Riverbend

ListServ Message 10/24/2008

October 20, 2008

Please read to the end of this Listserv Message for information that may affect your facility.

The latest issue of the Medical Review Quarterly newsletter can be reviewed on the RGBA Website at: http://www.rgbagov.com/Publications/Medical-Review-Quarterly/

Also, the latest issue of the Rural Health Courier is posted to the RGBA Website at:
http://www.rgbagov.com/Publications/RHC-Courier/index.shtml

Certain Inpatient Hospital Claims being Held
Riverbend GBA has received instructions from The CMS to hold inpatient hospital claims (11x bill types) that are assigned a diagnosis related group (DRG) 999 for all IPPS, IPF and LTCH providers pending further direction from the Centers for Medicare & Medicaid Services (CMS). These instructions were issued due to concerns by The CMS that DRG 999 could possible be assigned incorrectly to these claims. Riverbend GBA will update you on the instructions as soon as they are received from The CMS.

NPPES - Keeping It Safe and Keeping it Updated
This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES). The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners:

Know and maintain their NPPES User Ids and passwords.

Reset their NPPES passwords at least once a year.

See the NPPES Application Help page regarding the ‘Reset Password’ rules. Those rules indicate the length, format, content and requirements of NPPES passwords.

Review their NPPES records in order to ensure that the information reflects current and correct information.

Maintaining NPPES Account Information for Safety and Accessibility Health care providers, including physicians and non-physician practitioners, should maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes.

Viewing NPPES Information
Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways:
(1) By accessing the NPPES record at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.

If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page. If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled. Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID.
OR
(2) By accessing the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do. The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data. The health care provider can search for its information using the name or NPI as the criterion.

Updating NPPES Information

Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.

Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information. Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application. The paper NPI Application/Update Form can be downloaded and printed at http://www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf.

Need More Information?

Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203. Having trouble viewing any of the URLs in this message? If so, try to cut and paste any URL in this message into your web browser to view the intended information.

Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage

 

Centers for Medicare & Medicaid Services
Special Open Door Forum:
Quality Improvement Organization Beneficiary Protection Program
Thursday, October 30, 2008
2pm-3:30pm ET
Conference Call Only

The Centers for Medicare & Medicaid Services (CMS) will host this Special Open Door Forum (ODF)
to discuss improvements to the Quality Improvement Organization (QIO) Beneficiary Protection Program (BPP).The BPP incorporates several QIO functions, including quality of care reviews, reviews of beneficiary complaints, higher-weighted Diagnostic Related Group reviews, utilization reviews, early readmission reviews, EMTALA reviews, appeals of discharges from various provider settings (fee for service and Medicare Advantage), and hospital preadmission reviews.The purpose of this Special ODF is to gain insight regarding changes and improvements needed to the regulations governing the QIO program, specifically 42 CFR Parts 475, 476, 478, and 480.The feedback will facilitate CMS’ efforts to make the BPP more transparent to stakeholders, increase the effectiveness of QIOs in improving the quality of health care, and ensure the QIO regulations accurately convey all current legal requirements.

This Special ODF will focus on the following areas of the BPP:
Beneficiary Complaint Reviews
Quality of Care reviews
Transparency Process Requirements for QIO BPP functions

As CMS moves forward on transforming the Beneficiary Protection Program, additional Forums may be scheduled based on need.

 

We look forward to your participation.

 

Open Door Forum Instructions:

Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.

Dial: 1-800-837-1935
Reference Conference ID 67947865
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html . A Relay Communications Assistant will help.

An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning November 6, 2008 and available for 30 days.

For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/

 

Thank you.

Other Part A and Part B providers may now register for the Centers for Medicare & Medicaid Services

 

ICD-10-CM/PCS National Provider Conference Call that will be conducted on November 12, 2008 from 12:30 p.m. – 2:30 p.m. EST. To register for this call, go to http://www.cms.hhs.gov/icd10/Downloads/ICD10_otherproviders.pdf. To find additional information about this conference call and to access the ICD-10 Overview Presentation that will be discussed during the call, go to http://www.cms.hhs.gov/ICD10/07_Sponsored_Calls.asp.

