Wyoming Healthcare Financial Management Association (HFMA)

Wyoming Healthcare Financial Management Association (HFMA)
Part A/B Provider Outreach and Education Fall 2019

Agenda Noridian - Who Are We? Provider Based Enrollment/Billing
CMS Updates Telehealth vs Telemedicine Review Contractors Noridian Medicare Portal (NMP) November 2019

Noridian – Who Are We? November 2019

Focused on Government Healthcare
November 2019

NHS Medicare Administrative Contractor (MAC) Online
Part A – Hospitals, clinics or providers/suppliers that bill electronically - CMS-1450 or UB04 Part B – Specialty providers, physicians or clinicians in private practice that bill electronically or paper – CMS-1500 form November 2019

Provider Based Enrollment/Billing

What is Provider-Based?
Provider-based clinics are owned and operated by single entities referred to as “main providers” Treated as departments of main provider for Medicare purposes May be located on-campus or off-campus Clinics must meet location parameters for on-campus and off–campus designations November 2019

Provider-Based Exceptions
Provider types that do not meet provider-based status Ambulatory Surgical Centers (ASC) Comprehensive Outpatient Rehabilitation Facilities (CORF) Home Health Agencies Skilled Nursing Facilities (SNF) Hospices Inpatient Rehabilitation Units excluded from inpatient PPS for acute hospital services There are some exceptions to the category of Provider-Based Billing. This is the first of 3 slides that show providers/facilities that are not able to be provider-based… READ SLIDE. November 2019

Provider-Based Exceptions2
Independent Diagnostic Testing Facilities (IDTF) and laboratory tests paid only on fee schedule Facilities only furnishing Physical therapy (PT) Occupational therapy (OT) or Speech pathology (SP) services (unless at CAH) End Stage Renal Disease (ESRD) facilities These are also excepted… READ SLIDE. November 2019

Provider-Based Exceptions3
Departments of providers that perform functions necessary for successful operation of provider but do not furnish services for which separate payment could be made under Medicare or Medicaid Ambulances Rural Health Clinics affiliated with hospitals having 50 or more beds And these are excepted as well… READ SLIDE. November 2019

Providers Affected Billing UB-04 or electronic equivalent 837I
Outpatient departments Location determines payment On-campus located within 250 yards Off-campus located within 35-mile PO modifier identifies off-campus non-expected Validation edits affect off-campus November 2019

Provider-Based Billing Practice Address Verification
Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations These requirements not new What you can do Verify claim submission Verify PECOS enrollment Read more about provider-based facilities November 2019

Return to Provider Reason Code 34977
Implementation April 2020 Provider practice location address does not match any practice location Complete verification Full 9 digits of ZIP code ( ) DDE Page 3, F11 twice MAP171F Must match inquiries, option 1D November 2019

DDE Loops and Segments 2010AA Billing Provider Loop
2310E Service Facility Loop N3 Segment – Facility Address N301: Facility address; 1-55 alpha-numeric characters Example: N3✽123 MAIN STREET~ N302: Facility address; 1-55 alpha-numeric characters (only if 2 address lines are needed N4 Segment – Facility City, State, ZIP Code N401: City Name; 2-30 alpha-numeric characters N401: State: 2 alpha characters N403: Postal ZIP Code; 3-15 numeric characters Example: N4✽KANSAS CITY✽MO✽64108~ November 2019

Prov Practice Addr Quer – Option 1D
New option 1D for Provider Practice Address Query November 2019

Option 1D – MAP1AB1 Enter either the NPI or OSCAR (PTAN) of the facility and press [enter] November 2019

Option 1D – MAP1AB1 Selection
A list of offsite locations will display. Note that the main address does not display. To enter a file, place an ‘s’ in front of a line and press [enter] For example, on this slide I have typed in (which is not a real facility), and a fake CAH PTAN of and pressed the enter key by the number pad to display a summary of the practice locations IN ADDITION TO the primary location. November 2019

Option 1D – MAP1AB2 Information for that offsite location will display: MNT: PECOS: displays the date this file was created from PECOS. Please note that anything prior to 2017 will have December 19, 2016 from when it was created by CR 9913 Practice Term DT: will display as December 31st, of the year 9999 for current registered facilities Practice Location Key: displays the ID of the application approval. The first eight numbers contain the YYYYMMDD format Other Practice: displays the enrollment type selected from the bottom of page 20 of the CMS-855A, or electronic equivalent Address 1: displays the claims processing system offsite location address. Please note that claims billed for this offsite location must match the address exactly. Medicare will soon no longer accept ST instead of STREET in this case. City, State, Zip: are self explanatory, however the full 9 digit zip must be utilized. November 2019

Claim Entry – Page 3 – MAP1713 When submitting claims for offsite locations, the information from option 1D must be entered on Page 3. Offsite zip: first five digits of the offsite facility zip code. Additional information is entered on the Provider Practice Location Address screen by PF11, twice November 2019

F11 Twice – MAP171F MAP171F is a subsection of DDE claim entry, page 3. Remember that the address must match Option 1D exactly. This page requires the 9-digit zip code. November 2019

PECOS Main Page November 2019

Existing Enrollments Once you click the enrollments… each one will have an existing record for each facility. It is important that they find the right one by state and specialty, as there is a separate entry for each type of facility. If any of those locations have Part B operations, there will be separate entries for those as well. To verify the record, click the View Enrollment Record… this is very up to date. If any of the provider information here is wrong, the provider is out of compliance. Clicking here will give every detail on the record. The next screen shot is very long, so I had to split it into two slides. November 2019

Enrollment Record This is the first half of one screen… November 2019

Enrollment Record2 Each location has its own address and payment info
What is the address on file? Can see the PTAN and NPI information, For enrollment information, this is where the rubber meets the road. View the entire record. There are regulatory requirements that changes by the provider are reported within 90 days. November 2019

More Options Here is how They start the next step…. More options
More Options is where the provider would go to make updates or changes. Hit the radio button, it will guide thru a set of questions… very scenario driven. For example, CAHs will get different questions than a RHC. As you can see, there are several types of updates to make… Deactivate a record Create an initial enrollment Change the current enrollment Revalidation COA November 2019

Application Start Application Stay in the Fast Track View
Scroll down to the practice location and Special Payments address, find the GO TO TOPIC button After this it is just updating the practice information, resolve any errors that are on the application and clock submit, make sure you sign it, if you don’t it will develop Some claims issues are based on enrollment issues, no one wants to get deactivated, if your org isn’t in PECOS. One thing to remember, if your facility is using more than one name, and you use Doing Business As (DBA)… when a provider uses this alias, their information will need to be updated as well. And with that, I’ll turn our presentation back over to Tim… November 2019

