“ welcome to jurisdiction 10” workshop
DESCRIPTION
“ Welcome to Jurisdiction 10” Workshop. Presented by Cahaba Government Benefit Administrators ® , LLC J 10 A/B MAC Provider Outreach and Education April 21, 2009. Meeting Agenda. History of Cahaba Medicare Contracting Reform J10 Transition Georgia Dark Day Provider Enrollment - PowerPoint PPT PresentationTRANSCRIPT
“Welcome to Jurisdiction 10” Workshop
Presented by Cahaba Government Benefit Administrators®, LLC
J 10 A/B MAC
Provider Outreach and EducationApril 21, 2009
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Meeting Agenda History of Cahaba Medicare Contracting Reform J10 Transition
• Georgia Dark Day• Provider Enrollment• Medical Review• Medicare Secondary Payer• Electronic Data Interchange (EDI)• Provider Contact Center• Medicare Resources
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The History of Cahaba GBA® ,LLC
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Alabama Part A and Part B
since 1966
Cahaba GBA Expansion
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Georgia Part B Awarded 1996
Cahaba GBA Expansion
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Cahaba GBA Expansion
Iowa and South Dakota Part A including
RHHI Awarded 1999
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Mississippi Part B
Awarded 2000
Cahaba GBA Expansion
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Cahaba Government Benefit Administrators®, LLC
Part A Intermediary for AL
Part B Carrier for AL, GA & MS
Part A RHHI for 16 Northern/Midwest states
600+ employees
Three (3) office locations:Birmingham, AL; Savannah, GA; Des Moines, IA
Corporate office located in Birmingham, Alabama 8
Medicare Modernization Act
Signed into law on December 8, 2003 Largest amendment to the Social Security Act since the
inception of Medicare Provides several administrative, operational and functional
changes Includes CMS’ vision for contractor reform
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Title XVIII• 1816 and 1842 of
SSA• Beneficiary and
provider multiple contractors
• Either party can terminate
• Contracts and agreements year to year
MAC• Section 1874a of
SSA• Single contractor
for beneficiary and provider
• Only government may terminate
• Contracts will last a maximum of five years
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Evolution of Medicare Contracting Reform
Medicare Administrative Contractors
A/B Jurisdiction Map 11
Jurisdiction 10 MAC Award
Cahaba GBA awarded contract on January 7, 2009 New Jurisdictions to Cahaba
• GA Part A• TN Part A and B
Awaiting notification on the MS Part B workload
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WHAT SHOULD I DO BEFORE CUTOVER?
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FISCAL INTERMEDIARY
TO
A/B MAC
Transfer of Georgia Data
Dark day on May 4, 2009
Customer Service and claims system will not be available
Normal business operations will resume on May 5, 2009
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Daily Payment Cycle
Payments made on a daily basis
First payment processed May 4, 2009
PIP payments paid bi-weekly
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Provider Enrollment
CMS 588 Electronic Funds Transfer
New CMS 588 form MUST be completed Original signature is required Acknowledgement letter will be sent Download form at:
www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf
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Submit forms to:Provider Enrollment
PO Box 830867Birmingham, AL 35283-0867
Medical Review
Future Effective Local Coverage Determinations (LCDs)
No Intermediary Advisory Committee meeting
View LCDs at www.cahabagba.com/j10/lcds.htm
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Medicare Secondary Payer (MSP)
Contact COBC regarding MSP issues
1-800-999-1118 or
TTY/TDD: 1-800-318-8782
MSP Admission Questionnairewww.cms.hhs.gov/ProviderServices/Downloads/pro_othertool.pdf
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Vehicles of Communication
J10 Transition Newsline
Listserv messages
Face-to-Face events
Open Door Forums (ODF)
POE Advisory Group meeting
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Stay Connected www.cahabagba.com/j10
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Electronic Data Interchange (EDI)
New FISS and DDE passwords and IDs not required
Third party vendors IVANS
• 1-800-548-2690 ext. 3750 VisionShare
• 1-888-895-2649 Other approved vendors
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Electronic Data Interchange
Cahaba Secure File Transfer Protocol Server (FTP)www.cahabagba.com/j10/edi/edi ftp instructions.pdf
New Submitter IDs and Password• Letters mailed April 1, 2009
Testing not required
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Electronic Data Interchange (EDI)
Help Desk SupportTelephone Us 866-582-3253
Fax Us 205 402-5706
Email Us [email protected]
Write Us Cahaba GBAEDI Services
PO Box 12967Birmingham, AL 35202
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Provider Contact Center
Enterprise Call Center• Birmingham, Alabama• Savannah, GA
Voice Response Enhancement or IVR System• Speech recognition coming soon
Medicare Beneficiary – 1 800 Medicare (633-4227)
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CMS Resources
Medicare Administrative Contractorwww.cms.hhs.gov/MedicareContractingReform
MLN Matters Article SE0837www.cms.hhs.gov/MLNMattersArticles/downloads/SE0837.pdf
Change Request 6436www.cms.hhs.gov/transmittals/downloads/R467OTN/pdf
CMS Change Request 5979www.cms.hhs.gov/Transmittals/downloads/R33OTN.pdf
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Questions
Please complete your general inquiry feedback form.
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Thank You!
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Cahaba GBA, LLCJ10 A/B MAC