CA Hospice-POE Advisory Meeting
Teleconference
Tuesday, March 13, 2007
Attendees: Juliette Chenian, Jennifer Lillard, Kathy Jones, Carrie Wong, Linda Tanner, Annie Dills, Mandy Wilmer, Verna Bowman, Rose Baker, Ann Jackson, Peg Jaber-Teresi, Hospice of Petaluma, Ann Koepsell, Dennis Pierson.
Facilitator/Recorder: Juliette Chenian/Carrie Wong
AGENDA ITEM
/DISCUSSION
/ RESPONSIBLE PERSON/TARGET DATE /Meeting was called to order at 1:04 PM PDT, 3:04 PM CDT, 4:04 PM EDT / Juliette Chenian called the meeting to order.
Introduction and Review of the Agenda / Juliette Chenian, Manager of Provider Outreach and Education (POE), reviewed the attendance sheet and noted those individuals who were present.
Juliette reviewed the agenda and mentioned that an item not on the agenda regarding the new IVR system will be discussed.
She asked for any additions or changes to the agenda?
Ann Jackson asked if there is a way to print copies of the handouts now?
Juliette noted that if you do not print them before the session, the information is removed the day before the meeting.
Ann asked if on the email she could write “please print documents 24 hours before the meeting”.
Juliette said she would do that.
Provider Outreach and Education (POE) / Juliette Chenian gave the update.
UGS has a new name.
United Government Services is now National Government ServicesOur Mission· To serve the Medicare Community
New Name – Same Great Service· National Government Services is a merger of Wellpoint’s Medicare Business Organizations
· Effective January 1, 2007
Includes· AdminiStar Federal
· Anthem Health Plans of New Hampshire, Inc.
· Associated Hospital Service
· Empire Medical Services, and
· United Government Services
Does Not Include· Wellpoint’s Medicare Part D programs and other senior products
Medicare Experience· Part A (fiscal intermediary, regional home health intermediary and the national federally qualified health center intermediary
· Part B carrier, and
· Durable medical equipment Medicare administrative contractor (DME MAC)
Locations· We service nearly 22,525,000 Medicare beneficiaries in 29 states and territories
How Will It Impact Me?· Creates a culture centered on anticipating customer needs and providing quality service
· Strong, collaborative relationships with providers and suppliers
· Expanded geographical diversity with a local focus and national reach, and
· Substantial opportunities for operational synergies and cost savings that will contribute to keeping the cost of Medicare affordable for future generations
www.NGSMedicare.com
· New Web site URL for National Government Services
· Directs the user to a new portal page
· Customers may then access the home page for their legacy Medicare contractor
National Government Services Combined Newsletter Proposal· National Government Services is seeking CMS approval to combine all legacy contractors Part A & B newsletters into one publication.
· It will be a monthly newsletter and it will be published on the NGS website.
· Implementation date is scheduled for May 2007.
· A sample of the proposed newsletter was attached to this presentation.
The newsletter will be larger than before but will encompass Part A, Part B, national and local articles.
UB-04
Training Sessions / Juliette Chenian presented these slides but did not go into detail due to time constraints. A copy of the form was included in the package, the following is the information we will cover during the five sessions we currently have. This is not a recommendation for submitting hard copy claims. We encourage providers to submit claims electronically.National Government Services (NGS) UB-04 Training March 2007(These sessions should take no longer than two hours.)Housekeeping for Today’s WebinarJust a reminder!
· Please MUTE your phone
· Close all applications
· Please remember to be respectful to everyone on today’s call and NOT put your phone on HOLD
(We have added this slide because we have had too many situations where we can hear other conversations going on or music playing (when phone on hold) and have asked and asked to no avail.)
Agenda
· National Uniform Billing Committee (NUBC)
· Change Request Issued Upcoming Changes for March
· UB-04 is replacing UB-92
· Transition Period
· Drop Dead date
Change Requests Issued· CR 4023 – NPI
· CR 5072 – UB-04 crosswalk
· CR 5243 – Facility/Taxonomy crosswalk & Zip code instruction
Important Dates· Transition Period
· March 1, 2007 thru May 22, 2007
· Effective May 23, 2007
UB-04 Dataset Review
· The pieces of the puzzle, although mostly familiar, have been moved around (just a bit).