Special Edition 19007 Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations Continued efforts by CMS to enforce existing requirements for providers to properly document and report practice locations November 2019

PN Modifier Effective January 1, 2017
Non-excepted off-campus provider-based departments of hospital are required to report “PN” modifier on each claim line for non-excepted items and services including those for which payment will not be adjusted PN will trigger payment rate under Medicare Physician Fee Schedule The PN modifier is effective for dates of service on and after January 1, 2017. Non-excepted off-campus provider-based departments of a hospital are required to report a “PN” modifier on each claim line for non-excepted items and services. The use of modifier “PN” will trigger a payment rate under the Medicare Physician Fee Schedule. The expectation is that the PN modifier will be reported with each non-excepted item and service including those for which payment will not be adjusted, such as separately payable drugs, clinical laboratory tests, and therapy services. CMS expect the PN modifier to be reported with each non-excepted item and service including those for which payment will not be adjusted, such as separately payable drugs, clinical laboratory tests, and therapy services. This modifier is applicable for CAHs and Hospitals. We would not expect off-campus PBDs to report both the PO and PN modifiers on the same claim line. However, if services reported on a claim reflect items and services furnished from both an excepted and a nonexcepted off-campus PBD of the hospital, the PO modifier should be used on the excepted claim lines and the PN modifier should be used on the non-excepted claim lines. Neither the PO nor the PN modifier is to be reported by the following hospital departments: A dedicated emergency department as defined in existing regulations at 42 CFR (b) • A PBD that is “on the campus,” or within 250 yards, of the hospital or a remote location of the hospital as defined under 42 CFR November 2019

CMS Updates July We will begin at 1 PM CT

Health Professional Shortage Area (HPSA) Bonus Payments
Mental Health Specialties Specialty 26 is currently set up to receive bonus payments April 2020 all psychiatric specialties eligible to receive mental health bonus 27 86 CR11327 effective February 4, 2020 – for claims processed on or after 90 days from issuance This CR was issued 11/1/19 The Centers for Medicare & Medicaid Services (CMS) will make HPSA bonus payments for all mental health specialties. Currently, the claims manual indicates that for mental health HPSA bonus payments, only specialty 26 is set up to receive the bonus. November 2019

Health Professional Shortage Area (HPSA) Bonus Payments
HPSA Zip code used to pay claims AQ modifier - partially designated HPSA claims and HPSA geographic areas Physician bonus web page MM 11437 November 2019

Provider Enrollment Processing Instructions to Manuals and Processing Guides
Updates provider enrollment, including various processing alternatives Forms CMS-855 application, CMS and CMS-588 Processing Independent Diagnostic Testing Facilities (IDTFs) in chapter 15 of Publication CMS-855R processing guide CR Updates to Provider Enrollment Processing Instructions in Chapter 15 of Publication (Pub.) , Program Integrity Manual, and to the CMS-855R Processing Guide : The purpose of this Change Request (CR) updates general information for provider enrollment, including various processing alternatives for each Form CMS-855 application, Form CMS-20134, and Form CMS-588. This instruction also includes updates for Processing Independent Diagnostic Testing Facilities (IDTFs) in chapter 15 of Pub and an update to the CMS-855R Processing Guide. November 2019 July We will begin at 1 PM CT

Receipt/review of internet-based PECOS applications
Provider Enrollment Processing Instructions to Manuals and Processing Guides Receipt/review of internet-based PECOS applications Receipt and review Updates to paper applications Receiving missing/clarifying data/documents Disposition of registration applications Returns Rejections CR Updates to Provider Enrollment Processing Instructions in Chapter 15 of Publication (Pub.) The purpose of this Change Request (CR) is to provide application processing updates to the instructions to the A/B Medicare Administrative Contractors (MACs) Part B. November 2019 July We will begin at 1 PM CT

Mammography Editing Modification to ensure correct payment for screening and diagnostic services PC/TC on CAH claims corrected Pay or deny both FQHC/RHC provider-based billing instructions updated Reimbursed on base provider payment method CR CMS is modifying existing editing to ensure correct payment for claims related to screening and diagnostic mammography services. In addition, CMS was notified that the professional component on CAH claims for screening/diagnostic mammography was paid and the technical component on the same claim denied. This CR provides instructions to update the editing to deny the professional component service on CAH claims for screening/diagnostic mammography when the technical component service for the same encounter has been denied. FQHC/RHC technical and professional billing instructions are updated in the CR. Payment is based on the payment method for the base provider. November 2019 July We will begin at 1 PM CT

Emergency Medical Treatment and Labor Act (EMTALA)
Newborn protected by Born-Alive Infant Act Presumed presenting with emergency medical condition Requires medical screening to provide stabilizing treatment Communication between healthcare professional and patients Conditions of Participation: Patients rights are protected This MLN Matters Article SE is for Medicare participating hospitals (including critical access hospitals). EMTALA requires hospitals include CAHs to provide medical screening to every individual including women in labor and the unborn children. It includes stabilizing treatment for both with an emergency medical condition Arranging for transfer to another hospital with specialized services Accepting transfers of patient with unstable emergency medical condition if the hospital has what is needed to provide necessary stabilization treatment CMS encourages discussion between pregnant women and obstetricians, midwives pediatricians and family practice professions about potential emergencies This article also explains the reporting process for concerns and complaints regarding EMTALA. November 2019 July We will begin at 1 PM CT

MBI Timelines Important Timelines April 2018 - December 2019
MBI transition period January 1, 2020 HICN no longer accepted by Noridian All claims filed on/after January 1, 2020 regardless of date of service will require MBI November 2019

Obtaining the MBI Ask beneficiary for new Medicare card
MBI lookup tool through NMP MBI displays on remittance advice (RA) Learn more More information: November 2019 July We will begin at 1 PM CT

MBI Resources for Beneficiaries
New Card Not Received New card won’t be received if address is incorrect Call Social Security Log into online account at: Beneficiaries are encouraged to make sure addresses are up to date so they receive the new card in the mail. They can contact the SSA or use the online account to make any address updates or access their new MBI information. Now that all cards are distributed Do you have Providers asking questions on where is my card? Here a few resources for Beneficiaries Contact: Medicare ( ) Verify identity Update address Help getting new card Sign up for MyMedicare.gov Card mailing status View or print card- only if card has been mailed November 2019 July We will begin at 1 PM CT

