas Solutions employees, agents, and staff make no representation, warranty, or guarantee that this compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide. This presentation is a general summary that explains certain aspects of the Medicare program, but is not a legal document. The official Medicare program provisions are contained in the relevant laws, regulations, and rulings. Novitas Solutions does not permit videotaping or audio recording of training events. Producer: We strive to ensure our learning materials are current at all times. This presentation is a general summary which explains certain aspects of the Medicare program, but is not a legal document. The official Medicare program provisions are contained in the relevant laws, regulations, and rulings. As always, we encourage you to join our list to ensure you receive up to the minute changes in the Medicare Program. NEXT SLIDE

Agenda Enrollment Reminders Revalidation Overview
Updates and Reminders for Part A and Part B Preventive Services Novitasphere Portal Novitasphere Portal Enrollment Steps Overview Medicare Secondary Payer (MSP) Medicare Credit Balance Reporting Overview Billing Errors for Part A and Part B Self-Service Options

Objectives Review Enrollment updates, reminders and revalidation overview Review updates and reminders for Part A and Part B Review Preventive services Review Novitasphere portal and enrollment guidelines Understand Medicare Secondary Payer (MSP), MSP Questionnaire (MSPQ) and Self-funded Review Credit Balance Understand how to avoid billing errors for Part A and Part B Review Self-Service options

Acronym List 1 Acronym Definition AIR All-Inclusive Rate BCRC
Benefits Coordination & Recovery Center CMS Centers for Medicare & Medicaid Services CPT Current Procedural Terminology CWF Common Working File DDE Direct Data Entry EDI Electronic Data Interchange EIDM Enterprise Identity Management FAQ Frequently Asked Questions FQHC Federally Qualified Health Centers

Acronym List 2 Acronym Definition IVR HCPCS
Healthcare Common Procedure Coding System ICD-10 International Classification of Diseases 10th Review IHS Indian Health Services IVR Interactive Voice Response (IVR) MAC Medicare Administrative Contractor MBI Medicare Beneficiary Identifier MLN Medicare Learning Network Connects NPPES National Plan and Provider Enumeration System NPI National Provider Identifier MSP Medicare Secondary Payer (MSP)

Acronym List 3 Acronym Definition MSPQ
Medicare Secondary Payer Questionnaire PECOS Provider Enrollment, Chain and Ownership System PTAN Provider Transaction Access Number QMB Qualified Medicare Beneficiary RA Remittance Advice RARC Remittance Advice Remark Codes PR Pulmonary Rehabilitation SSN Social Security Number

Enrollment Reminders

Enrollment Information
Must enroll prior to billing Medicare Must keep all information current 2018 Application Fee of $ must be paid prior to submitting the application: Fee applies to: IHS hospitals, FQHCs, Grandfathered FQHCs, ambulance, Ambulatory Surgical Center (ASCs) and Durable Medical Equipment(DME) suppliers There are two ways for providers/suppliers to submit or update their application: Internet-based PECOS Paper application IHS cover sheet must be completed if submitting paper forms

Provider Enrollment Requirements for Writing Prescriptions for Medicare Part D Drugs
Special Edition Article SE1434 (Revised) Key Points: Mandatory Medicare enrollment or have a valid Opt-Out Affidavit on file Applies to physicians and eligible professionals who write prescriptions for Part D drugs If not enrolled must submit enrollment applications CMS-855I, CMS-855O, or Opt-Out Affidavit: Delay in the Enforcement Date until February 1, 2017 Full Enforcement Date January 1, 2019 CMS Medicare Enrollment and Opt-Out file

Processing Timeframes-Internet-based PECOS Applications
Initial Enrollments, Revalidation, Reactivations: calendar days from receipt 80% of applications will be processed within calendar days Reassignments and Change Requests: 45-90 calendar days from receipt 90% of applications will be processed within 45 calendar days Processing timeframes will vary contingent upon the number of development requests and whether or not a site visit is required: To help avoid delays ensure all sections of the enrollment applications are completed and any supporting documentation is provided

Processing Timeframes- Paper Applications
Initial Enrollments, Revalidations and Reactivations: calendar days from receipt 80% of applications will be processed within calendar days Reassignments/Change Requests: calendar days from receipt 80% of applications will be processed within 60 calendar days Processing timeframes will vary contingent upon the number of development requests and whether or not a site visit is required: To help avoid delays ensure all sections of the enrollment applications are completed and any supporting documentation is provided

Timely Reporting of Provider Enrollment Information Changes
Special Edition Article SE1617 Key Points: All physician and non-physician practitioners and physician and non-physician organizations must report the following changes within 30 days: A change of ownership An adverse legal action A change in practice location All other changes must be reported to your MAC within 90 days of the change Changes can be reported via the Internet-based PECOS or the CMS 855 paper enrollment application

Using Internet-based PECOS
The most efficient way to submit your revalidation information is by using the Internet-based PECOS PECOS allows you to review information currently on file, update and submit your revalidation via the Internet IHS should choose the State of “Texas” You must either electronically sign the revalidation application or print, sign, date, and mail the paper certification statement to Novitas In addition, please either upload any supporting documentation into PECOS or mail it along with your paper certification statement Please do so IMMEDIATELY in order to avoid delays

Application Questionnaire – IHS Provider
Next question is asking if the applicant is an Indian Health Services (IHS) facility. For today’s group/clinic Part B example, we’re going to select “No” and then click on “Next Page”.

Revalidation Overview

Changes to Cycle 2 CMS has established due dates by which you must revalidate Unsolicited revalidation submissions will be returned Providers/suppliers who are within two months of their listed due dates, but have not received a revalidation notice are encouraged to submit their revalidation application Revalidation letters/notifications will be sent to at least 2 addresses on file (correspondence, special payments, and/or practice address) Non-response to revalidation or development requests will result in a hold on Medicare payments and deactivation of your enrollment Reactivation will occur when a complete application is received There will be a gap in coverage (no payments) between the date of deactivation and the receipt date of the new, completed application: Retroactive billing privileges back to the period of deactivation will not be granted

Due Dates in Cycle 2 CMS has established due dates for when you must revalidate: Due dates will always be on the last day of the month Posted due dates Revalidation due date displayed, if due within six months “TBD” (To Be Determined) displayed in the due date field for all other providers/suppliers Revalidation due date posted up to 6 months in advance to allow time for provider/supplier to comply No extensions of the due date Revalidation Notices sent via mail: Novitas Solutions will send a revalidation notice 2-3 months prior to your revalidation due date to at least two of your reported addresses: Correspondence, special payments and/or your primary practice address

