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Last Modified: 8/11/2017 Location: FL, USVI Business: Part A


Florida and U.S. Virgin Islands Part A Provider Outreach and Education Advisory Group (POE AG)

Tuesday, July 18, 2017

2:00-3:30 p.m.

External participants
Victoria Bolton, Jupiter Medical Center
Melissa Burns, Memorial HealthCare System
Christine Davenport, Brooks Rehab
Dale Gibson, HMA Naples
Heike Hollmig, Baptist Health Care
Felice Landry, Reingruber & Company
Kelly Laughter, Adventist Health
Sarah Pernett, Fleet Landing
Debra Pizzulo, Palm Healthcare Management, LLC
Rob Sikorsky, DaVita
Brenda Tuohey, Health First
Internal participants
Leslie Brinson, Supervisor, Provider Contact Center (PCC), Customer Service Operations
Mary Carrazana, Provider Relations Representative (PRR), Data Analysis and Compliance (DAC)
Christine Cubillan , Sr. PRR, DAC
Charles Johnson, PRR, Provider Outreach and Education (POE)
Kimberly Karnes, Manager, POE
Robert Lewis, PRR, POE
Terri Stanton, Sr. PRR, POE
Ursula Weaver, PRR, POE
Mark Willett, Sr. Manager, Medicare Websites and Provider Self-service Technologies


1. Welcome and introductions
2. Review of minutes/action items from prior meeting
3. Campaign to increase POE AG Part A membership
4. Suggestions for reducing providers' administrative burdens
5. First Coast's self-service technologies
6. First Coast 2017 educational strategy update
Provider enrollment project
Medical documentation project
Medicare Speaks 2017
Upcoming educational events
7. Education Action Team (EAT) update
8. Collaboration with Medicare contractors
9. Open discussion and announcements
New Medicare card project
10. Verify all action items and process out
Next meeting November 7

Welcome and introductions

Kim Karnes welcomed everyone to the meeting. All participants and staff present within the room and on the teleconference introduced themselves. Kim reviewed the agenda.

Review of minutes and action items from March 8 meeting

Kim indicated there were no action items from the previous meeting. She demonstrated the pathway to find minutes from previous POE AG meetings on First Coast's provider website.

Campaign to increase POE AG Part A membership

Kim reported that nine new members have joined the POE AG this year. She stated that we continue to execute steps in our plan to increase membership with more outreach efforts and reiterated the goal of the POE AG.
Kim then asked for examples of challenges providers have in the way of participation. Members indicated the timeframes of the meetings are sometimes in conflict with other meetings. For instance, our call was scheduled at the same time as a Centers for Medicare & Medicaid Services (CMS) provider call. In the future, this will be taken into consideration.

Suggestions for reducing providers' administrative burdens

Kim spoke about a CMS conference she attended with representatives from other Medicare Administrative Contractors (MACs). The discussions during the conference included ways to reduce provider burdens. Kim had requested input prior to this meeting from our POE AG members for questions on this topic and reviewed some of the responses during the call.
Kim facilitated a poll regarding features that First Coast is looking to add to SPOT. Kim will provide responses to Mark Willett for consideration.
Kim asked for suggestions for topics that may be used for educational videos, such as the appeals process or provider enrollment. A member suggested a video on rules and billing for skilled nursing facilities (SNFs). It was suggested that videos should also have a written follow-up document.
Kim also asked if members used Twitter and whether it would be a good tool for marketing our events. Some members indicated they did use Twitter and it would be effective, while others disagreed.

First Coast's self-service technologies

Mark Willett provided the report for self-service technologies.
Several POE AG members have provided feedback and requests in the past regarding the sign-on process for the Secure Provider Online Tool (SPOT). To that point, Mark addressed the current registration process with Enterprise Identity Management (EIDM) and that First Coast will be moving to our own registration platform. The process will look the same but it gives First Coast more communication abilities. He also explained how to avoid having an account expire.
He reminded members that the local coverage determination (LCD) lookup was removed from the First Coast website but advised that the LCDs will eventually be loaded to the First Coast website as PDFs and will allow providers to search again. Mark also indicated the fee schedule lookup was recently enhanced for consistency.