Noridian’s MBI Webpage
Noridian website Jurisdiction E/F Medicare Part A/B Browse by Topic Medicare Beneficiary Identifier (MBI) Keep up to date on the MBI Information can be found on the Noridian Website Jurisdiction E/F Medicare Part A/B Browse by Topic Medicare Beneficiary Identifier (MBI) November 2019 July We will begin at 1 PM CT

Medicare Diabetes Prevention Plan (MDPP)
MDPP is a behavior change intervention expanded from CDC’s National Diabetes Prevention Program (National DPP) The program helps prevent the onset of type II diabetes for eligible Medicare beneficiaries. Medicare pays suppliers to provide group-based services for up to 2 years. This is a preventive services and so there is no out of pocket expense for the beneficiary. The program focuses on diet, physical activity and weight loss. The link takes you to the CMS website for more information. November 2019

Reducing Opioid Misuse
CMS continues fight CMS roadmap updates Videos Learn more CMS continues the respond to the opioid epidemic by promoting safe and responsible pain management, making sure patients can access treatment for opioid use disorder, and using data to target prevention and treatment. Take a closer look to the opioid epidemic by using the resource attached. Review the roadmap and watch the featured video series November 2019 July We will begin at 1 PM CT

Reducing Opioid Misuse Letter
CMS mailed letters to all fee-for-service providers addressing opioid crisis CMS committed to protect beneficiaries and communities affected Opioid Treatment Programs January 1, 2020 bundled payments for opioid use disorder (OUD) treatment services CMS directed the Medicare Administrative Contractors (MACs), to mail letters to all Medicare fee-for-service providers about our work to reduce opioid misuse by people with CMS is committed to offering viable options to address the opioid crisis in addressing many aspects of the opioid epidemic. November 2019 July We will begin at 1 PM CT

Opioid Misuse Review While performing AWV; if beneficiary at risk:
CMS strongly encourages opioid-use review during medical/family history Important to introduce prevention, education and treatment CMS Special Edition (SE)18004 CMS Reducing Opioid Misuse CMS encourages the review of opioid use during review of the medical and family history while performing the IPPE or the AWV. Providers are encouraged to pay close attention to opioid use to help in the reduction of misuse. It is important that providers introduce prevention, education and treatment to beneficiaries that are possibly at risk. CMS Special Edition (SE) 18004: CMS Reducing Opioid Misuse: November 2019

MIPS Program Merit-Based Incentive Payment System (MIPS)
Medicare Access and CHIP Reauthorization Act (MACRA) Contact CMS or Quality Payment Program (QPP) contractor for questions, outreach, etc. Website: Phone #: Even though Noridian is tasked with either paying providers additional monies or payment reduction based on MIPS information, we are not to educate, so I wanted to provider you with this information. November 2019

Telehealth vs Telemedicine

Telehealth Eligibility criteria Providers located at distant site
Patient must be at originating site Health Professional Shortage Area (HPSA) Non-MSA geographic location Originating site fee billed HCPCS Q3014 Providers located at distant site Must be enrolled as Medicare provider Bill services to MAC where performed Based on the pre-questions that were received POE will start out with definitions of a few terms that will clarify the purpose of this Ask the Contractor Teleconference. Telehealth defined: Medicare beneficiary receiving services from a distant site provider through secure audio and video telecommunication. The originating site is located either in a rural health professional shortage area (HPSA) or a county outside a Metropolitan Statistical Area (MSA). The eligible distant site providers and eligible codes to bill can be found in the downloadable attachment, Noridian Part AB webpage, to find it go to Browse by Topic, Telehealth, and Education on Demand. Distant site services will be billed by the distant site provider to the appropriate MAC. All MACs have the same information. November 2019

Telehealth Eligibility Search Analyzer
Eligible Not Eligible To find out if the location is eligible, go out to the HRSA data warehouse website and type in the address. This website allows you to type in the address of a provider to find out if they meet the Criteria for being an originating site. If it is eligible, the results will be in a green box. If the address isn’t eligible, it’ll be in red and remember that means that the telehealth services are noncovered. November 2019

Originating Billing Guidelines
Originating Site Payment Methodology Type of Bill Revenue Code Outpatient Hospital Outside of OPPS 12X 078X Inpatient Hospital Outside DRG CAH Separate from cost based (80% of originating site facility fee) FQHC or RHC Separate from Prospective Payment System (PPS) or All Inclusive Rate (AIR) 77X or 71X Hospital-Based or CAH-Based Renal Dialysis Center In addition to ESRD PPS or Monthly Capitation payment 72X SNF Outside of SNF PPS (not subject to consolidated billing) 22X or 23X CMHC Not a partial hospitalization service (or used to determine payment for partial hospitalization). Not bundled in per diem. 76X November 2019

CY 2019 Medicare Telehealth Services
HCPCS/CPT Service Telehealth consultations, emergency department or initial inpatient G0425-G0427 Office or other outpatient visits ESRD related services for home dialysis per full month, patient younger than 2yrs 90963 Complete list of billable services on the CMS telehealth fact sheet November 2019

Telemedicine Clinical services provision by physicians and practitioners From distant site using electronic communications to hospital or CAH patient either simultaneously or non-simultaneously Example: Not face-to-face, analyzing reading or tele-ICU Enrollment>Telehealth/Telemedicine Noridian web page “Telemedicine,” as the term means the provision of clinical services to patients by physicians and practitioners from a distance via electronic communications. The distant-site telemedicine physician or practitioner provides clinical services to the hospital or CAH patient either simultaneously, for example, as in tele-ICU services, or non-simultaneously, as is the case with many teleradiology services. November 2019

Part A Virtual Communication
Patient receives medical discussion or remote evaluation Not related to RHC and FQHC services Previous 7-days or 24-hours Bill HCPCS G0071* Paid average of HCPCS codes G2010 and G2012 *New code beginning 2019 The medical discussion or remote evaluation, means communication through or telephone Is for a condition not related to an RHC or FQHC service provided within the previous 7 days Does not lead to an RHC or FQHC visit within the next 24 hours or at the soonest available appointment. Paid based on non-facility payment rate for HCPCS G0071 Medicare waives the RHC and FQHC face-to-face requirements when an RHC or FQHC furnishes these services to an RHC or FQHC patient. RHCs and FQHCs receive payment for communication technology-based services or remote evaluation services when an RHC or FQHC practitioner provides at least 5 minutes of communications-based technology or remote evaluation services to a patient who has been seen in the RHC or FQHC within the previous year. November 2019