Medicare Revalidation Lookup Tool – data.cms.gov/revalidation

Avoid Deactivation Avoid deactivation due to non-response:
Submit a complete revalidation application by your due date Respond to all development requests from Novitas within 30 days: Avoid a hold on your Medicare payments Avoid deactivation of your Medicare billing privileges Applications or additional requested information received after the due date will result in your provider enrollment record being deactivated

Deactivation: Non-Response to Revalidation
If you are deactivated due to non-response: Providers/suppliers deactivated will be required to: Submit a new full and complete application: In order to reestablish their provider enrollment record and related Medicare billing privileges The provider/supplier will maintain their original PTAN but: Interruption in billing will occur during the period of deactivation resulting in a gap in coverage Reactivation after a period of deactivation is based on the receipt date of the new full and complete application No retroactive billing privileges will be granted

Overview of the Enrollment/Revalidation Process
Submit a CMS-855 Medicare enrollment application by using internet-based PECOS, or by mailing a hardcopy application: Internet-based PECOS: Providers/suppliers must have an active NPI and have a web user account established in NPPES Physicians and non-physician practitioners will access internet-based PECOS with the same user ID and password that they use for NPPES Paper Applications: To enroll via paper, download the appropriate, current CMS-855 Medicare Enrollment Application Mail all hardcopy applications/supporting documents to the correct address depending on your location Use IHS Coversheet

Mailing Address For Revalidation
JH Providers Revalidation Mailing Address: Novitas JH Provider Enrollment Services P.O. Box Jacksonville, FL 32231

Provider Enrollment Status Inquiry Tool
Enrollment Status Tool

Further Details on the Revalidation of Provider Enrollment Information
Special Edition Article SE1605 Key Point: CMS has implemented several revalidation processing improvements included in this article

Updates and Reminders for Part A and B

2018 MAC Satisfaction Indicator (MSI) Survey
This survey measures your satisfaction with our processes and service delivery so we can gain valuable insights and determine process improvements: CFI Group is conducting the survey on behalf of CMS: Evaluate our services in 10 minutes Responses are kept confidential Provide your name, telephone number and address if you would like to be contacted about your survey responses Improvements based on 2017 MSI feedback: Added a "Was this page helpful?" interaction to all content pages Designed and debuted new information centers for Enrollment, Appeals and Claims Enhanced and expanded data provided by many of our self-service lookup tools MSI Survey JH The 2018 MAC Satisfaction Indicator (MSI) survey is available now. The MSI measures your satisfaction with our processes and service delivery so we can gain valuable insights and determine process improvements. CFI Group is conducting a survey on behalf of CMS: Evaluate our services in 10 minutes Responses are kept confidential Provide your name, telephone number and address if you would like to be contacted about your survey responses Here are some highlights of changes and enhancements we made to our website as a result of your feedback in 2017: Added a "Was this page helpful?" interaction to all content pages Designed and debuted new information centers for Enrollment, Appeals and Claims Enhanced and expanded data provided by many of our self-service lookup tools Watch our website and eNews listserv for more details on how you can participate Follow the links provided to participate in the survey JH Providers: JL Providers:

Removal of Social Security Numbers
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019: Medicare Beneficiary Identifier (MBI) will replace the SSN-based current Medicare Number on the new Medicare cards Initiative will help prevent fraud: Fight identity theft Protect private healthcare Protect financial information The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires us to remove Social Security Numbers (SSNs) from all Medicare cards by April So by the end of April you will no longer see the very familiar Medicare card as shown in the lower right corner of your screen. A new randomly generated Medicare Beneficiary Identifier, known as the MBI, will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. This will include the Medicare Advantage plan beneficiaries, original Medicare beneficiaries, and the Railroad Retirement beneficiaries. The HICN will still be assigned to each beneficiary for internal data exchanges between CMS and the states but the MBI will need to be used for all interactions with the beneficiary, providers and all external partners. No earlier than April 2018, CMS will start sending the new Medicare cards with the new MBI to all people with Medicare, which is roughly 60 million beneficiaries. This should be completed by April 2019. The main reason the SSN is being removed from the Medicare cards is to fight medical identity theft and prevent fraud. By replacing the SSN-based HICN on all Medicare cards we can better protect private health care and financial information as well as Federal health care benefits and service payments. It also minimizes burdens for beneficiaries and providers. .

New Medicare Card MBI characteristics:
Same number of characters as the current Medicare Number (11) Contains uppercase alphabetic and numeric characters Occupy the same field as the current Medicare Number on transactions Be unique to each beneficiary (e.g. husband and wife will have their own MBI) Be easy to read: Alphabetic characters upper case only and will exclude S, L, O, I, B, Z Not contain any embedded intelligence or special characters Not contain inappropriate combinations of numbers or strings that may be offensive The new card will have the same number of characters as the current HICN but will be visibly distinguishable from the HICN. It contains uppercase alphabetic and numeric characters throughout the 11 digit identifier. The MBI will occupy the same field as the HICN on transactions, it will be unique to each beneficiary (e.g. husband and wife will have their own MBI). It will be easy to read and limit the possibility of letters being interpreted as numbers (e.g. S, L, O, I, B, Z. All alphabetic characters will be upper case only. The MBI will not contain any embedded intelligence or special characters, and will not contain inappropriate combinations of numbers or strings that may be offensive.

MBI Format Position 1, 4, 7, 10, and 11 will always be a number (0-9)
Position 2, 5, 8, and 9 will always be a letter (A-Z): Exclusions: S, L, O, I, B, Z Position 3 and 6 will be a letter or a number: Position 1, 4, 7, 10, and 11 will always be a number (0-9) Position 2, 5, 8, and 9 will always be a letter (A-Z) except for those exclusions, ( S, L, O, I, B, Z). Position 3 and 6 will be a letter or a number with the exception of the exclusions. The example on the slide shows what the current SSN based number looks like on the top line and what the new MBI looks like underneath. As you can see in the comparison the MBI is clearly different than the HICN.

MBI New Design New Medicare card: Health and Human Services (HHS) logo
Gender and signature line removed CMS unveiled the new card in a press release and this was everyone’s first look at the newly designed Medicare card. This card will be sent out to all people with Medicare who are actively enrolled or new. Some things I would like to point out with the new card are, notice the Health and Human Services (HHS) logo in the top left corner (use pointer to logo). The railroad retirees Medicare cards will look the same except for the logo which we will look at on the next slide. This cards shows the HHS logo. The new card will maintain the red, white and blue palette and will be printed on white paper. It is a little smaller in size than the traditional card and will match the size of a standard credit card. Keep in mind the new MBI is confidential like the SSNs and should be protected as Personally Identifiable Information. Notice the dashes within the MBI, they aren't used as part of the MBI and wont be entered into computer systems or used in file formats. Also notice there is no gender information provided and the signature line, as on the traditional cards, is eliminated. I also wanted to mention CMS anticipates that the MBI number will not be changed for individuals unless that MBI is compromised or other limited circumstances which are still undergoing review.

