MED Group Competitive Bidding Institute Weekly Update-October 20, 2011

Dear MED Group Competitive Bidding Institute Members,

Round 1 Information:  
All Medicare Provider and Supplier Payments to be made by Electronic Funds Transfer

Existing regulations at 42 CFR 424.510(e)(1)(2)  require that at the time of enrollment, enrollment change request or revalidation, providers and suppliers that expect to receive payment from Medicare for services provided must also agree to receive Medicare payments through electronic funds transfer (EFT). Section 1104 of the ACA further expands Section 1862 (a) of the Social Security Act by mandating federal payments to providers and suppliers only by electronic means. As part of CMS’s revalidation efforts, all suppliers and providers who are not currently receiving EFT payments will be identified, and required to submit the CMS 588 EFT form with the Provider Enrollment Revalidation application.

For more information about provider enrollment revalidation, review the Medicare Learning Network’s Special Edition Article #SE1126, titled “Further Details on the Revalidation of Provider Enrollment Information.”

 

Round 2 Information:

Tip:   Update your contact information on file with National Supplier Clearinghouse (NSC). 

Task:   The following contact information in your enrollment file at the National Supplier Clearinghouse (NSC) must be up to date before you register to bid. If your file is not current, you may experience delays and/or be unable to register and bid. DMEPOS suppliers should review and update:
         o The name, Social Security number, and date of birth for all authorized official(s) (if you have only one authorized official listed on your enrollment file, consider adding one or more authorized officials to help with registration and bidding); and
         o The correspondence address.

DMEPOS suppliers can update their enrollment via the internet-based Provider Enrollment, Chain and Ownership System (PECOS) or by using the 7/11/2011 version of the CMS-855S enrollment form. Suppliers not currently using PECOS can learn more about this system by accessing the PECOS website (http://www.cms.gov/MEDICAREPROVIDERSUPENROLL) or reviewing the PECOS fact sheet at the following link: (http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_DMEPOS_FactSheet).

Information and instructions on how to submit a change of information via the hardcopy CMS-855S enrollment form may be found on the NSC Web site (http://www.palmettogba.com/nsc) and by following this path: Supplier Enrollment/Change of Information/Change of Information Guide.

MED Suppliers Network Weekly Update-August 4, 2011-Competitive Bidding Institute

Round 1 Updates: 

MLN Matters: DME National Competitive Bidding: Correction to Permit Payment for Certain Grandfathered Accessories and Supplies-This article is for suppliers billing Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for certain grandfathered accessories and supplies furnished to Medicare beneficiaries after the start of a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). 

STOP – Impact to YouThis article is based on CR7389 which informs Medicare suppliers and DME MACs that Medicare payment is permissible to a non-contract, grandfathered supplier for furnishing certain purchased, covered accessories or supplies furnished for use with capped rental equipment.

CAUTION – What You Need to KnowThere are limitations on the duration of this permission as well as constraints on the applicable Healthcare Common Procedure Coding System (HCPCS) codes. The KY modifier should not be annotated on claims for these HCPCS codes after September 30, 2011.

GO – What You Need to DoSee the Background and Key Points Sections of this article for clarification and details regarding these changes.  To see this article in full, go to:  http://www.cms.gov/MLNMattersArticles/downloads/MM7389.pdf

  

Round 2 Tips & Tasks:
NOTE: This information was previously published June 9, 2011 but many missed the update, so I am resending the information.
Tip:   You and/or your designated staff should be sure that your Medicare Enrollment Application (Form 855S) is accurate and up-to-date.

Task:  

1.  Critical to valid bidder registration-be sure information is correct and up to date.  Any changes to your busines (except enrolling a new business location) must be reported within 30 days of the effective date of the change.  To access the Form 855S, go to:  http://www.cms.gov/cmsforms/downloads/cms855s.pdf

2.  Authorized official(s)-Section 6 (page 23) and 15 (page 31)-very important

 3.  Correspondence address-Section 2A2 (page 8)

4.  Please note-it can take CMS 45 days to make these changes.

Upcoming Webinars (8/9 and 8/22 are repeats for those who missed them in July):

8/9/2011- 11:00 am CDT-Introduction to MED Group Round 2 Competitive Bidding Institute-(No charge)-to register: https://www2.gotomeeting.com/register/680808338

8/17/2011 -11:00 am CDT How to Implement Activity Based Costing for Competitive Bidding Products -($49 per member)- to register:

https://www2.gotomeeting.com/register/848065883

8/22/2011 -1:00 pm CDT Preparing to Submit a Bid for Round 2 Competitive Bidding -(No charge)-to register:  https://www2.gotomeeting.com/register/545368090

MED Suppliers Network Weekly Update-July 28, 2011 Competitive Bidding Institute

Round 1 Updates: 

2nd quarter Form C is to be RECEIVED by CBIC no later than tomorrow, Friday, July 29, 2011.