Part B Virtual Visits Performed by physicians
Established patient still image(s) and/or video is evaluated Not related to in-person visit previous 7-days or 24-hours Billed and reimbursed for G2010 and G2012 under MPFS Virtual visits are performed by physician to an “established patient” whose still image(s) and/or video is being evaluated Established Patients. The patient whose still image(s) and/or video is being evaluated must be an “established patient” of the billing physician or Qualified health care provider (QHCP). An established patient is defined as one who has received professional services from the physician or qualified health care professional (or another physician or QHCP of the exact same specialty and subspecialty who belongs to the same group practice) within the past 3 years. Billing Practitioner. The new code does not dictate what type of practitioner can bill for evaluating the image. However, HCPCS G2010 is NOT billable if the evaluation is performed by clinical staff or a practitioner not qualified to furnish E/M services. Consent and Documentation. Advance consent from the patient must be obtained verbally or electronically, and must be documented in the medical record. There is no specific requirement for service-level documentation. Copayment. A practice must collect the requisite copayment from the patient for each service billed, as with all Medicare Part B services. Timing of In-person Visit. If the remote evaluation of the image (i) takes place during an in-person visit, (ii) takes place within seven (7) days after an in-person visit, or (iii) triggers an in-person visit within twenty-four (24) hours (or the soonest available appointment), the evaluation is NOT billable, and payment is considered to be bundled into the relevant in-office E/M code. Patient Follow-Up. The code requires follow-up by the practitioner with the patient based on the evaluation of the still or video image(s) in the form of a 5-10 minute discussion with the patient. November 2019

Virtual Communication
HCPCS Definition Reimbursed G0071 RHC/FQHC virtual communication services, minimum 5 minutes $ Average G2010 Remote evaluation of patient-submitted recorded video and/or images $ PAR G2012 Brief communication technology-based service, 5-10 minutes of medical discussion. $ PAR Only codes used for billing Medicare VC services. November 2019

Technical/Professional Components (TC/PC)

Date of Service (DOS) Special Edition (SE) 17023 – Revised
Radiology & Clinical Lab Surgical/Anatomical Pathology/Cardiovascular Care Plan Oversight (CPO) Home Health Certification/Recertification Physician End-Stage Renal Disease (ESRD) Transitional Care Management (TCM) Home Prothrombin Time (PT/INR) Monitoring Psychiatric Testing/Evaluation A few months back, a Special Edition was released that gave instruction on how to bill the DOS for PC/TC components when 2 providers may be billing separately for their service. The services listed on this slide were included in this SE November 2019

Radiology Services DOS
Technical component (TC) DOS is date patient had test performed Profession Component (PC) DOS is date of review & interpretation completed Global Service TC - DOS is date patient received service PC – DOS is date when review and interpretation is completed, or date TC was performed Typically, radiology services have two separate components: a professional and technical component. These services will have a PC/TC indicator of “1” on the Medicare Physician Fee Schedule (MPFS) Relative Value File. The technical component is billed on the date the patient had the test performed. professional component with a date of service reflecting when the review and interpretation is completed When billing a global service, the provider can submit the professional component with a date of service reflecting when the review and interpretation is completed or can submit the date of service as the date the technical component was performed. This will allow ease of processing for both Medicare and the supplemental payers. November 2019

Surgical & Anatomical Pathology DOS
Technical component (TC) DOS is date specimen collected Surgery date Profession Component (PC) DOS is when review and interpretation is completed Global Billing Submit PC with DOS reflecting when review and interpretation is completed, or Date TC was performed Collections span two calendar dates Bill date collection ended November 2019

Stored Specimens Specimen stored less than or equal to 30 calendar days from date collected, DOS of test must be date test performed only if all are met: Test ordered by patient’s physician at least 14 days following date of discharge from hospital Specimen collected while patient undergoing hospital surgical procedure Medically inappropriate to have collected sample other than during hospital procedure for which patient was admitted Results of test do not guide treatment provided during hospital stay; Test reasonable and medically necessary for treatment of an illness Specimens over 30 day Considered archived DOS is date specimen obtained from storage For more information, see the Medicare Claims Processing Manual, Chapter 16, Section 40.8, which is available at November 2019

Cardiovascular Monitoring Services
TC/PC or combination Single point of time, 24 or 48 hours or 30-day periods DOS determined by CPT descriptor and time TC - DOS is monitoring conclusion PT - DOS is when physician completes review and interpretation Globally - DOS is physician review date Cardiovascular Monitoring Services Per MLN Matters SE17023: November 2019

Summary DOS is date test performed or completed
Some exceptions apply Check MPFSDB for PC/TC indicators Check CPT descriptions Some codes include review and interpretations DOS is date service performed or completed Some exceptions apply Check MPFSDB for PC/TC indicators Check CPT descriptions Some codes include review and interpretations as part of the code (not separated out) November 2019

Date of Service Billing Guide
FAQs - Change Request 7631 November 2019

Review Entities

Review Contractor Learning Objectives
Understand CMS contracted entities roles How to identify and respond to review requests Where to find helpful tools Apply instructions to your practice/facility Compliance Officer, Case Managers Learning objectives: Understand CMS contracted entities roles How to identify and respond to review requests Where to find helpful tools Apply instructions to your practice/facility November 2019

Various Review Entities
Noridian Medical Review Quality Improvement Organizations (QIO) Comprehensive Error Rate Testing (CERT) Recovery Audit Contractor (RAC) Supplemental Medical Review Contractor (SMRC) Unified Program Integrity Contractor (UPIC) Office of Inspector General (OIG) There are several different medical review entities. Please be advised that CERT, RAC, SMRC, UPIC and OIG reviews are conducted by an outside entity, not NHS. NHS is providing the determination from the outside reviewing entity and processes the claim determination in the FISS system. You will receive your Remittance advice with the NHS logo. Additionally, if you disagree with a review determination the appeal should be submitted to NHS following the normal NHS appeal process for an independent review. November 2019

Prevent Improper Payment
The Goal of Any Review Process claims: To legitimate providers For covered services and items Which are correctly coded, and correctly billed Provided to an eligible beneficiary The goal is to pay the right amount to a legitimate provider, for covered, correctly coded and correctly billed services, provided to an eligible beneficiary. Prevent Improper Payment November 2019