· Form Locators
· Eliminated
· Replaced
· Renamed
· Relocated
· New
UB-92 to UB-094 Form Locator Overview UB-92 UB-04
FL2: Unlabeled FL2: Now Pay to Name, Address, City, State ID
FL3: Patient Control Number FL3: Now Patient Control Number (line a) and
Medical Record Number (line b)
FL7: Covered Days FL7: Covered Days Eliminated (use Value
Code); FL7 now unlabled
FL8: Non-Covered Days FL8: Non-Covered Days Eliminated (use
Value Code; FL8 now Patient Name (line
a) and ID (line b)
FL9: Coinsurance Days FL9: Coinsurance Days Eliminated (use
Value Code; FL9 now Patient Address,
City, State, ZIP and Country Code
FL10: Lifetime Reserve Days FL10: Lifetime Reserve Days Eliminated;
(use Value Code); FL10 now Patient
Birth Date
FL11: Unlabeled FL11: Now Patient Sex
FL12: Patient Name FL12: Now Admission Date; Patient Name
Moved to FL8
FL13: Patient Address FL13: Now Admission Hour; Patient Address
Moved to FL9
FL14: Patient Birth Date FL14: Now Type of Admission; Patient Birth
Date moved to FL10
FL15: Patient Sex FL15: Now Source of Admission; Patient Sex
moved to FL 11
FL16: Patient Marital Status FL16: Patient Marital Status Eliminated; now
Discharge Hour
FL17: Admission Date FL17: Now Patient Discharge Status;
Admission Date moved to FL12
FL18: Admission Hour FL18: Now a Condition Code field;
Admission Hour moved to FL 13
FL19: Type of Admission/Visit FL19: Now a Condition Code field; Type
Of Admission/Visit moved to FL14
FL20: Source of Admission FL20: Now a Condition Code field; Source
Of admission moved to FL15
FL21: Discharge Hour FL21: Now a Condition Code field;
Discharge Hour moved to FL16
Fl22: Patient Status/Discharge FL22: Now a Condition Code field;
Code Patient Status/Discharge Code moved
To FL17
FL23: Medical/Health Record FL23: Now a Condition Code field;
Number Medical Record Number moved to
FL3 (b)
FL29: Condition Code field FL29: Now accident state
FL30: Condition Code field FL30: Now Unlabeled
FL31: Unlabeled FL31: Now Occurrence Code/Date field
FL35: Occurrence Code/Date field FL35: Now Occurrence Span Code/Date
FL37: ICDN/DCN FL37: Now unlabeled; ICDN/DCN moved
To FL64
FL43: Revenue Code Description FL43: “Page _ of _” added to line 23
FL44: HCPCS/Rate/HIPPS Code FL44: “Creation Date” added to line 23
FL51: Employer Location FL51: Name changed to Health Plan ID
FL56: Unlabeled FL56: Now NPI
FL57: Unlabeled FL57: Now Other Provide ID (Primary,
Secondary, Tertiary)
FL64: Employer Status Code FL64: Employer Status Code Eliminated;
FL64 now Document Control
Number (DCN)
FL66:Employer Location FL66: Employer Location Eliminated;
FL66 now Diagnosis and Procedure
Code Qualifier (DX Version
Qualifier)
FL67: Principal Diagnosis Code FL67: Expanded to Include Other Diagnosis
Codes (A thru Q)
FL68: Other Diagnosis Codes field FL68: Now not used
FL69: Other Diagnosis Codes field FL69: Name changed to Admitting
Diagnosis Code
FL70: Other Diagnosis Codes field FL70: Name changed to Patient’s Reason
For visit (A thru C)
FL71: Other Diagnosis Codes field FL71: Name changed to PPS Code
FL72: Other Diagnosis Codes field FL72: Name changed to External Cause of
Injury Code (E-Code)
FL73: Other Diagnosis Codes field FL73: Now unlabeled
FL74: Other Diagnosis Codes field FL74: Name changed to Principal
Procedure Code/Date; Expanded to
Include FL74 (A-E) Other
Procedure Code/Date
FL75: Other Diagnosis Codes field FL75: Now unlabeled
FL76: Admitting Diagnosis Code FL76: Now Attending Provide Name and
ID (including NPI); E-Code
moved to FL72 (External Cause
of Injury Code)
FL78: Unlabeled FL78: Now Other Provider Name and ID
(including NPI)
FL79: Principal Coding Method Used FL79: Principal Coding Method Used
Eliminated; FL79 now Other
Provider Name and ID (incl NPI)
FL80: Principal Procedure Code/Date FL80: Now Remarks; Principal
Procedure Code/Date moved to
FL74
FL81: Other Procedure Code/Date FL81: Now Code-Code field; Other
Procedure Code/Date moved to
FL74 (a thru e)
FL82: Attending Physician ID FL82: Moved to FL76
FL83: Other Physician ID FL83: Moved to FL78
FL84: Remarks FL84: Moved to FL80
FL85: Provider Rep Signature FL85: Eliminated
FL86: Date FL86: Eliminated
January System Updates· New field for Taxonomy Code in MEDA DDE
· New field for 9 digit Zip Code in MEDA DDE
· Updates to CWF edits for NPI
Resources· www.nubc.org
· www.cms.hhs.gov
· www.npi.gov
· www.NGSMedicare.com
· Customer Service 1-866-380-4745 (CA)
1-877-309-4290 (WI)
There are five sessions scheduled for 3/22, 3/23, 3/29, 4/5, 4/19. We have a total of over 1000 registrants for the four sessions (which are now closed). There is still space available for the 4/19 session. If more sessions are needed, we will be more than happy to accommodate.