New Medicare Card Mailing Waves
These mailings will follow the sequence outlined in this table. Additional details on timing will be available as the mailings progress. Starting in April 2018, people with Medicare will be able to check the status of card mailings in their area on Medicare.gov. FYI speaker: This information has been added to the CMS New Medicare Card homepage as of Jan 2018:

During Transition Period
Beginning October 2018 through transition period: When submitting claim using the current Medicare Number : Both the current Medicare Number and MBI will be returned on remittance advice MBI will be in same place you currently get the changed current Medicare Number : 835 Loop 2100, Segment NM1 (corrected Patient/Insured Name) Field NM109 (Identification Code) Message field on eligibility transaction responses will indicate when new Medicare card has been mailed to each person The current Medicare Number and MBI for the same patient in same batch of claims: During the transition period: All claims with either the current Medicare Number and MBI can be in the same batch During the transition period, we’ll return the same beneficiary identifier to you that you submitted on the incoming transaction/claim. Beginning in October 2018 through the end of the transition period, when providers submit a claim using the patient’s HICN, Novitas and other contractors will return both the HICN and the MBI on remittance advices. The MBI will be in the same place you currently get the “changed HICN”: Navigator: Outline the 835 bullet. It’s the 835 Loop 2100, Segment NM1 (Corrected Patient/Insured Name), Field NM109 (Identification Code) Now if you are checking eligibility through the 270 eligibility transaction request during the transition period, beginning in April 2018 if you submit an HICN we’ll tell you in the message field on the 271 response when we’ve mailed a new Medicare card to each individual with Medicare. The message will say, ‘CMS mailed a Medicare card with a new Medicare Beneficiary Identifier (MBI) to this beneficiary, Medicare providers please get the new MBI from your patient and save it in you systems’. Beginning on January 1, 2020 you must use the MBI to get a valid eligibility response. Your eligibility service provider can give you that information so you’ll want to be sure to follow-up with them on that. You can also submit either an HICN or MBI through the common working file (CWF) or HETS eligibility transaction request to get eligibility information through December 31, January 1, 2020 you muse use the MBI to get a valid eligibility response. CMS is encouraging the provider community to start using the MBIs as soon as possible even though systems will accept either the MBI or the HICN interchangeably during the transition period. Please keep in mind that once CMS starts mailing out new Medicare cards, people new to Medicare for the first time will only be assigned an MBI. That’s why your systems must be ready to accept the MBI by April 2018. One last thing, during the transition period the use of the HICN and MBI for the same patient on the same batch of claims will be accepted and processed. So, we will accept all claims with either the HICN or MBI, even when both are in the same batch.

Novitasphere Secure free Web-based portal Part B:
Access to Eligibility, Claim Information and Remittance Advice, Claim Submission with File Status, Electronic Remittance Advice (ERA), Claim Correction, Secure Messaging and a MailBox Novitasphere MBI Lookup Coming June 2018 Live Chat feature Dedicated Help Desk For demonstrations and more information

After Transition Period
January 1, 2020 use MBIs on your claims Exceptions for Fee-for-Service claims: For appeals: Either the current Medicare Number or MBI for appeals and related forms For claim status query: Either the current Medicare Number or MBI if the earliest date of service is before January 1, 2020 Status of dates of service after January 1, 2020 you have to use the MBI Lets talk about those limited exceptions after the transition period. On January 1, 2020, even for dates of services prior to this date, you must use MBIs for all transactions. The exceptions when you can use either the HICN or MBI for Fee-for-service claims, on Appeals – You can use either the HICN or MBI for claim appeals and related forms. For Claim status query – You can use HICNs or MBIs to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, If you are checking the status of a claim with a date of service on or after January 1, 2020, you must use the MBI.

Medicaid and Supplemental Insurers
CMS will provide State Medicaid Agencies and supplemental insurers MBIs for Medicaid eligible people who also have Medicare Crossover claims: During transition period either the current Medicare Number or MBI is accepted Supplemental insurer: During transition period: Continue using your unique numbers After transition period: Use MBI where the current Medicare Number would have been used What about Medicaid and supplemental insurers? CMS will give State Medicaid Agencies and supplemental insurers the MBIs for Medicaid-eligible people who also have Medicare before they mail out the new Medicare cards. During the transition period, we will process and transmit Medicare crossover claims with either the HICN or MBI. For non-Medicare business, private payers won’t have to use the MBI. If you are a supplemental insurer, CMS will continue to use your unique numbers to identify your customers, but after the transition period, you must use the MBI for any Medicare transactions where you would have used the HICN.

More CMS Products Poster Tear off pad Product ordering CMS Flyer

Get Ready for the New MBI
Patient may not get a new card if their address with SSA is not correct Verify your patients addresses: If the address you have on file is different than the address you get in electronic eligibility transaction responses, ask your patients to contact Social Security and update their Medicare records This may require to verify and correct address Beneficiaries contact: Social Security: Railroad Retirement Board: Another thing you may want to do for your patients is to verify your Medicare patients’ addresses. They won’t get a new card if their address isn’t correct with SSA. If the address you have on file is different than the address you get in electronic eligibility transaction responses from us, encourage your Medicare patients to correct their address in Medicare’s records by either: Calling Social Security at , or going online to their online account at For your patients who qualify for Medicare under the RRB Calling the RRB at So this effort to verify the patients addresses may require coordination between your billing and office staff.

Be Prepared Participate in CMS quarterly open door forums
Sign up for weekly MLN Connects® newsletter Obtain technical information from your regular communication channels Test your systems Work with your billing office staff to be sure you are ready for the new MBI format CMS’ new Medicare card website CMS will provide outreach and education to approximately 60 million beneficiaries, their agents, advocacy groups and caregivers, also Health Plans, the provider community which consists of approximately 1.5M providers, States and territories, as well as key stakeholders, vendors & other partners. Be prepared and stay informed by attending CMS’ Open Door Forums, Sign up for weekly MLN Connects® newsletter, you’ll receive those notifications. Obtain technical information from your regular communication channels and test your system changes. Moving to new Medicare numbers and cards requires a lot of changes to our systems and how we do business. The same is true for you -- our business partners. Work with your billing office staff, clearinghouse, or vendor, to be sure you are ready for the new MBI format. Bookmark and check the CMS new Medicare card website for updated information regularly. And we’ve provided that direct link on the screen. Novitas will also be conducting education such as the webinar you are attending today so that you are prepared for the new MBI and you can receive any updates through our mailing list and information on our website. Lastly,

Medicare Deductible, Coinsurance and Premium Rates for 2018
MM10405: Effective: January 1, 2018 Implementation: January 2, 2018 Key Points: 2018 Part A – Hospital Insurance: Deductible: $1,340.00 Coinsurance: $ a day for 61st-90th day $ a day for 91st-150th day (lifetime reserve days) $ a day for 21st-100th day (Skilled Nursing Facility coinsurance) 2018 Part B –Medical Insurance: Deductible: $ a year Coinsurance: 20 percent PART A/B Change Request (CR) provides instruction for MACs to update the claims processing system with the new Calendar Year (CY) 2017 Medicare deductible, coinsurance, and premium rates. Make sure your billing staffs are aware of these changes. 2018 PART A - HOSPITAL INSURANCE (HI) • Deductible: $1,340.00 • Coinsurance $ a day for 61st-90th day $ a day for 91st-150th day (lifetime reserve days) $ a day for 21st-100th day (Skilled Nursing Facility coinsurance) $ a month • Base Premium (BP): $ a month • BP with 10% surcharge: $ a month • BP with 45% reduction: $ a month (for those who have quarters of coverage) 2018 PART B - SUPPLEMENTARY MEDICAL INSURANCE (SMI) • : $ a month • : $ a year • o $ st month • BP with 45% reduction and 10% surcharge Standard Premium Deductible Pro Rata Data Amount o $ nd month • Coinsurance: 20 percent

2018 Indian Health Services (IHS) Hospital Payment Rates
Each year the new rates are published in the Federal Register CMS must issue a Change Request (CR) in order for Novitas to implement the new rates. CR 10511: Effective: January 1, 2018 Implemented: April 1, 2018 Lower 48 States CY 2017 CY 2018 Outpatient AIR $349 $383 Inpatient Ancillary $679 $740 Alaska CY 2017 CY 2018 Outpatient AIR $577 $595 Inpatient Ancillary $1,046 $1,061

Sequestration Reminder
Mandatory Payment Reduction of 2% continues until further notice for the Medicare Fee For Service Program Payment reduction FAQs

Pulmonary Rehabilitation (PR) Services Addition to Chapter 19, Indian Health Services (IHS)
MM10276: Effective: For dates of service on or after January 1, 2010 Implementation: April 2, 2018 Key Points: Patients with chronic respiratory impairment Evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities: Individually tailored and designed to optimize physical and social performance and autonomy Mandatory components: Physician-prescribed exercise Education or training Psychosocial assessment Outcomes assessment An individualized treatment plan R is a multi-disciplinary program of care for patients with chronic respiratory impairment. It is an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities; and is individually tailored and designed to optimize physical and social performance and autonomy. The Medicare Improvements for Providers and Patients Act of 2008 (MIPPA) added payment and coverage improvements for patients with chronic obstructive pulmonary disease and other conditions, and now provides a covered benefit for a comprehensive PR program under Medicare Part B effective January 1, This law provides a single PR program, which was codified in the Medicare Physician Fee Schedule (MPFS) final rule at 42 Code of Federal Regulation (CFR) , which you can find at. CR10276 provides that, effective January 1, 2010, MIPPA provisions added a physician–supervised, comprehensive PR program, which includes the following mandatory components: Physician-prescribed exercise Education or training Psychosocial assessment Outcomes assessment An individualized treatment plan As specified at 42 CFR (f), pulmonary rehabilitation program sessions are limited to a maximum of two (2) one (1)-hour sessions per day for up to 36 sessions, with the option for an additional 36 sessions if medically necessary. Effective January 1, 2010, IHS providers are paid, for PR services, separately from the All Inclusive Rate (AIR). Your MACs will pay IHS claims for PR services containing HCPCS code G0424 and revenue code 0948 (Pulmonary Rehabilitation Services) on Types of Bill (TOB) 12X (Hospital Inpatient Part B) and 13X (Hospital Outpatient) under the Medicare Physician Fee Schedule (MPFS), and TOB 85X (Critical Access Hospital Outpatient) based on reasonable cost. These services are paid separately from the All Inclusive Rate. MACs will accept the inclusion of the KX modifier on the IHS claim lines as an attestation that further treatment beyond the 36 sessions is medically necessary up to a total of 72 sessions for a beneficiary. PR services may be billed on IHS claims with or without a clinic visit. MACs will deny your PR claims that exceed 72 sessions.

Pulmonary Rehabilitation Guidelines
PR Billing Guidelines PR services will be reimbursed separately from the AIR HCPCS code G0424 and revenue code 0948 (Pulmonary Rehabilitation Services): Types of Bill (TOB) 12X (Hospital Inpatient Part B) and 13X (Hospital Outpatient) under the Medicare Physician Fee Schedule (MPFS) TOB 85X (Critical Access Hospital Outpatient) based on reasonable cost PR sessions are limited to a maximum: Two (2) one (1)-hour sessions per day for up to 36 sessions, with the option for an additional 36 sessions, if medically necessary KX modifier on the IHS claim lines is an attestation that further treatment beyond the 36 sessions is medically necessary up to a total of 72 sessions for a beneficiary: Claims that exceed 72 sessions will be denied Can be billed with or without a clinic visit

1500 Claim Form Editing of Always Therapy Services
MM10176: Effective: January 1, 2018 Implementation: January 2, 2018 Key Points: During analyses of Medicare claims data for Out Patient Therapy (OPT) services, revealed these “always therapy” codes and modifiers are not always used in a correct and consistent manner CMS revealed OPT professional claims for “always therapy” codes without the required modifiers; and, claims that reported more than one therapy modifier for the same therapy service; e.g., both a GP and GO modifier, when only one modifier is allowed The contractor shall return/reject claims which contain an "always therapy" procedures that does not also contain the appropriate "always therapy" modifier of GN, GO, or GP Part B During analyses of Medicare claims data for OPT services, the Centers for Medicare & Medicaid Services (CMS) has found that these “always therapy” codes and modifiers are not always used in a correct and consistent manner. CMS found OPT professional claims for “always therapy” codes without the required modifiers; and, claims that reported more than one therapy modifier for the same therapy service; e.g., both a GP and GO modifier, when only one modifier is allowed.

Therapy Cap Values for Calendar Year (CY) 2018
MM10341: Effective: January 1, 2018 Implementation: January 2, 2018 Key Points: Outpatient therapy limits for: Physical Therapy (PT) and Speech-Language Pathology (SLP) combined is $2,010.00 Occupational Therapy (OT) is $ 2,010.00 Part B - JH Key Points: The allowed dollar amount for CY 2017 outpatient therapy limits for PT and SLP combined is $1980 OT is $1980 SPEAKER NOTE: This is a $20 increase from CY 2016.