Signature Requirements For Medical Review Purposes
For medical review purposes, Medicare requires that services provided/ordered be authenticated by the author. The method used shall be a hand written or an electronic signature. Stamp signatures are not acceptable. Note: Refer to exceptions for stamped signatures For medical review purposes, Medicare requires that services provided/ordered be authenticated by the author. The method used shall be a handwritten or electronic signature. Stamped signatures are not acceptable. With exception of #4, which I will discuss in an upcoming slide. The CMS rules pertaining to signatures apply to all providers/suppliers of Medicare services. Any medical record submitted to Medicare for review must contain a valid signature. Ensure that all documents are properly signed before submitting the documentation to the entity requesting the documentation. November 2019

Noridian Medical Review Targeted Probe & Educate (TPE)
Services selected based on data analysis If provider selected, MR conducts reviews Provides one-on-one education 1-3 rounds of prepayment probe review Learn from education/improve results in next "round“ Goal to lower provider error rates CMS has authorized Noridian to conduct the Targeted Probe and Educate (TPE) Pilot review process for certain providers by Medical Review. November 2019

TPE Review Results Ambulance Example: Denial Reasons
Beneficiary could have been safely transported by other means of transportation Documentation not received within 45 days Documentation did not support level of service billed Documentation not legible No PCS (non-emergent, scheduled, repetitive) Incomplete/invalid/illegible PCS (non-emergent, scheduled) November 2019

Medical Review (MR) Reopening
Request Reopening If denial related to missing or insufficient documentation Contact MR Contact clinical reviewer to discuss MR will evaluate if reopening requirements met Reopening form sent to provider within 3 business days November 2019

Medical Review (MR) Reopening2
Provider submits documentation Fax reopening form and documentation within required time frame Failure to submit form/documentation timely revokes reopening rights If revoked, submit redetermination request November 2019

TPE Provider Noncompliance
If not responding to Additional Development Requests (ADRs), Noridian refers provider to ZPIC/UPIC, RAC, etc. If high denial rates continue after 3 rounds, MACs will refer to CMS for additional action, which may include 100% prepayment review Extrapolation Referral to ZPIC/UPIC, RAC, etc. If not responding to Additional Development Requests (ADRs), Noridian can refer provider to ZPIC/UPIC; RAC; etc. If high denial rates continue after 3 rounds, MACs will refer to CMS for additional action, which may include 100% prepayment review Extrapolation Referral to ZPIC/UPIC; RAC; etc. November 2019

Comprehensive Error Rate Testing Program (CERT)
Measures Medicare fee-for-service improper payments Randomly select claims, documents are requested CERT reviews make payment determination to complying with Improper Payment Elimination and Recovery Act of 2010 CERT Program Definition Comprehensive Error Rate Testing (CERT) program is to measure improper payments in the Medicare fee-for-service (FFS) program. The CERT program cannot be considered a measure of fraud. Since the CERT program uses random samples to select claims, reviewers are often unable to see provider billing patterns that indicate potential fraud when making payment determinations. CERT is designed to comply with the Improper Payments Elimination and Recovery Act of 2010 November 2019

CERT Review Contractor
AdvanceMed Attn: CID# 1510 E. Parham Road Henrico, Virginia 23228 Phone: Fax: Medical documentation with bar coded sheet Website admedcorp.com/ The information listed here can also be found on the Noridian website under the CERT & Reviews tab by selecting the CERT option. If you need to contact one of the review contractors directly we do provide their information. We do recommend that providers begin with Noridian first if you have questions as often times your questions will be returned/referred back to the contractor. However if you are just looking for a mailing address this is the correct information to use when submitting documentation. November 2019

August 2015 MAC Contact Information Part A/B Provider Contact Center (JF) (JE) Noridian Part A, send an to Noridian Part B, send an to PHI should not be included in s It is very important that you get immediate answers regarding CERT claims selected for review. Noridian is responsible for tracking CERT requests and making the changes to the claim based on the CERT decision. Please call the Provider Contact Center for your state with your questions. If you call the CERT contractor they will direct your call back to your MAC. Call Noridian first or send a written question to the appropriate listed here and follow the easy instructions on the next slide. Please remember when ing Noridian DO NOT include Protected Health Information (PHI) or sensitive information in the subject line OR in the body of the . November 2019

CERT Reviews Call and Letter Timelines
We also have guidance for the CERT reviews. Follow the flow chart to give you guidance on the CERT process. November 2019

Recovery Auditor (RAC) Issues
Clinical Laboratory Add-on Codes (primary code denied) Clinical Social Worker (CSW) during Inpatient Drugs& Biologicals Excessive/Insufficient Drug Units Evaluation and Management (E/M) Same Day Dialysis Excessive Units of Critical Care Facility vs. Non-Facility Reimbursement Inappropriate Home Visit E/M During Inpatient Monthly Capitation Payment (MCP) for ESRD (4>month) Ophthalmology - Not a New Patient Observation Same Day as Inpatient Admission Physician Services During Hospice Period From the Recovery Auditor Contractor or RAC files, here are their current issues and if you bill any of these, you may want to make sure your documentation will uphold the billing. November 2019

Recovery Auditor Provider Options
A reminder that if you receive a letter from the RAC with a recovery of payment from a previously paid claim, there is a discussion period you can have. We see providers who automatically appeal the decision. Before appealing the decision, enter into a discussion period with the RAC. It’s possible you can overturn the decision and not have to appeal, but work with the RAC. We have on our website under the Reviews tab, RAC, a determination decision tree By answering the question sets, the decision tree with display your options available to you. November 2019

CERT vs. RAC CERT reviews take precedence over RAC audits
August 2015 CERT vs. RAC CERT reviews take precedence over RAC audits CERT may sample claim that has been reviewed by RAC RAC may not sample claim that has been selected for review by CERT What happens when the CERT and the RA review the same claim, same claim lines, even? The CERT’s review will always take precedence over the RA’s review. This is because the CERT reviews are fewer and impact the error rates. The CERT may absolutely review a claim previously reviewed by the RA; however, it does not work both ways. November 2019

August 2015 CERT vs. RAC2 If RAC reviews claim that has been first selected by CERT, Noridian CERT coordinators Noridian will request closure file from RAC Negates RAC’s decision Corrective adjustment keyed upon receipt of closure file CERT review will stand and is subject to change only via CERT’s decision or appeal determination Although it is rare, the RA has sampled and reviewed a claim which had already been reviewed by the CERT and a decision made. If this should happen, please contact Noridian. We will request a closure file from the RA, which means that they will vacate their decision and restore the claim to it’s previous status. Then, the CERT determination will stand, whatever it may be. November 2019