We are also updating the Computer Based Training sessions to accommodate the UB-04 and the NPI. We are aiming for them to be completed by April 15.
Comment: That’s great news!
Any other comments or suggestions?
Comment: This presentation is very detailed and easy to follow, well thought through.
Juliette: Providers can keep a copy at their desk for quick reference.
Juliette: We will be changing the titles on the screens very soon. This was brought up at the Home Health meeting this morning.
Juliette provided the members with an update.
We have completed 35 sessions (through 2/07) of the 87 sessions scheduled for the year. March, April and May we are very busy and we are currently on schedule.
Two sessions were for hospice billing.
Future sessions are:
2 Hospice billing
2 FISS
1 ACT
1 RTP & Reject
3 NPI
5 UB-04 (If associations would like us to partner with them, we will be glad to attend. Please email Juliette Chenian with any requests.)
IVR / On 3/1, a listserv was sent out about the new IVR. Juliette included slides regarding the different functions. She also included an IVR Navigation Tree as a handy guide.
For the next 2-3 months, we will be reviewing this information in all of our training sessions.
Q&A / No questions were submitted so is everything wonderful?
Comment: Yes.
Updates: Claims / Annie Dills had nothing to report.
Updates: EDI / No update, please get your NPI.
Updates: Medical Review / Verna Bowman gave the update.
Pending workload is very current, 25 days old. The data unit will be compiling Jul-Dec to see if there is any new probe activity.
Updates: Provider Audit / No update.
Update: Billing Trend Analysis / Juliette Chenian reviewed the billing trend analysis and Reason Codes.
We have a training session that shows providers how they can see their own RTPs and Rejects. With the home health group we saw an improvement after they attended these sessions. Unfortunately that is not the case here. What can we do to improve the hospice errors?
Question: Are the reviewers looking at it differently?
Juliette: No, these are straight edits. You can go the our website and look at the reason code tips (for which 38200 is there) and it will tell you how to correct this error and how to prevent it in the future. Should we do a brown bag on the 2 highest reason codes?
Comment: Perhaps if you could see which providers are making these numbers go up or if there is a system problem, you could target the education to those providers. We have not seen anything like this in the associations.
Juliette: Are there any other topics you would like to see?
Comment: That’s a hard one to answer but looking at the trends is important.
Juliette: Are any of you going to the National Meeting?
Question: Can you review that data again?
Juliette: It’s in May in Chicago and it’s for WI and CA workloads on May 18.
Any other questions? / Question: MSP updates? We need training.
Juliette: At the end of all the Computer Based Training sessions, there is an MSP section. We are considering a stand-alone MSP course that will hopefully be completed in 2008.
Meeting Adjourned at 1:51 PM PDT, 3:51 PM CDT, and 4:51 PM EDT / The next meeting is on 5/18/07 National meeting in Chicago which is a face-to-face.
The meeting was adjourned.
The guidance provided during this teleconference/meeting is deemed to be reliable. However, at any time, such guidance is subject to change or clarification. For that reason, please be sure to check the UGS website for the most current information before taking action on any issue.