Elimination of the GT Modifier for Telehealth Services
MM10152: Effective: January 1, 2018 Implementation: January 2, 2018 Key Points: The requirement to use the GT modifier on professional claims for telehealth services has been eliminate The use of telehealth Place of Service (POS) code 02 certifies that the service meets the telehealth requirements The GQ modifier is still required when applicable CMS Telehealth page

Sleep Studies Guidelines
Sleep studies are continuous and simultaneous monitoring and recording of various parameters of sleep for six or more hours with physician review, interpretation and report Sleep studies are performed to diagnose a variety of sleep disorders Sleep disorder testing must meet the indications that are defined in Novitas Local Coverage Determination (LCD), L35050 Outpatient Sleep Studies: LCD 35050

Additional Sleep Study Guidelines
Billing Sleep Studies: If all of the requirements are met: The AIR can be billed on the UB-04 The interpretation if not included in the testing codes can be billed on the 1500 Claim form FAQs Diagnostic Testing for Sleep Disorders: National Coverage Determination (NCD) for Sleep Testing for Obstructive Sleep Apnea (OSA) ( )

Electronic Remittance Advice (ERA) Tips
ERA is generated 14 days from the date the file was submitted, and is available to retrieve for 45 days The EDI department can reset an ERA within those 45 days Save you ERA where you can easily locate it in the future if necessary, and maintain ERAs until accounts are reconciled ERA files can be translated to a readable format: Existing claim software Medicare Remit Easy Print (MREP) PC Print ABILITY | PC-ACE Retrieve ERAs each day Novitas offers training modules to help you successfully retrieve and read your ERA files: Part A Part B

Preventive Services

Quick Reference Chart for Medicare Preventive Services
Interactive educational preventive services tool provides: Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT codes) ICD-10 diagnosis codes Coverage requirements Frequency requirements Patient liability Quick Reference Chart for Medicare Preventive Services

Quick Reference Chart

How Do Providers Verify Preventive Services?
Novitasphere HIPAA Eligibility Transaction System (HETS) IVR – Select option 2, then option 3 and provide procedure code: You will receive patient’s next eligible technical and professional date No preventive information will be returned: If the code provided is not a preventive service If there is no information available for that service If the patient is not eligible for that service (male patient for pap test) IVR Guide Part A & B Providers: Novitasphere HIPAA Eligibility Transaction System (HETS) Links for JH & JL Providers:

Part B Replacement of Mammography Codes, Waiver of Coinsurance and Deductible, and Addition of Anesthesia and Prolong Services MM10181: Effective: January 1, 2018 Implementation: January 2, 2018 Key Points: Replacement of Mammography HCPCS codes G0202, G0204, and G0206 with CPT codes 77067, 77066, and 77065 Ultrasound, abdominal aorta CPT is replacing HCPCS G0389 and coinsurance and deductible waived Deductible and coinsurance will be waived for new CPT code 00812: Deductible will be waived for new CPT code when submitted with the PT modifier PT modifier – Colorectal cancer screening test; converted to diagnostic test or other procedure Prolonged preventive services will be payable when billed as add-on to applicable preventive service and deductible and coinsurance will be waived Part A and B Effective January 1, 2018: Replacement of Mammography HCPCS codes G0202, G0204, and G0206 with CPT codes 77067, 77066, and 77065 So effective for claims with dates of service 1/1/2017 through December 31, 2017 report HCPCS codes G0202, G0204, and G0206. For claims with dates of service on or after January 1, 2018 report CPT codes 77067, and respectively. 77067 – screening mammography, bilateral (2-view study of each breast), including CAD when performed 77066-diagnostic mammography, including CAD when performed; bilateral diagnostic mammography, including CAD when performed unilateral Speaking of waiving the deductible and coinsurance for Ultrasound, abdominal aorta CPT which is replacing HCPCS code G0389. Another item waived from the deductible and coinsurance is a new CPT code when submitted with PT modifier: The definition of CPT – Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy PT modifier is defined as – Colorectal cancer screening test; converted to diagnostic test or other procedure So anesthesia services furnished in conjunction with and in support of colorectal cancer screening services will be waived from the deductible and coinsurance. Another item where the deductible and coinsurance will be waived is Prolonged preventive services. Prolonged services will be payable when billed as add-on to covered preventive services and the deductible and coinsurance will be waived. The language and policy referred to in this Change Report are included in Chapter 18, Sections 20 and 240 (new) of the Medicare Claims Processing Manual. Current Procedural Terminology (CPT) only copyright 2017 American Medical Association. All rights reserved.

Medicare Diabetes Prevention Program (MDPP) Enrollment
Change Request (CR) 10356: Effective: January 1, 2018 Implementation: January 19, 2018 Key Points: Entities may enroll as an MDPP supplier May have preliminary or full recognition as determined by the Center for Disease Control and Prevention (CDC) and Diabetes Prevention Recognition Program (DPRP) Must have valid tax identification number (TIN) and National Provider Identifier (NPI) New and specific form CMS is forthcoming MDPP is an additional Preventive Service and will be paid using the Part B Trust Fund. CMS MDPP page On November 2, 2017, the Centers for Medicare & Medicaid Services issued the Calendar Year (CY) 2018 Physician Fee Schedule (PFS) final rule, which finalizes policies to implement the Medicare Diabetes Prevention Program (MDPP) expanded model starting in The expanded model is a structured intervention with the goal of preventing progression of type II diabetes in individuals with an indication of pre-diabetes. The CY 2018 PFS includes the MDPP payment structure as well as enrollment requirements and supplier compliance standards. The effective date for furnishing services is April 1, 2018. MDPP suppliers may begin enrolling on January 1, 2018, through a new MDPP-specific enrollment application, which will be available prior to January 1, Screening individuals that will be furnishing the MDPP services will be identified as coaches on the MDPP-specific form.