Livanta BFCC-QIO Patients may appeal hospital discharge decisions, file complaints and get help from Livanta website Provider must have a Memorandum of Agreement (MOA) agreement Medicare requirement, complete for compliance Form and instructions on website November 2019

QIO Short Stay Reviews CMS provides Livanta monthly universe of eligible paid provider claims with less than two midnight May be picked once within 6-month round High or increasing number of short stay claims per area 25 cases sampled How are reviews of short inpatient hospital stays conducted? Livanta conducts “Short Stay Reviews” per 42 CFR on a sample of Medicare Part A claims for appropriateness of inpatient admission under the Two Midnight Rule for acute care inpatient hospitals, long-term care hospitals, and inpatient psychiatric facilities impacted by FY 2016 OPPS Final Rule, CMS-1633-F, effective January 1, CMS provides Livanta with a monthly universe of eligible paid provider claims with lengths of stay of less than two midnights. A provider is eligible for sampling once within a 6-month Round. As of April 2017, the top 175 providers with a high or increasing number of Short Stay claims per Area may be sampled for 25 cases, and other providers previously identified as having a “Major Concern” in the prior 6-month Round may be sampled for 10 cases. November 2019

Supplemental Medical Review Contractor (SMRC)
Review claims to lower improper payment rates and claim errors Conduct nationwide medical review Part A Part B Durable Medical Equipment (DME) Notify CMS of improper payments and noncompliance of documentation requests May result in claim adjustments completed by MACs Noridian is the new review contactor for Supplemental Medical Review Contractor (SMRC). This is a contract that is awarded through competitive procedures in keeping with Section 1874A of the Social Security Act. The Supplemental Medical Review Contractor is a contractor that performs Medicare medical review activities as directed by CMS. This contractor conducts special Medical Review Studies of Part A and B claims on a quarterly basis and vary in topic. The focus of the reviews can include, but is not limited to, vulnerabilities identified by CMS internal data analysis, the Comprehensive Error Rate Testing (CERT) program, professional organizations and Federal oversight agencies. November 2019 July We will begin at 1 PM CT

Supplemental Medical Review Contractor (SMRC)
Website Conduct nationwide Part A/B medical review Documentation requests Current and completed projects Discussion & education period The SMRC information can also be found at the bottom our Noridian home November 2019

UPIC Purpose is to detect, prevent, deter, reduce and make referrals to recover fraud, waste and abuse Integrate program integrity functions for audits and investigations across Medicare and Medicaid May refer providers to State Boards Medical Review pre and post-pay reviews based on Data Analysis Provider Time-frame Beneficiary Demographic Scheme Benefit/Utilization Provider-based Time-frame based Beneficiary based Demographic based Scheme based Benefit/Utilization November 2019

Office of Inspector General (OIG)
OIG website at Active workplans Newly published reports Finally, we have the Office of Inspector General (OIG) and they focus on fighting fraud, abuse and waste in Medicare, Medicaid and other Health and Human Services (HHS) programs. November 2019

August 2018 OIG Report Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities Noridian article: OIG Report: Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities The Office of Inspector General (OIG) determined that Medicare inappropriately paid acute-care hospitals for outpatient services provided to beneficiaries who were inpatients of other facilities, including long term care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, and critical access hospitals. As a result, beneficiaries were unnecessarily charged outpatient deductibles and coinsurance payments. In the report, the OIG recommended that CMS instruct the Medicare Administrative Contractors (MACs) to more effectively educate acute-care hospitals not to bill Medicare for outpatient services provided to beneficiaries who were inpatients of other facilities, but rather to provide those services under arrangements and look to the inpatient facilities for payment. Read the full OIG report November 2019

OIG Report Medicare Paid Twice While Patient in SNF
Medicare made Part B payments to ambulance suppliers for transportation services that were also included in Medicare Part A payments to SNFs as part of consolidated billing requirements WHY WE DID THIS STUDY In 2012, Medicare Part B paid $5.8 billion for ambulance transports, almost double the amount it paid in Historically, Medicare has been vulnerable to fraud involving ambulance transports. In 2013 and 2014, the Centers for Medicare & Medicaid Services (CMS) imposed temporary moratoria on the enrollment of new ambulance suppliers in two metropolitan areas. Medicare billing for ambulance transports warrants scrutiny, given its rapid growth and its vulnerability to fraud and abuse. HOW WE DID THIS STUDY To identify inappropriate payments and questionable billing, we analyzed claims data for 7.3 million ambulance transports during the first half of We examined transport billing including, but not limited to, transport destinations, transport levels, distance of urban transports, other Medicare services that beneficiaries received, and the geographic locations where the beneficiary who received the transport resided. WHAT WE FOUND We identified both improper payments for ambulance transports and questionable billing by ambulance suppliers. We found that Medicare paid $24 million in the first half of 2012 for ambulance transports that did not meet certain program requirements to justify payment. For example, Medicare paid $17 million for transports that were to or from noncovered destinations such as physicians' offices. In addition, Medicare paid $30 million for transports for which the beneficiaries did not receive Medicare services at the pick-up or drop off locations, or anywhere else. These claims may have been inappropriate. We also found that about one in five suppliers had questionable billing. For example, a supplier may have had an unusually high average mileage for the transports that it provided to beneficiaries residing in urban areas. Questionable billing is geographically concentrated, with more than half of all questionable transports provided to beneficiaries residing in four metropolitan areas. WHAT WE RECOMMEND Our findings indicate that inappropriate and questionable billing for ambulance transports pose vulnerabilities to Medicare program integrity. In response, CMS should enhance existing fraud and abuse safeguards. Our report made five recommendations. CMS concurred with our recommendations for it to (1) determine whether a temporary moratorium on ambulance supplier enrollment in additional geographic areas is warranted, (2) require ambulance suppliers to include the National Provider Identifier of the certifying physician on transport claims that require certification, (3) increase its monitoring of ambulance billing, and (4) determine the appropriateness of claims billed by ambulance suppliers identified in the report and take appropriate action. CMS partially concurred with our recommendation for it to implement new claims processing edits or improve existing edits to prevent inappropriate payments for ambulance transports. CMS indicated that it will review data on claims identified in this report; CMS should use the results of its review to implement new, or modify existing, claims processing edits needed to prevent inappropriate payments. Copies can also be obtained by contacting the Office of Public Affairs at November 2019

CMS Ambulance Booklet https://www. cms
November 2019

Medical Necessity Defined
Nature of ambulance’s response (whether emergency or not) does not independently establish or support medical necessity for ambulance transport Beneficiary’s condition at time of transport determines whether service is medically necessary To read more about Medical Necessity, utilize this link ( pdf) November 2019

