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News
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Aug 19
2010CMS will host a national provider conference call on "ICD-10 Implementation in a 5010 Environment". This call will be held on Monday, September 13 and will include a review basic information on ICD-10 and 5010. A question and answer session will be held at the end of the call. Medical coders, physician office staff, provider billing staff, health records staff, vendors, educators, system maintainers and all Medicare fee-for-service (FFS) providers are encouraged to attend. Registration is required and will close at 11:00 am CST on September 10, 2010, or when space has been filled. To register for the call go to: http://www.eventsvc.com/palmettogba/091310
When: Monday, September 13, 2010 Time: 11:00 am – 12:30 p.m. CST
Agenda:
- ICD-10 implementation for services provided on and after October 1, 2013
- Differences between ICD-10 and ICD-9-CM codes
- ICD-10-CM basic information for all users
- Tools for converting codes – General Equivalence Mappings (GEMs)
- Proposal to freeze ICD-9-CM and ICD-10 code updates except for new technologies and diseases
HIPAA Version 5010
- Compliance dates and timelines (No contingencies)
- 5010 before and after ICD-10 Implementation
- Readiness review for implementing HIPAA version 5010 and D.0
- What you need to be doing to prepare
- Medicare fee-for-service activities update
- Other issues and considerations
Conference Title: ICD-10 Implementation in a 5010 Environment Follow-Up National Provider Call
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Jul 13
2010
Birmingham/Montgomery, Alabama, July 13, 2010……As part of the strong commitment to facilitate the activities surrounding health information exchange, MediSYS has announced plans to release the MediSYS Physician Information Network in the first quarter of 2011. This MediSYS Physician Information Network will allow providers treating mutual patients to share pertinent health information electronically. Quickly and securely sharing information within a network of providers such as labs and diagnostic information, office notes, hospital documents, patient demographics, etc. will assist providers in the diagnosis and treatment of a patient.This physician information network streamlines the referral process by making provider-selected information immediately available to the referred-to physician. In addition, clinical data generated by the referred-to physician may be electronically transmitted back to original referring physician or onto another physician group if needed. This immediate access to patient information eliminates the need for the clinic to print, fax, scan, and mail the relevant information. The result is a huge savings in human resources and helps streamline patient care which is a major element in healthcare initiatives.
MediSYS has already established and implemented a high level of connectivity across the healthcare community in Alabama. With the current MediSYS EHR interoperability with 18 hospitals all over state, national and local lab reference companies, SureScripts, Medicaid Together for Quality, and others, providers already have access to a wealth of patient health information. With current electronic health record system links to over 300 Alabama providers, it is a logical extension for MediSYS to offer a network among physicians to share health information generated within the clinic. The addition of the MediSYS Physician Information Network is expected to become a significant resource to further enhance initiatives to foster information exchange across the state and across the nation.
MediSYS is 100% dedicated to improving the workflow and revenue of physicians, and has been for over twenty years. MediSYS serves more than a thousand physicians through medical practice management software, electronic health records, medical billing services and practice management services.
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Jul 9
2010Due to provider concerns surrounding PECOS enrollment issues, CMS will not implement the July 6 PECOS deadline. According to the email notification below from CMS, for payment for claims will not be affected by PECOS enrollment.
CMS TO REVIEW PECOS ENROLLMENT PROCESS
Medicare Working with Ordering and Referring Providers and Suppliers to Streamline Enrollment Process
The Centers for Medicare & Medicaid Services (CMS) is working with providers to address concerns about enrollment in the Provider Enrollment, Chain and Ownership System (PECOS) to ensure that Medicare beneficiaries continue to receive the health care services and items they need. PECOS is the electronic system used to enroll physicians and eligible professionals into the Medicare program.
As part of those efforts, CMS will, for the time being, not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010. While more than 800,000 physicians and other health professionals have enrolled and have approved applications in the PECOS system, some providers have encountered problems. CMS is continuing to update and streamline the process, and more providers have been enrolled in the past few days.
CMS issued an interim final regulation on May 5, 2010 implementing provisions of the Affordable Care Act that permit only a Medicare enrolled physician or eligible professional to certify or order home health services, durable medical equipment, prosthetics, orthotics, and supplies
(DMEPOS) , and certain items and services under Medicare Part B. The new law applies to orders, referrals and certifications made on or after July 1.
The comment period for the regulation closes on July 6, after which the comments will be reviewed and considered before a final regulation is issued.
The Affordable Care Act provisions and the regulation were designed as steps to prevent fraud in Medicare by ensuring that only eligible and identifiable providers and suppliers can order and refer covered items and services to Medicare beneficiaries.
Many physicians and other providers and suppliers have continued to make good faith efforts to comply with the requirements of the law and regulation. These efforts will be a significant factor in determining the procedures and processes that will be incorporated in the final rule.
While the regulation will be effective July 6, 2010, CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS. However, until the automatic rejections are operational, providers should not see any change in the processing of submitted claims, they will continue to be reviewed and paid as they have historically been reviewed and paid.
Additionally, though CMS is taking a more deliberative approach to using the PECOS enrollment system, the agency will employ a contingency plan to meet the ACA requirement that written orders and certifications are only issued by eligible professionals effective July 1.
CMS will continue to send informational notices to providers reminding them of the need to submit or update their enrollment and will work with the provider community to provide guidance on enrollment and will process all applications expeditiously.
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Jun 28
2010Cahaba GBA, the J10 A/B Medicare Administrative Contractor (MAC) for the states of Alabama, Georgia, and Tennessee, announced in a recent email notification that they will merge three claims processing environments by August 3. Below is their notification:
Dear Medicare Part B Providers,Multi-Carrier System Merge for J10 Providers (Alabama, Georgia, and Tennessee)
Cahaba Government Benefit Administrators,® LLC currently has three Multi-Carrier System (MCS) claims processing environments, which were inherited when we transitioned to the Jurisdiction 10 A/B Medicare Administrative Contractor (MAC). The three regions or segments are:
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Alabama
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Georgia
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Tennessee
The Centers for Medicare & Medicaid Services (CMS) has instructed Cahaba GBA to merge these environments. The transition to the new MCS claim processing environment is scheduled to begin on Saturday, July 31, 2010 and be fully operational on Tuesday, August 3, 2010.
The purpose of this merge is to unify all of the Part B claims processing functions into a single claims processing environment. This includes all data values and files, such as procedure code files and claims history. The merger will result in significant administrative savings while having virtually no impact upon beneficiaries or providers following the merge.
Cahaba GBA is committed to providing the Medicare community we serve with the highest level of service. Our goal is to make this a seamless transition with as few disruptions as possible. In the event we identify changes that will affect the provider community, we will communicate these changes through our website, via e-mail communications, and in our monthly newsletter, the Medicare B Newsline. In addition, we have established a dedicated section on our website at http://www.cahabagba.com/part_b/ .
We encourage the provider community to visit our website, to receive current and up to date information quickly.
Thank you,
Provider Outreach & Education (POE)
Cahaba GBA- J10 A/B MAC
Cahaba GBA- Title XVIII Part B Carrier for Mississippi
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