CA Home Health-POE Advisory Meeting
Teleconference
Tuesday, March 13, 2007
Attendees: Juliette Chenian, Joe Hafkenschiel, Arthur Lurvey, Kathleen Sullivan, Carrie Wong, Lisa Silveria, Annie Dills, Ken Ottmann, Sherry Boyett (for Verna Bowman), Debbie Reed (CMS), Carol Snow, Paul Giles, Carolyn Bonner, Bonnie Fox, Sharon Fudge, Peg Jaber-Teresi, Dee Thorpe.
Facilitator/Recorder: Juliette Chenian/Carrie Wong
AGENDA ITEM
/DISCUSSION
/ RESPONSIBLE PERSON/TARGET DATE /Meeting was called to order at 8:04 AM PDT, 10:04 AM CDT, 12:04 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. She also reviewed the agenda and asked for any additions or changes to the agenda?
Juliette asked why there aren’t as many attendees for this meeting? How can we increase membership? Joe Hafkenschiel noted that there is a QIO/Lumetra training concurrently going on. Juliette noted that these meetings are set up prior to the start of the new fiscal year so that schedules can be accommodated.
Lisa Silveria noted that even though that is true, things come up that cannot be helped. Juliette said she knows that there is a lot of activity going on but she wanted to know if there was anything that could be done on this end to help the attendance at this meeting. No other comments.
Juliette also mentioned that an item not on the agenda regarding the new IVR system will be discussed.
Provider Outreach and Education (POE)
UB-04
Training Sessions / 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.
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.
Comment: That’s great news!
Any other comments or suggestions?
Comment: This presentation is very detailed and easy to follow, well thought through.
Paul Giles asked if the titles on the screens will be changed to UB-04? They currently still say UB-92.
Juliette: We will be changing the titles very soon.
Lisa Silveri asked “What percentage of the attendees for the UB-04 are Home Health Providers?”
Juliette: We will find out and put the answer in the minutes.
Juliette asked Joe Hafkenshiel if we could do this presentation at the CAHSAH meeting in May?
Joe will get back to Juliette after he finds a meeting room.
Juliette asked if Francie Bernstein was going to cover therapy or coverage at this meeting?
Joe said that since Dr. Lurvey and Julia Buckley could not attend, they wanted Francie to cover those items.
Sessions Completed:
We have completed 35 sessions (through 2/07) of the 87 sessions scheduled for the year. We are currently on schedule.
Three sessions were for home health and we are currently conducting a consolidated billing session as we speak.
2 DDE sessions with many home health providers attending.
2 FISS sessions.
1 RTP & Reject
3 NPI Over 50% of the attendees were home health.
Joe asked “with the impending changes to PPS, therapy case-mix, is there any new information?
Juliette noted that when the information is available, we will share it. When the time comes, we will incorporate it in the FISS training. Can we partner with CAHSAH?
Joe said yes, do you know when it will be?
Juliette, we do not have a date yet. I will let you know.
Remaining Sessions:
There are 2 FISS update sessions to go, several association meetings, 2 DDE and on April 4 there is an Ask the Contractor (ACT) for home health. If you have any questions for the ACT, send them to Jeffrey White.
We still have 2 home health sessions, 1 consolidated billing, 1 RTP & Rejects and 5 UB-04 to complete.
Juliette: If you can think of anything else, please let me know.
Joe: Julia Buckley used to do a documentation class in November, are you still doing that?
Juliette: We don’t know yet who is going to be doing this. We would like to continue it. I will have to get back to you on this. / Juliette Chenian
Juliette Chenian to follow-up with clinical POE
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.
Lisa Silveri: At the end, can we still speak to a CSR?
Juliette: Yes.
Juliette: On a quarterly basis, I send out items to be included in the association newsletters. This will be one of those items.
Q&A / We received some questions from Joe Hafkenshiel which are being researched.
I will include the answers in final minutes. / Juliette Chenian
Updates: Claims / Annie Dills gave the update.
Reason Code E551#6 – editing on RAPS, has been reported and they are working on it. There will be a Morning News article on it.
Updates: EDI / Ken Ottmann gave the update.
Ken wanted to asked that the providers please include their NPI and Oscar numbers on their claims.
Joe asked if they should include something on our website and newsletter?
Yes.
Updates: Medical Review / No update.
Juliette: Are there any concerns to be reported back to MR?
No response.
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.
If you look at the top three reason codes (38050, 38137, 38007) you can see that they have gone down this the prior month. This shows us that the training is helping the providers reduce their error rates so we are excited about that.
Sharon asked if there will be any MSP training?
Juliette: Not in this FY but in FY2008 we are considering a CBT course.
Joe: Is there any MSP on the website?
Juliette: There are Medicare Memos and Hot Topics articles. Also at the end of every Computer Based Training course there is a section just on MSP.
The listing for the MSP information is on the website under Medicare Memos for March 23, 2003 and in the Hospital Manual in Chapter 7.
Any other questions? / No.
Meeting Adjourned at 9:10 AM PDT, 11:10 AM CDT, and 12:10 PM EDT / The next meeting is on 5/17/07 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.