Document clear picture of patient’s condition at time of transport
Medical Records Document clear picture of patient’s condition at time of transport 42 CFR (A) (6) Sufficient information. The provider, supplier, or beneficiary, as appropriate, must furnish to the intermediary or carrier sufficient information to determine whether payment is due and amount of payment. Per the Code of Federal Regulations or CFR 424.5, all of this verbiage is just saying….. TO make sure your documentation will support what you billed…this applies to all Medicare claims, not just Ambulance. It is the key to audit success, by ensuring payment for services rendered, protecting both patients and providers and painting that picture of the patient’s “transport” condition. November 2019

Claims Overlap Medicare providers are expected to verify
Eligibility prior to or at the time of service Avoids billing disputes, denial, rejections Overlapping dates of service Patient discharge status Long Term Care Facility (LTCH) services Skilled Nursing Facility (SNF) services Ambulance services Medicare providers are expected to verify a beneficiary's Medicare eligibility at the time of or prior to admission to ensure that the patient is eligible to receive the services covered by Medicare. Checking the beneficiary's eligibility records also ensures that the facility/agency verifies if the patient is receiving services from another entity that would cause an overlapping situation. November 2019

Hospital/Ambulance Claims
Hospital bills inpatient claim and receives payment Independent ambulance supplier bills services using date of hospital discharge Denial results; line items falls within admission and discharge dates IPPS claim Ambulance supplier looks to hospital for payment Ambulance service included in facility PPS Excludes: Date of admission Date of discharge Any leave of absence days The CWF searches paid claim history and compares the line item service date on an ambulance claim to the admission and discharge dates on a hospital inpatient stay. The CWF rejects the line item when the ambulance line item service date falls within the admission and discharge dates on a hospital inpatient claim. Based on CWF rejects, the A/B MAC (B) must deny line items for ambulance services billed by independent suppliers that should be bundled to the hospital. November 2019

Hospital/Ambulance Claims2
Internet Only Manual (IOM) , Chapter 3, Section 5 Independent ambulance bills and receive payment Inpatient hospital claim processes Recoupment results; line item falls within admission and discharge date Ambulance supplier looks to hospital for payment Upon receipt of a hospital inpatient claim, CWF searches paid claim history and compares the period between the hospital inpatient admission and discharge dates to the line item service date on an ambulance claim billed by an independent supplier. The CWF shall generate an unsolicited response when the line item service date falls within the admission and discharge dates of the hospital inpatient claim. November 2019

Reminder Your documentation:
Affects your payments Can affect your ability to appeal Can be reviewed post-pay by CERT and Recovery Auditor Can be reviewed pre-pay by Noridian Medical Review (MR) Affects recipients of your referrals and orders Can affect their ability to appeal Their claims also reviewed pre and post-pay Please work with the provider that is dispensing DMEPOS, taking the labs or x-rays and billing for service they provide. It can delay their billing for services or items if records are not given to them. Payments could be recouped if documentation does not exist while under a review. If they need to submit an appeal and do not have required elements, they will not have a favorable appeal. November 2019

Responding to Additional Documentation Requests (ADR)
Gather information quickly and neatly Make sure signatures are present and legible Verify documentation supports Medical necessity Meets requirements of LCD Submit all requested documentation Ensure information sent as instructed It is very important to respond to the requesting contractors in a timely manner. Each demand has a response date and the type of information they are requesting Make sure that the documentation is legible Fax documents remember no highlights- goes black Make sure address are correct and it might be helpful to assign a designated person within your organization to address these requests For question please see information on letter for contact information. November 2019

TOB Quick Reference If your TOB equals: Responsible Contractors:
XX1-8 or XXI NHS Medical Review, UPIC or OIG XXH CERT or RAC XXP QIO Providers can identify which medical review entity completed your claim determination by the type of bill (TOB). The comment section of the claim will also indicate who is conducting the review. November 2019

Noridian Medicare Portal (NMP)
I was asked if other insurances could use our portal and the answer is no. Only for provider offices and billing services. Here’s the link. Quick link

Provider Enrollment Enroll in Medicare – lists application steps
Enrollment on Demand (EoD) – self-paced video tutorials Follow application progress – view status Enroll in Medicare - View a listing of information that enrollees should know before beginning an application. Access information to enroll and/or make changes online using PECOS Web, Electronic Funds Transfer (EFT), Reasons for delays. Web page also explains the Two Ways to Submit an Initial Enrollment, Revalidation, or Changes to Provider Information Enrollment on Demand Tutorials - Access self-paced application tutorials to assist in the application completion Enrollment Application Status Search - This search allows providers and suppliers to follow the application progress. Enter an Application/Reference Number or Web Tracking ID into its search field and select "View Application Status" November 2019

Provider Enrollment on Demand
New web content and webinar courses Medicare Diabetes Prevention Program (MDPP) Submitting Your Enrollment Online Part 1 (I&A) Part 2 (PECOS) Telehealth/Telemedicine Enrollment only There is new content on the Noridian Medicare webpage for Provider Enrollment Complex Specialties. Housed on the Part B Enrollment portion of our website, under Enroll in Medicare; there is a Complex Specialties page that has specific information on the specialties listed on this slide. We aim to expand this further in the future to add all complex specialties that can enroll in Medicare. New webpages topics on Enrollment Ambulance Ambulatory Surgery Center (ASC) Clinical Laboratory Improvement Amendments (CLIA) Independent Diagnostic Testing Facility (IDTF) Intensive Cardiac Rehabilitation (ICR) Mammography Screening Center Medicare Diabetes Prevention Program (MDPP) Portable X-Ray Suppliers (PXRS) Telehealth/Telemedicine November 2019

Provider Enrollment Application and Correspondence
New details available in NMP Application status View/download correspondence Upload documentation for applications currently being processed Download notification letters (once application is complete) Access granted to provider admin or dual users Part A organizations can only view their organizational applications Part B providers can view Group and Rendering applications Provider Enrollment Application and Correspondence Details Available in NMP New functions for Enrollment have been added within the Noridian Medicare Portal (NMP). Users may see an application status, view/download correspondence, and upload documentation for applications currently being processed. Access to the Enrollment section is granted to users by the Provider Administrator or Dual User. Part A Organizations can only view their organizational applications Part B Providers can view Group and Rendering applications. If you are looking for an application currently in process, check out the "In Process" tab as it will display the application status and any Request for Information s that have been sent to the contact. Once an application is complete, Notification letters can be downloaded from here as well. November 2019 July We will begin at 1 PM CT