First Coast 2017 educational strategy update

Kim introduced this topic and additional POE team members gave updates to multiple strategies.
Provider enrollment
Stephanie Scott provided an update on the provider enrollment project team. The POE AG members were reminded that anyone interested in joining may notify Stephanie via email at
The internal project team continues to focus on education regarding the internet-based Provider Enrollment, Chain, and Ownership System (PECOS). The option for requesting appointments is still available on our events calendar and Stephanie works with those providers individually. Also, our provider enrollment POE AG subcommittee suggested a webcast on registering for the system, which is done via PECOS Identity & Access (I&A), and this has been added to POE's internal events calendar for October 25, 2017.
We'll continue to educate on revalidation, as necessary, and communicate with the provider community on any issues trending with those applications. Also, the provider enrollment section on the First Coast provider website will continue to be reviewed and enhanced based on feedback, suggestions, and CMS changes.
Stephanie advised she may do a webcast for Part D prescribers due to their enrollment requirements. This is still tentative but she is looking at September to perform this education. The education may be targeted and invitation only, contacting specific providers for attendance. If it is posted to the First Coast website, Stephanie will notify members.
The last topic Stephanie shared was regarding the modernized National Plan and Provider Enumeration System (NPPES). She explained some of the updates CMS has made for NPPES, including surrogacy, single account for multiple individuals or organizations, submission of multiple applications at the same time, and the ability to add more than one practice location. The resources available for the modernized NPPES implementation were also shared.
Medical documentation
Terri Stanton provided an update for the medical documentation project team.
Terri advised since the March POE AG meetings, as well as throughout the remainder of the year, the medical documentation project has focused on several specialties with a high error rate nationally, as well as within our jurisdiction, mostly due to insufficient documentation errors.
On March 22, 2017, we held the 'Ask-the-contractor' teleconference (ACT) webcast for Physical Therapy Services (B), where we focused on Comprehensive Error Rate Testing (CERT) program related errors and the medical policy requirements to reduce or eliminate those errors.
Terri also said we are continuing with a focus from last year on the clinical laboratory specialty, in particular for drug assays and substance abuse screening. We have a webcast scheduled for September 6, 2017, that will focus on the CERT errors and the LCD for controlled substance monitoring and drugs of abuse testing.
As reported in March, we added a new topic to the strategy this year for chiropractic services based on CERT errors and local data. At this time we're in the process of updating the web-based training (WBT) on First Coast University with examples of current CERT errors and how to avoid those errors based on documentation requirements. Once the update is completed, the WBT will be marketed to the Chiropractic Association as well as through eNews.
For the ambulance services specialty, a face-to-face presentation was facilitated earlier in the year to a small group of association members and a webcast was held on July 11, 2017. As a result of probe reviews on ambulance services and CERT errors, a pre-payment edit will be put in place in August 2017, on certain ambulance services. The purpose of the webcast was to continue to provide education to our ambulance providers on common errors found through the probe reviews and CERT errors and how to be proactive with their documentation requirements for the upcoming prepayment reviews.
Terri spoke about psychiatric/psychotherapy services and the webcast held in January- recording is available on the First Coast website. The POE team for Puerto Rico also held a Spanish webcast on Psychotherapy Services (B) on May 11, 2017, discussing results of probe reviews and the LCD for the psychiatric diagnostic evaluation and psychotherapy services coverage and documentation requirements. We are currently monitoring the billing patterns and plan to send focused education letters to newly identified providers in our data analysis that may need additional education in addition to promoting the webcast recordings.
Terri continued with the cardiology specialty, explaining that we're renewing a focus on this due to errors reflecting medical policy education is needed, specifically for myocardial perfusion imaging procedures. POE facilitated a webcast in February 2017, on this topic and Puerto Rico POE conducted a Spanish webcast in June 2017. In addition, major enhancements have been made to the specialty page on our English and Spanish provider website.
Even though much of the project team's focus is Part B, attention will also be given to outpatient hospital services billed on type of bill 13X, concentrating on the specific types of insufficient documentation errors for those services in CERT feedback files. Examples of these CERT errors have been included in the Medicare Speaks Part A Tackling the Complexities of Institutional Medical Documentation class.
POE collaborated with POE AG on enhancements to the resources section of the oncology specialty webpage, standardizing information to include and add several links to useful First Coast and CMS resources, as well as specialty associations and societies. Additionally, links were added directly to the PWK process article, as this is essential to that specialty. A POE AG member provided the following comments: "This resource list is extremely comprehensive…the most comprehensive list for anything oncology-related."
First Coast's ADR campaign continues this year with education on ways for providers to respond to an ADR effectively, efficiently, and timely. For upcoming events, we had our classes at Medicare Speaks Tampa and the clinical lab ACT coming up September 6, 2017, that will cover the controlled substance monitoring and drugs of abuse testing.
Terri reported with all the efforts that go in to what the project team members do, five of the seven specialties we focused on have had an error rate reduction, with some being substantial, since the 2016 final report.
Medicare Speaks 2017
Ursula advised that Medicare Speaks Tampa would be the following week on July 26 and 27, 2017. She then stated that if providers could not make it to Tampa, we would be in Jacksonville in September.
Upcoming educational events
Ursula briefly reported on upcoming educational events by reviewing our events calendar.

EAT update

Christine Cubillan reported for the EAT.

EAT will be facilitating an ACT on Part A Medicare Secondary Payer (MSP), during December. This topic was selected based on customer service feedback, and is consistent with the EAT's data relating to the top claim submission errors and inquiries.

Christine asked the members to respond to the following questions

1. What are the biggest challenges you face when billing MSP claims?
2. Do you have any best practices you would like to share on avoiding MSP claim submission errors?
Members indicated issues with the common working file (CWF) not being updated, issues with accidents not being closed and continuous inconsistent denials for Black Lung were problematic. No best practice examples were shared.

Christine indicated members could email her with any additional feedback at

Collaboration with Medicare contractors

Kim summarized First Coast's recent and upcoming outreach partnerships with multiple external contractors, including the durable medical equipment (DME) MAC, CGS, and the home health and hospice (HHH) MAC, NGS.

Open discussion and announcements

Terri provided a report out for the Social Security Number Removal Initiative (SSNRI), which is now being referred to as the new Medicare card project. She recommended everyone ensure they received CMS and First Coast list serve messages to obtain the latest information about this project as it is released. First Coast has added resource links to the First Coast provider website.
Open discussion
One POE AG member requested SPOT provide eligibility for older dates. While this cannot be done at this time, we do have a frequently asked question (FAQ) on the First Coast website that does not address the timeframe for accessing eligibility on SPOT or with the interactive voice response (IVR) system. This FAQ will be updated to address timeframes.
Another member suggested an animation regarding credit balance reports. Kim will follow up with Mark and the Provider Audit and Reimbursement Department (PARD) to see if this can be accomplished.

Verify all action items and process out

The next Part A POE AG meeting is scheduled for November 7, 2017
Action items
The following action items were captured during the meeting:
Update FAQ that provides resources for obtaining eligibility to include the timeframes for SPOT and IVR.
Kim to follow up with Mark and PARD on possible development of a credit balance report animation.
Kim concluded the meeting at 3:15 pm.
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