 

Medicare Fee-for-Service Professional Providers and Suppliers:

 

Version 2.5 of the MREP software is available for download at http://www.cms.hhs.gov/AccesstoDataApplication/02_MedicareRemitEasyPrint.asp on the CMS website. For a description of thechanges in this version, see the “What’s New” section of the MREP User Guide – Version 2.5 at http://www.cms.hhs.gov/AccesstoDataApplication/Downloads/EasyPrintUserGuide.pdf.

 

Note: The latest Codes.ini file is now available. This file is necessary when the MREP software is distributed.

 

CMS Announces Updates to the Physician Quality Reporting Initiative Webpage

 

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce a new E-Prescribing Incentive Program section page on the Physician Quality Reporting Initiative (PQRI) webpage at www.cms.hhs.gov/pqri/03_EPrescribingIncentiveProgram.asp#TopOfPage on the CMS website.This new section page will provide information about the new E-Prescribing incentive program that was authorized by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).

Included on this page in the Downloads section is an “Introduction to E-Prescribing Incentive Program” Fact Sheet that describes the MIPPA provisions for the E-Prescribing incentive program.Additional information about the E-Prescribing incentive program and how to qualify for the E-Prescribing incentive for the 2009 reporting year will be posted in early November.

Information is continually being added, so please visit the Physician Quality Reporting Initiative webpage at https://www.cms.hhs.gov/PQRI on the CMS website often.

CMS Updates Hospital Outpatient Department Payment Information for Value-Driven Health Care

To support the delivery of high-quality, efficient health care and enable consumers to make more informed health care decisions, President Bush directed the U.S. Department of Health and Human Services to make cost and quality data available to all Americans. As part of this initiative, Medicare posted information in 2006 and 2007 about the payments it made during the previous year for common and elective procedures and services provided by Hospitals, Ambulatory Surgery Centers (ASCs), Hospital Outpatient Departments, and Physicians.

Earlier this year, Medicare updated the Hospital information and moved it to the Hospital Compare Website where it can be viewed along with hospital quality information. The Hospital compare website may be found at www.medicare.gov.

On October 17, 2008, Medicare posted an update to the Hospital Outpatient Department data. ASC and Physician payment data were updated earlier this year. The information is being displayed in the same format as in previous years, updated with calendar year (CY) 2007 data. The posting updates may be found at: www.cms.hhs.gov/HealthCareConInit/.

End of Listserv Message.

October 23, 2008

Riverbend GBA is aware that FISS is currently unavailable; however, we have no estimated time frame as to when the system will again be up. As soon as we are notified by our Data Center, we will advise you of the status. Thank you for your patience.

 

FISS is back up! Thank you for your patience while our Data Center worked to again make FISS available for production.

 

October 24, 2008

Riverbend GBA had reported a problem to CDS and to the Fiscal Intermediary Standard System this week concerning claims that were Returned to the Provider for correction (RTP’s). Riverbend retains RTP’d claims in FISS for 2 months (or 60 days), and initiates a system purge every month, on the third Saturday of each month. So in actuality some claims can be held longer than 2 months (depending on the timing of the RTP and the purge). When our claims purge ran this past Saturday October 18, 2008, RTP’d claims that were younger than 2 months were purged. Because of this issue, providers were advised to re-submit their claims with the necessary correction to prevent another RTP (the 201 reports show the reason for the RTP so you may make the corrections).

However. the problem with the RTP’d claims being purged too soon has been identified and resolved.FISS is sending our EDC the programming required to add the RTP’d claims back to the system. Riverbend GBA will advise you when the program fix have been installed. We have also been made aware of at least two other FI’s who experienced the same problem.

We do apologize for this inconvenience, and do appreciate your patience while our Data Center works to correct this issue.

End of Listserv Message.