Novitasphere Portal

Novitasphere Secure free Web-based portal Part A: Part B:
Access to Eligibility, Medical Review Record Submission, Claim Submission with File Status, and Audit and Reimbursement Cost Reports Submission Part B: Access to Eligibility, Claim Information and Remittance Advice, Claim Submission with File Status, Electronic Remittance Advice (ERA), Claim Correction, Secure Messaging and a MailBox Novitasphere MBI Lookup Coming June 2018 Live Chat feature Dedicated Help Desk For demonstrations and more information

Eligibility Information
Part A and B Eligibility Effective and Termination Dates End Stage Renal Disease (ESRD) dates and information Deductible Part B Total Deductible Remaining for Calendar year Occupational, Physical and Speech Therapy amounts applied to the capitation limits Rehabilitation Session counts Medicare Advantage Plan (MAP) Contract Name, Number, Address and Telephone Number Type of Medicare Advantage Plan The Bill Option code of the Plan type Effective and Termination Dates Medicare Secondary Payer (MSP) The reason Medicare is secondary Name of Insurance Company and Address Hospice/Home Health Certification codes and dates Home Health Episode Start and End Dates Home Health Episode termination date Provider NPI Number of the Home Health Facility Preventive Services Number of Smoking Sessions remaining Preventive Service Procedure Code Preventive Technical and Professional Dates Deductible Applied for the Calendar Year Deductible Remaining for the Calendar Year Coinsurance Remaining for the Calendar Year Inpatient Date of earliest and latest billing activity for the spell of illness Hospital Information Skilled Nursing Facility Information QMB QMB Effective and Termination Dates QMB Deductible and Coinsurance Remaining QMB Inpatient Spell, Hospital Information and SNF Information The Eligibility feature offers the following information: Eligibility, Medicare Advantage Plan (MAP), Medicare Secondary Payer (MSP), Hospice/Home Health, Preventive Services, Inpatient and Qualified Medicare Beneficiary (QMB) information. Again, you will be able to click on each of the blue tabs to view the data returned. If the tab is grey, then there is no information returned from HETS for that tab and you’ll be unable to open it. ***We don’t need to read this all to the attendees***

Benefits & Eligibility Page (HETS)
Choose the Eligibility Feature on the left. This Eligibility feature actually interfaces directly with the CMS HIPAA Eligibility Transaction System (HETS) system. Complete the designated fields, at a minimum the fields with a red * are required. You may also select the specific beneficiary data you want to retrieve from the “Types of Data” drop down menu, then click submit. Eligibility information specific to this Beneficiary will be displayed as shown on the next slide.

Beneficiary Tab

Eligibility Tab

Medicare Advantage Plan (MAP) Tab

Medicare Secondary Payer (MSP) Tab

Novitasphere Portal Enrollment Steps Overview

Enrollment Three Basic Steps
Complete the Novitasphere Portal Enrollment form Register for Enterprise Identity Management (EIDM) User ID and password Register Novitasphere role in EIDM: Register a Multi-Factor Authentication (MFA) Device To gain access to the Novitasphere portal, the following items must be completed. Novitasphere Enrollment form: Only one form needs to be completed per office Register for a Enterprise Identity Management (EIDM) user ID and password: Will receive an acknowledging a successful registration Once that you are registered, you will go back into EIDM and register your role Registering a Multi-Factor Authentication (MFA) Device: Will be required to enter a security code at login

Roles and Responsibilities
Office Approver (OA) Does not have to be the Provider/Owner Office Back-up Approver (OBA) End User Has access to all features Must be listed as the OA on the EDI Portal Enrollment form Must be listed as the OBA on the EDI Portal Enrollment form Should NOT be listed on the EDI Portal Enrollment form Responsible for creating the Organization in EIDM Will enroll in EIDM after the OA has been approved Responsible for approving all End Users access request Access is granted by the OA or OBA Responsible for certifying all End User access annually Annual Certification completed by OA/OBA Here are the roles and responsibilities: (Pilot/flight attendant) Everyone will have access to all the features within the portal. The OA – must be listed as the OA on the enrollment form. Only one enrollment form needs to be completed for the office. The OA will also be responsible for creating the organization in the EIDM system They will approve all End Users access request Responsible for certifying all End User access annually You do not have to be the provider or owner to be the OA. The Back-Up Approver or (OBA) Must also be listed on the EDI enrollment form as the OBA They also are responsible for approving all End Users access request They do not have to be the provider or owner of the office to be the OBA The OBA will enroll in EIDM after the OA has already been approved. End Users: Should not be listed on the EDI portal enrollment form They will enroll in EIDM after the OA has been approved End Users can only gain access once the OA or OBA has approved and grated them access.

Novitas-Solutions Homepage
ASK HOST TO OPEN UP Q&A’s This is a screenshot of the Novitas Solutions homepage. Both sides of our website have the Novitasphere Portal center link on the left navigation bar. It’s important that you are accessing the Novitasphere link under the appropriate jurisdiction because the forms for both JL and JH are state specific.

Medicare Secondary Payer (MSP)

MSP Coverage primary to Medicare: Novitas MSP Resource
Working aged Disability Worker’s Compensation End Stage Renal Disease Black Lung Various Federal programs Automobile Insurance Novitas MSP Resource Medicare Secondary Payer Fact Sheet

Updating Information with the Benefits Coordination & Recovery Center (BCRC)
Special Edition Article SE1416 Key Points: New MSP initiative will affect how you may update beneficiary information to the BCRC Article describes initiatives that both CMS and the BCRC are undertaking to maintain the most up-to-date and accurate beneficiary MSP information on Medicare's CWF Make sure that appropriate staff is aware of these options for updating a beneficiary’s MSP information and that they are aware of new contact information at the end of this article for the BCRC

Part A MSPQ MSPQ is required for every: Six part model Use in sequence
Inpatient admission Outpatient encounter Six part model Use in sequence Retain questionnaire for 10 years after date of service Medicare Questionnaire can be located in Chapter 3, Section

Part A MSPQ FAQs Question: Answer:
Does the patient have to sign the MSPQ every time? Answer: No. Patient signature is not a requirement Can I file a claim if we forgot to get the MSPQ completed? Yes. However, processes must be in place to obtain the information when required. CMS can request to see the MSPQ on a patient’s date of service for 10 years

Tribal Self-Funded Insurance
Medicare’s systems cannot distinguish self-insurance from third-party insurance: This does not affect claims processing or payment; however, CMS’ BCRC may later include IHS provider claims in a demand for repayment The tribe’s self-insurance is a valid defense against the inclusion of such claims; to assert this defense: The tribe must provide the BCRC with documented proof that it was self-insured at the time the IHS facility provided the relevant services Upon receiving the appropriate documentation, the BCRC will remove the IHS provider claims from the debt Instructions on billing Self-Funded claims or submitting adjustments 75

Tribal Self-Funded Insurance Tips
Claim must be filed to Novitas Claim must be submitted as a secondary claim: Part A: Can be submitted via DDE, Novitasphere and/or ABILITY | PC-ACE (Free Medicare Billing Software): Can be processed initially: No denial would be required If a denial is received submit the appropriate adjustment form: If provider has DDE, adjustment can be done through the DDE system The complete Internal Claim Number is required: Part A must include “TXA” at the end of the number (paper adjustments only) Part B: Can be submitted via Novitasphere and/or ABILITY | PC-ACE (Free Medicare Billing Software): Can be process initially: If a denial is received submit the appropriate adjustment form

