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Last Modified: 1/12/2012
Location: USVI
Business: Part A, Part B
Minutes
U.S. Virgin Islands Part A/B Provider Outreach and Education Advisory Group
Tuesday, December 13, 2011
1:00-2:30 PM
Meeting participants
Dona Aaron, Governor Juan Luis Hospital
Jill Burgos, First Coast Service Options Inc.
Avril Davis-Howard, Virgin Islands Heart
Toni Johnson, Carolyn Merritt, MD PLLC
Kimberly Karnes, First Coast Service Options Inc.
Jessica LaPlace, Comprehensive Primary Care Specialists
Debra Lowery-Williams, First Coast Service Options Inc.
Deborah Rhymer, Consultant
Lee Shirk, Virgin Islands Orthopaedics & Sports Medicine
Eveth Vialet, Dermatology & Wellness Center, LLC
Sharon Walters, St. Croix Obstetrics/Gynecology
Ursula Weaver, First Coast Service Options Inc.
Mark Willett, First Coast Service Options Inc.
Agenda
1. Welcome and Introductions
2. Review of minutes and action items from last meeting
3. Customer Service update
4. Medicare website update
5. FCSO University update
6. Medicare committee updates
• Provider Enrollment
• Health Insurance Portability and Accountability Act, version 5010 (HIPAA 5010)
• International Classification of Diseases, Tenth revision (ICD-10)
• Comprehensive error rate testing (CERT) program and Evaluation and Management (E/M) services
• Recovery Audit Contractor (RAC)
7. Education strategy for 2012 contract year
8. Inpatient Medicare severity--diagnosis-related group (MS-DRG) initiative
9. Medifest
10. Recommendations/suggestions for Ask the Contractor webcasts (ACTs)
11. Next POE AG meeting
12. Process Out
Welcome and Introductions
Debra Lowery-Williams, Project Consultant, Provider Outreach and Education (POE), welcomed everyone to the webcast meeting. All participants introduced themselves and identified their organization.
Review of action items from last meeting
Debra Lowery-Williams reviewed the minutes from the last meeting on the FCSO provider website
Customer Service updates
Jill Burgos, Provider Contact Center, encouraged participants to monitor the status of provider enrollment revalidation requests via the FCSO Medicare provider website and to contact customer service regarding any status concerns. An enhancement has been made to the Part B Interactive Voice Response (IVR) system, in that providers can now verify if the ordering or referring physician is eligible to order or refer items or services for Medicare beneficiaries. The IVR has also been enhanced to provide status of redeterminations. Lastly, post cards were mailed for the Annual Participation Open Enrollment Period of November 15 through December 31, 2011.
Medicare website update
Mark Willett, Manager, Provider Self-Service Technologies and Websites, reviewed and provided updates to the current provider website projects in the works
• FCSO Medicare provider websites recently made available several look-up tools, including provider enrollment revalidation requests and HIPAA reject codes. Mark reviewed where these tools are located, encouraging all participants to share this information with colleagues and peers.
FCSO University
Kim Karnes, Manager, Online Manuals and Learning Solutions Center, reported on improvements made to the FCSO University website, including: better navigation, animations, provider surveys, and banners on the main page of the website to market events (e.g., Medifest) and courses.
Medicare committee updates
Ursula Weaver, Provider Relations Representative, POE, provided the updates associated with the POE-AG committees (Provider Enrollment, HIPAA 5010, ICD-10, and CERT & E/M)
• Provider Enrollment
• Addition of provider enrollment revalidation section to the provider website
• New revalidation frequently-asked questions (FAQs) available
• Webcast held October 25, 2011 on revalidation initiative and recording available under the Education section of the provider website
• Future projects includes creation of Internet Provider Enrollment Chain and Ownership System (PECOS) web animations and provider look-up
• HIPAA 5010
• POE and the electronic data interchange (EDI) department facilitated several webcasts to discuss testing issues
• At the time of the meeting, we did not have additional information regarding the enforcement delay
• ICD-10
• October 1, 2013 -- ICD-10 implementation date
• FCSO’s ICD-10 website page will continually be updated as new options become available
• CERT services
• E/M portion of this committee has completed it work
• Committee will address CERT related error rate findings
• End Stage Renal Disease (ESRD) and Skilled Nursing Facility (SNF)
• Two new POEAG committees added for contract year 2012
• Debra asked the hospital staff to participate on the ESRD committee
Education strategy for contract year 2012
• Focused, targeted and wide-spread education will include the following CERT-related topics: Inpatient DRG, E/M, medical documentation and physician signature, Medicare secondary payer (MSP), prevention of claim denials, provider enrollment, physical therapy and billing of the KX modifier
• POE will continue to facilitate regularly scheduled ask-the-contractor teleconferences (ACTs)
• POE will enhance educational sessions by delivering scenario-based content
Inpatient DRG initiative
Debra discussed the program integrity and provider outreach educational strategy relative to this topic. Although not directly related for this provider community, the hospitals can benefit from upcoming sessions to gain a better understanding of the documentation requirements for inpatient services.
Virtual Medifest
Back by popular demand, FCSO POE its second Virtual Medifest, February 28 through March 1. Last year, only one (1) provider from the U.S. Virgin Islands took advantage of these free educational sessions. All POE AG members are encouraged to register and invite as many of their colleagues to also attend.
Recommendations/suggestions for ACT webcasts
Ursula Weaver stated the ACTs are moving from bi-monthly to a quarterly event
Next POE-AG meeting
The next meeting is targeted for February, 2012
Process Out
No additional comments noted