Remitance Advice Change to Financial Control Number Impacting IVREffective July 15, 2011 in response to CMS Change Request 7068, there has been a change to the information available on the remittance advice. The Financial Control Number (FCN) no longer displays the number associated with the offset. This field now displays the Claim Control Number of the claim which has been offset for all or a portion of the overpayment. Additionally, the Health Insurance Claim Number of the patient associated with the claim, and the amount applied to the debt are provided in the "PROVIDER ADJ DETAILS PLM REASON CODE" portion near the end of the remittance advice.

Although the label is still "FCN", it is important to understand this number cannot be used to inquire on an overpayment through the Interactive Voice Response (IVR) System. For Suppliers to learn the original patient and date of service that caused the overpayment on remittance advices dated 07/15/2011 and after, they may:

1. Refer to the original overpayment letter mailed to them by NAS or a different CMS-authorized entity (e.g., Recovery Audit Contractor)
2. Call the Contact Center Customer Service Representatives (1-866-243-7272) with your NPI, PTAN, TIN and remittance advice date. The CSRs can then provide you with the FCN associated with the overpayment. This information will enable you to obtain the overpayment details from the IVR.

Note: Customer Service Representatives are unable to release the details of the cause of an overpayment (patient's name, date of service, amount paid and denied on original claim).

  

Round 2 Tips & Tasks:

Tip: Based on information from our MED Members involved directly in Round 1 of Competitive Bidding, they stated one of the most important items was to start now with your planning.  To begin this you will need to assemble your team to help with the bid process, evaluating your business as well as striving to make your business more efficient as we go forward in the "New Environment" that Competitive Bidding is requiring our businesses to operate in. 

  

Task: Assemble your team.  As more information is released from CMS, you will start to have weekly meetings but now is the time to get these individuals up-to-speed on what will be happening in the next few months and what their role will be in helping to prepare for the bid. The recommendations of staff for the team are as follows (may need one or more staff from these depts. depending on the structure and size of your company):

1.  Senior Management Person to drive the meetings and team
2.  Purchasing

3.  Finance

4.  Marketing

5.  Sales

6.  Operations

Show Support for HR 1041 

In last week's webinar, Wayne discussed the process of sending your legislators an email to show support of HR 1041 and to Stop Competitive Bidding for Round 2.  I have created step by step instructions for this process.  Please feel free to forward this information to your patients, co-workers, and referral sources to have them show their support in the effort to STOP and REPEAL Competitive Bidding.  To access this set of instructions to attach to an email, click here.

MED Suppleirs Network Weekly Update-July 14, 2011

Round 1 Updates: 

2nd quarter Form C is to be RECEIVED by CBIC no later than July 29, 2011.

Updated ABN: The latest version of the ABN (with the release date of 3/2011 printed in the lower left hand corner) is now available for immediate use and can be accessed via the link below. In order for providers and suppliers to have time to transition to using the newly posted notice, mandatory use of this version begins on November 1, 2011. All ABNs with the release date of 3/2008 that are issued on or after November 1, 2011 will be considered invalid.

The mandatory use date has been changed from September to November to accommodate those providers and suppliers with pre-printed stockpiles of ABNs so that they have additional time to exhaust their supplies of the outgoing ABN. Go to http://www.cms.gov/BNI/02_ABN.asp to view the information and download the ABN.

  

Prospective Billing for Refills of DMEPOS Items Provided on A Recurring Basis:

To view this MLN Matters article, you may click on the link below or paste the following into your Internet browser:http://www.cms.gov/MLNMattersArticles/downloads/MM7452.pdf

Round 2 Tips & Tasks:
Tip:   Attend one of the two webinars being hosted by THE MED Group in the next week to learn about the Competitive Bidding Program MED has put together for its members to help you prepare for  Round 2 Competitive Bidding.

Task: Select the staff you wish to attend one or both of these webinars.  The same webinar will be hosted twice to accomodate schedules and time zones. To register go to:

July 14, 2011 at 11:30 am CDT: https://www2.gotomeeting.com/register/628598227

July 20, 2011 at 1:00 pm CDT: https://www2.gotomeeting.com/register/390176378

Additional Upcoming Webinar:  Preparing to Submit a Bid for Round 2 of Competitive Bidding-July 21, 2011 at 12:00 pm CDT

The MED Group realizes that Round 2 of Medicare competitive bidding is one of the biggest concerns for our industry.  While the final regulations are not published yet and as and Industry, we are not completely clear on the rules and protocol--the time to prepare your organizaiton is NOW and MED has the right tools and programs for you.

This webinar will help you understand the activities you need to be engaging now in order to submit an accurate bid and/or evaluate your company to determine whether you will bid or not.  Please join Wayne Grau, VP of Contracting and Business Services, The MED Group as he discusses information you will need to know to prepare your company for submitting a bid for Round 2 of Medicare Competitive Bidding.  