Medicare Credit Balance Reporting Overview

What is a Medicare Credit Balance?
Overpayments for Medicare services Duplicate payments Payment received for services not performed Payment received for non-covered services Payment received for outpatient services that should have been bundled to inpatient Overpayment due to deductible or coinsurance miscalculations Only the credit balances still outstanding as of the last day of the quarter should be reported on the Medicare Credit Balance Report Do NOT submit duplicative credit balances: If the voided or adjusted claim has completed/finalized (does not include a suspended claim) by the end of the quarter, do not include it in the Medicare Credit Balance Report If the void or adjustment hasn’t completed by the end of the quarter provider must include credit on the Medicare Credit Balance Report Novitas will check the system to verify the provider initiated adjustment has finalized prior to adjusting the claim

Importance of CMS-838 Form and How to Locate
Provider determines a credit is due to Medicare for an overpayment Medicare credit balances include money due to the Medicare program regardless of its classification in a provider’s accounting records JH Home Page Click on the Forms Center: In the Forms Catalog, you will find the Financial & Overpayment /Refund Forms section Scroll down to the form “Medicare Credit Balance Certification (CMS-838)” CMS-838 Form

Medicare Credit Balance Report Due Dates
Quarter End Medicare Credit Balance Report Due Warning Letter Mailed Placed on 100% Payment Withhold March 31 April 30 May 15 June 03 June 30 July 30 August 15 September 03 September 30 October 30 November 15 December 03 December 31 January 30 February 15 March 03

No Medicare Credit Balance to Report
If your credit balance amount is ZERO at the end of the quarter: Required to sign, date and return the Medicare Credit Balance Report Certification Page Medicare Credit Balance Report Certification Page must be faxed

Medicare Credit Balance Paid by Check
All Providers: Novitas Solutions, Inc. Attn: Cashier 2020 Technology Parkway, Suite 100 Mechanicsburg, PA 17050 One check per Credit Balance Report

Payment Withhold Provider will be placed under 100% payment withhold if a required acceptable Medicare Credit Balance Report, including certification page, is not received by the deadline date If your facility is placed under 100% payment withhold submit an acceptable CMS-838 form immediately Fax Medicare Credit Balance Report or certification page: Fax Number: Attention: Credit Balance

Medicare Credit Balance Report CMS-838 Form Page 1
Remind audience that the signature is certified , true, correct and correct.

Certification Page Must be signed and dated by an officer (Chief Financial Officer or Chief Executive Officer) or the administrator of the facility One of the following must be checked: Signature attests provider qualifies as a low utilization provider Detail page or pages are included Signature attests there are NO Medicare Credit Balances in the provider records for the reporting quarter Provide a contact name and phone number: Point of contact should be someone who can provide assistance with processing/completion of the claim 6 digit provider number

Medicare Credit Balance Report CMS-838 Form Page 2

Can You File Electronically?
Medicare Credit Balance Report cannot be ed or submitted online You may: Preferred method of submission: Fax ALL Medicare Credit Balance Reports and certification pages: Except Credit Balance Report being paid by check Fax Number: : Attention: Credit Balance Submit diskette or Compact Disc Read Only Memory (CD-ROM) Mail report through United States Postal Service (USPS) Mail report through Courier (FedEx/UPS)

Credit Balance Reminders
Medicare Credit Balance Report and the certification page can be faxed Faxing is the preferred method of submission When submitting a check it is imperative to include a copy of the check with the Medicare Credit Balance Report: Don’t forget to include a corrected UB-04 One check per Credit Balance Report Submit both the check and the Medicare Credit Balance Report to the cashier at the following address: Novitas Solutions, Inc. Attention: Cashier 2020 Technology Parkway, Suite 100 Mechanicsburg, PA 17050

IHS Billing Errors for Part A and Part B

Billing Errors Billing errors: Part A Part B

Self-Services Options

Novitas Solutions Website

Website Novitas website Separates content based on line of business:
Medicare Part A-Hospital and other facilities Medicare Part B- Physician and other health professionals

Customized Content Selection: Part A or B
After you have chosen your Jurisdiction from our Home Page, you will be given the option to choose your line of business. This selection allows us to customize content for you, and should be remembered indefinitely until you decide to change it. If you continue to get the pop-up asking you to select your preference, and then please enable "cookies" in your web browser for this feature to be remembered. If you have questions about how our organization uses "cookies", please view our Privacy Policy available at the bottom of any page.

Home Page

Part A Centers on the Novitas Solutions Website
Home Novitasphere Portal Appeals CERT Claims Contact Us Cost Reporting Education Center Electronic Billing - EDI Enrollment Evaluation & Management Frequently Asked Questions (FAQs) Fee Schedules Forms IHS/Urban/Tribal Providers (JH only) IVR Join Our Lists Medical Policy / LCDs Medical Review Publications Self-Service Tools Specialties/Services The 22 Centers are listed in the order of the left-navigation bar on the website. Introduce the center names and their main page – hover over the center to show the fly-out windows Appeals Center: demo the Appeals status inquiry tool, Timeframes calculator, Redetermination Request, Reopening Request Appeals vs CER - It has come to our attention that both Part A and Part B - providers are not aware of the difference between an appeal vs a CER (using the Medicare Part A Redetermination and Clerical Error Reopening Request Form (Form 1000).) Part A - one of the biggest issues is providers submitting claims for a Clerical Error Reopening (CER) when they can make the corrections themselves (i.e. deleting lines (they can cancel and rebill) or wanting to add line items (we cannot do this, they are required to adjust and add the line or cancel the claim and rebill a new one) if the provider does this on their own the claim will be reprocessed within days, CER takes up to 60 days. Additional info on our website: Article: “Late or Omitted Charges – Not acceptable for Clerical Error Reopening Requests” at OR CERT- (review the template information contained in the handout) Slide #27 (see handout) Claims - New look to the Main Landing Page! Others to follow! New Credit Balance section. Contact Us (satisfaction surveys) done during Landing page demo Education & Training Center (POE) Event Calendar Novitas Medicare Learning Center Join our List (Center) Electronic mailing lists Center Novitasphere Portal has been added to your selections Medical Policy Center: Active LCDs and Articles Index Pages (with HCPCS and CPT codes) LCD#, Article#, CPT/HCPCS codes Live Chat feature! (screen shot in handout) 9-1:00pm CST OR 10-2:00pm ET Medical Policy Searches available (CMS.gov) Novitasphere is a secured web-based Internet Portal for the Medicare Fee-for-Service community to utilize as a more proficient interface with Novitas and the Medicare systems. Novitasphere allows Part A customers to connect via the Internet directly to Novitas Solutions to: Obtain beneficiary eligibility Submit cost reports Submit medical records Submit your electronic claims and retrieve electronic claim reports. Novitasphere is not available for Veterans Affairs providers at this time. *Live Web Chat About Novitasphere for Part A Specialties/Services- These pages have been developed to consolidate information for provider specialties and other specific services in one consolidated index dedicated to each. While this information is also available in other locations on our web site, these pages provide direct access to the most up-to-date topics, training and coverage information in these specific areas such as Ambulance, CAH, ESRD, FQHCs, LTCH, MSP, Observation, RHC, SNF, Therapy, and IPPS Search filters: Demo a live search and explain filters and categories used.

