J15 Part A Ask the Contractor Teleconference Call Transcript December 13, 2011 at 2:00p ET Confirmation #

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J15 Part A Ask the Contractor Teleconference Call Transcript December 13, 2011 at 2:00p ET Confirmation # 33823667 Palmetto GBA, LLC.

At this time, I would like to welcome everyone to the J15 CGS Part A Ask the Contractor Teleconference Call. All lines have been placed on mute to prevent any background noise.

1 J15 Part A Ask the Contractor Teleconference Call Transcript December 13, 2011 at 2:00p ET Confirmation # