WPS Medicare Updatespresented to Aksarben Chapter AAHAM

Aileen K. Sigler and Mary E. MuchowProvider Outreach & Education

Created 04/02/14

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CERT Program Identified Errors

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CERT Task Force

• MACs collaborate to educate • Goal: reduce National payment error rate• Departments>CERT>CERT A/B MAC

Outreach & Education Task Force

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CMS Secure Net Access Portal (C-SNAP) News

• New features coming summer of 2014• Part B Providers

• Clerical Error Reopening• Ability to make corrections to existing claims

• Overpayment Adjustments• Ability to submit Medicare Secondary Payer (MSP)

and non-MSP overpayment • Appeals Status

• Ability to check the status of Appeals• Now available for Part A providers

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FYI Database

• Left hand navigation throughout website

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Top Part B Phone and Written Correspondence

• FAQ web page

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Website Search Tips

• Upper right corner of web page

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Website Satisfaction

• Comments help enhance website• Please be specific

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Self Service Tools

• No limits• Available when you are • No wait, or hold time • Easy answers • Multiple users at one time • Most current information available

Change for Eligibility Inquiries

• CR 8248, SE 1249• Common Working File (CWF) queries for

eligibility terminated• Providers may transition to HIPAA Eligibility

Transaction System (HETS)• Claim submission/correction in Direct Data

Entry (DDE) not impacted• Eligibility still available with C-SNAP and

Interactive Voice Response (IVR)

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Appeals Navigator Tool

• Interactive• Questions/responses guide you

• Expedite processing• Select correct form• Submit to proper address

• Departments>Appeals>Calculators/Tools>Appeals Navigator

NEW!

Coordination of Benefits

• Restructure of Coordination of Benefits Contractor (COBC) and Medicare Secondary Payer Recovery Contractor (MSPRC)

• Commercial Repayment Center (CRC)• Disability, Working Aged and ESRD

• Benefits Coordination and Recovery Contractor (BCRC)• No Fault, Liability and Worker’s Comp

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Questions?