Part B Centers on the Novitas Solutions Website
Home Novitasphere Portal Appeals CERT Claims Contact Us Education Center Electronic Billing - EDI Enrollment Evaluation & Management Frequently Asked Questions (FAQs) Fee Schedules Forms IHS/Urban/Tribal Providers (JH Only) IVR Join Our Lists Medical Policy / LCDs Medical Review Publications Self-Service Tools Specialties/Services The 21 Centers are listed in the order of the left-navigation bar on the website. Introduce the center names and their main page – hover over the center to show the fly-out windows Appeals Center: demo the Appeals status inquiry tool, Timeframes calculator, Redetermination Request, Reopening Request Appeals vs CER - It has come to our attention that both Part A and Part B - providers are not aware of the difference between an appeal vs a CER (using the Medicare Part A Redetermination and Clerical Error Reopening Request Form (Form 1000).) Part A - one of the biggest issues is providers submitting claims for a Clerical Error Reopening (CER) when they can make the corrections themselves (i.e. deleting lines (they can cancel and rebill) or wanting to add line items (we cannot do this, they are required to adjust and add the line or cancel the claim and rebill a new one) if the provider does this on their own the claim will be reprocessed within days, CER takes up to 60 days. Additional info on our website: Article: “Late or Omitted Charges – Not acceptable for Clerical Error Reopening Requests” at OR CERT- (review the template information contained in the handout) Slide #27 (see handout) Claims - New look to the Main Landing Page! Others to follow! New Credit Balance section. Contact Us (satisfaction surveys) done during Landing page demo Education & Training Center (POE) Event Calendar Novitas Medicare Learning Center Join our List (Center) Electronic mailing lists Center Novitasphere Portal has been added to your selections Medical Policy Center: Active LCDs and Articles Index Pages (with HCPCS and CPT codes) LCD#, Article#, CPT/HCPCS codes Live Chat feature! (screen shot in handout) 9-1:00pm CST OR 10-2:00pm ET Medical Policy Searches available (CMS.gov) Novitasphere is a secured web-based Internet Portal for the Medicare Fee-for-Service community to utilize as a more proficient interface with Novitas and the Medicare systems. Novitasphere allows Part A customers to connect via the Internet directly to Novitas Solutions to: Obtain beneficiary eligibility Submit cost reports Submit medical records Submit your electronic claims and retrieve electronic claim reports. Novitasphere is not available for Veterans Affairs providers at this time. *Live Web Chat About Novitasphere for Part A Specialties/Services- These pages have been developed to consolidate information for provider specialties and other specific services in one consolidated index dedicated to each. While this information is also available in other locations on our web site, these pages provide direct access to the most up-to-date topics, training and coverage information in these specific areas such as Ambulance, CAH, ESRD, FQHCs, LTCH, MSP, Observation, RHC, SNF, Therapy, and IPPS Search filters: Demo a live search and explain filters and categories used.

You Can Chat With Us Novitas can help you find information on our website though our Chat: For example: Medical Policies Medical Review information Forms And much more Live Chat: Monday-Friday 10:00 a.m.- 2:00 p.m. ET Click the “ Need Help" tab on the right side of your screen to start a chat

Website Satisfaction Surveys
Before we close out today’s program we would like to ask you if you like the improvements we have made on the website? If so, let us know by completing the ForeSee survey. You may have noticed some of the many recent enhancements to our website. We continue to strive towards building the best MAC website, and your feedback plays a major role in those efforts. Our customers are randomly offered the chance to complete a website satisfaction survey, conducted by ForeSee. We would appreciate your participation when it’s offered, so you can tell us more about what we’re doing that you like, as well as share your ideas for future website enhancements. Every comment we receive is reviewed by our experts. This screen shot gives you a visual of what the survey pop-up will look like, if you are selected to complete one. You’re eligible to complete a survey once every 30 days, and we’d appreciate hearing from you every time you are asked, so we can track how we’re doing.

Join Our Email List Today
Stay current with Medicare by receiving s twice a week Available lists (not all-inclusive): Jurisdiction H Part A Part B Indian Health Services (IHS) Electronic Billing Novitasphere Portal ABILITY| PC-ACE Medicare Remit Easy Print (MREP) Users Join list Producer: If you have not already, you can sign up for our list. This subscription will allow you to receive the latest Medicare news and updates via on Tuesdays and Fridays. In addition , every Thursday we will issue the CMS eNews Newsletter to our list subscribers as well. If you have signed up and are not receiving the Medicare News s, check your spam folder. Again, the Medicare News s are sent to our subscribers every Tuesday and Friday. Once you have signed up for the list, make sure you add the to your safe list. Without further ado, I am going to turn things over to the presenter for today, _____________, an education specialist in the provider outreach and education department. Enjoy your session. NEXT SLIDE

Customer Contact Information Providers are required to use the IVR unit to obtain: Claim Status Patient Eligibility Check/Earning Remittance inquiries Customer Contact Center Provider Teletypewriter Patient / Medicare Beneficiary: 1-800-MEDICARE ( )

IHS Education and Training Webinars
Date Time (CT) Education Event May 1, 2018 1:00 pm Ask the Contractor (ACT) June 5, 2018 IHS Updates and Top Errors Webinar August 1, 2018 September 11, 2018 November 13, 2018 December 4, 2018 2018 Register for Face-to-Face Workshops

IHS Education and Training Events
Date Time (CT) Location June 13, 2018 8:00am-4:00pm Albuquerque, NM July 11, 2018 Tuba City, AZ August 9, 2018 Gallup, NM August 14, 2018 Ada, OK August 22, 2018 Bemidji, MN August 29, 2018 Portland, OR October 10, 2018 Aberdeen, SD October 23, 2018 Phoenix, AZ

Summary Discussed Enrollment updates, reminders and Revalidations
Discussed updates, reminders and Preventive services for Part A and Part B Reviewed Novitasphere and enrollment steps Reviewed Medicare Secondary Payer (MSP) and Medicare Credit Balance Reports Reviewed billing errors for Part A and Part B Reviewed the Self-Service Options

Thank You Gail Atnip Education Specialist, Provider Outreach and Education Kim Robinson Janice Mumma Supervisor, Provider Outreach and Education Stephanie Portzline Manager, Provider Engagement

2018 CMS ITU Albuquerque, NM April 24, 2018.

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2018 CMS ITU Albuquerque, NM April 24, 2018.

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