Provider Enrollment Revalidation
Resubmission of documentation is not required Necessary information was included in previous submission or Development request will be mailed for supporting documentation You can submit applications 7 months in advance of the revalidation due date To better explain the entire revalidation process in addition to sharing two updates issued by CMS regarding documentation and timelines for submission, we have expanded the information available on the Revalidation webpage. If Noridian can locate a provider's necessary supporting documentation within previously submitted applications (EFT, IRS documents, etc.), resubmission of the documentation is not required. If we cannot find this information, a development request will be mailed to the provider. Applications can now be submitted 7-months in advance of the revalidation due date. This is a change from the previously communicated 6-month timeline. Check out all the updates on the Revalidation webpage. Please share this information with office for staff members who work on Provider Enrollment and related efforts November 2019

NMP Remittance Advice Get full remittance advices for hospitals/clinics that receive paper remits Download or print PDF format View last 30 days Search by date range, check amount or check number Learn more: Education on demand tutorial or NMP user manual NMP now offers Full Remittance Advices for Part A that receive paper remits. The Full Remittance Advices are available on the “Remittance Advices” section of NMP and are in a PDF format that may be downloaded or printed. Users can choose to view the Last 30 Days of remittances, or search for a specific remittance by date range, check amount or check number. November 2019

NMP Eligibility Inquiry Responses
MSP - Displays pertinent MSP diagnosis codes MDPP - Includes MDPP Preventive Service Codes, etc. HMO or MCO - Displays HMO/MCO plan benefit number and name NMP Offers Additional Information on Eligibility Inquiry Responses MSP Diagnosis Code, MDPP, and MCO PBP Plan Name and Number Medicare Secondary Payer (MSP) Displays all MSP diagnosis codes, if applicable, for each MSP enrollment period Medicare Diabetes Prevention Program (MDPP) Includes MDPP Preventive Service Codes to help providers determine next available MDPP service for beneficiary HMO/MCO Displays Managed Care Organization (MCO) Plan Benefit Package (PBP) number and name, if applicable to beneficiary November 2019

NMP Expanded Denial Details
Alien, Incarcerated - Lists dates SNF and ESRD Facility - Overlapping dates and NPI shared NMP Offers Additional Expanded Denial Details - Alien, Incarcerated, SNF, and ESRD Facility: The Noridian Medicare Portal (NMP) now offers the ability to view claim denial details for Alien, Incarcerated, Skilled Nursing Facility (SNF), and End Stage Renal Disease (ESRD) Facility. For alien and incarcerated denials, the listed dates will be shared. For SNF and ESRD denials, the overlapping dates and NPI will be shared. For more information, see the Expanded Denial Details section of the NMP End User Manual November 2019

Qualified Medicare Beneficiary (QMB)
Dual-eligible Medicare/Medicaid beneficiaries Medicare patients also enrolled in Medicaid receive help with Medicare premiums and cost-sharing. Providers may not bill patients deductibles, coinsurance. State Medicaids may pay those costs. November 2019

MSP Claims Corrections in NMP Payer Type
Incorrect payer type/provision? Use NMP to reopen MSP claims for reject/denial for payer type/provision Do NOT call customer service or provide written reopenings to fix these simple issues. The 2digit value electronic codes are listed on the right. Here is a list of all of the value code payer types under MSP also referred to as provisions It is important to use the correct value code on your electronic claim or the claim might deny or reject. November 2019

Send Questions via Portal Message
If receive documentation request from CERT or Noridian Medical Review teams only Send Noridian secure messaging nmp/end-user-manual/send-us-a-message NMP users have the ability to Send Us A Message for the Noridian Medical Review or the Noridian CERT liaison teams regarding their concerns. Exchanges help providers understand the claim review decisions and are better prepared to avoid future denials. Messages sent regarding non-Medical Review/CERT will be redirected to contact the Provider/Supplier Contact Centers. Additional instructions are within our User Manual and self-paced tutorials. November 2019

Education Team

Sign Up - Medicare News! Receive most recent Noridian/CMS news
MLNs posted under What’s New Articles Tuesday/Friday Simple/quick signup Noridian posts MLNs to the What’s New Articles. Signing up for the Part A/B List Serv will ensure you are notified when a new MLN is posted to the Noridian Medicare website. The Part A/B List Serve sends out updates on Tuesday and Friday unless there is a special newsletter sent out. The sign up is simple and quick. November 2019

Social Media Facebook YouTube Give us a ‘Like’
August 2018 Social Media Facebook Give us a ‘Like’ ‘Follow' us to stay connected YouTube Our Social Media growth is continuing to expand Our facebook page for the provider and supplier community continues to grow daily The Noridian Facebook page will pass along updates from Noridian and Medicare through articles and links previously published to our website. Upcoming educational events and self-paced tutorials will also be available here for you to stay connected. Inquiries may be submitted and answered during regular business hours, however, some inquiries may require further research from another department. Keep in mind that PHI or PII is not accepted. Give us a ‘Like' and ‘Follow' us to stay connected. We hope to see you there! YouTube! Our channel provides education and tutorials on several topics including Enrollment, General Medicare Coding and Billing, Preventive Services, Evaluation and Management, MSP, Appeals, Modifiers and more. Subscribe to our YouTube channel to be notified when new videos are added November 2019

Upcoming Webinars Earn CEUs Part A Part B After Hours webinars
JE: Part B JE: After Hours webinars Attend an upcoming webinar The links on this slide will list all upcoming webinars we offer for JE and JF providers Throughout each year we also offer many webinars to keep you updated and to help your earn your CEUs. After Hours webinars will continue in 2018 November 2019 July We will begin at 1 PM CT

Online Provider Education
Education on demand View self-paced tutorials at your convenience Certificate ed upon completion Learn More Education & Outreach Do you like education on demand? Education on Demand: View self-paced tutorials at your convenience Certificate ed upon completion Want to learn more- Find the tutorials under Education and Outreach November 2019 July We will begin at 1 PM CT

Provider Outreach & Education Request Form
Complete and send to: Subject line: Education request Contact Provider Contact Center for claim specific information Noridian offers the opportunity for education targeted to the particular needs of each health care provider. If you are looking for education please complete the form Provider outreach & education request form found under Education. Claim specific information contact your Provider contact center November 2019

Thank you! Questions? July 2017 We will begin at 1 PM CT
Thank you all for attending, what questions do you have? Thank you! July We will begin at 1 PM CT

Wyoming Healthcare Financial Management Association (HFMA)

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