The information provided in this webinar will be based on the bidding process from Round 1 of the Competitive Bidding Program.  Once the final regulations are released, we will be providing a follow up webinar to discuss any changes that CMS makes.

This webinar is at no charge for MED members. To register go to: https://www2.gotomeeting.com/register/708990442.

MED Suppliers Network Weekly Update-June 30, 2011

Round 1 Updates:

CMS has sent out 3 updates to information on different matters that could be pertinent to your company whether involved in Competitive Bidding or not.  Below is the topic and the link for the complete article from CMS. 

Auto Denial of Claims Submitted with a GZ Modifier:  http://www.cms.gov/MLNMattersArticles/downloads/MM7228.pdf

Claims Modifiers for Use in the DMEPOS Competitive Bidding:
http://www.cms.gov/MLNMattersArticles/Downloads/SE1035.pdf

Edit to Deny Claims for Repairs to Capped Rental DME:
http://www.cms.gov/MLNMattersArticles/downloads/MM7212.pdf

Round 2 Tips & Tasks:
Tip:   When submitting the bid, you will need the following hardcopy items (if CMS follows the same criteria as Round 1). When the Round 2 information is published we will update the information and send it to you.

Task: Locate the following items and have them in a folder or place of your choice so you have them readily on hand when time to submit a bid. You may need to meet with your CPA to begin talks of having this information readily available when needed.

Financial Statements for the Last (immediate one (1) year prior) calendar year:

1.  Income Statement-includes revenue, adjustment to revenue, cost of goods sold, expenses by category, Net Income/Loss

2.  Balance Sheet-includes current assets, total assets, current liabilities, total liabilities, stockholder or owner’s equity

3.  Statement of cash flow-sectioned into different areas as resulting from operating activities, financing activities and investing activities

4.  Tax return extract for the last operating year (calendar or fiscal year)-this is the revenue and expense portion of the organization’s tax return 
    a. If tax return has not been filed and supplier has requested an extension of time, the tax extension form filed with the IRS must be submitted
     b. Tax extension form must be submitted with other hardcopy documents
     c. If tax extension filed, the tax extract that is filed with the extension to the IRS, it must be submitted also
    d. The final tax extract must be sent to CBIC within three (3) business days of filing the return with the IRS.
    e. Tax returns that are date after the date of the extension to file are not acceptable and the bid will be rejected.
    f.  If other deductions are claimed as expenses, must send documentation details to support
    g. If bidding supplier is a subsidiary of a parent company
             i. If subsidiary files its own tax return, submit only the subsidiary financial documents.
            ii. If subsidiary does not file its own tax return, submit both parent and subsidiary documents and parent company tax return extract.

MED Suppliers Network Weekly Update-June 23, 2011

This past week MED Suppliers Network exhibited at the Case Managers Society Association Annual Convention in San Antonio, TX.  The exhibit was a great success and we had access to over 2,200 case managers to promote our MED Members on the website, www.medsuppliersnetwork.com and how easy it is to locate a supplier closest to their patient.  All were excited about the easy access and ways to help their patient. 

Form C for Round 1 of Competitive Bidding

For those in Round 1 of Competitive Bidding, the 2nd quarter Form C is due July 29, 2011. 

Tip:  The importance of having good credit and proper credit lines with your manufacturers cannot be overstated.  The members who are doing well within Round 1 of Competitive Bidding have established strong relationships with their manufacturers to move the relationship to a partnership level.  Getting the manufacturers involved early and establishing compliance levels along with making sure proper credit lines and financing lines are established before the bidding process was essential to their success.  The MED Group will be providing a webinar for our members to learn about business credt and what you can do to help increase your credit score and lower your borrowing costs.  We will be announcing that webinar within the next couple of months.

Task: 

1. Run your credit report-choose one of the following below-remember this will be used to find problems with your credit report.  You will also need to submit a credit report with your bid submission (numerical number included, but it cannot be older than 90 days at the time of bid submission).
        a.  Experian-www.experian.com     b.  Transunion-www.transunion.com     c.  Equifax-www.equifax.com     d.  Dun & Bradstreet-www.dnb.com     e.  Standard & Poor's-www.standardandpoors.com
2. Verify if the information is correct (name, social security number or TIN, address and claims)
3. Settle any issues and disputes that are on the credit report
        a.  There are procedures on each website on "How to dispute a charge or claim"

Double check the credit report to be sure it is updated to show disputes or items that have been settled or changed
     a.  This could take up to 60 days to be processed and handled
     b.  Be ready to provide proof if something was paid that should be marked as such on the credit report
     c.  Very difficult to have an item removed from a credit report-could be settled, disputed or paid (usual and customary)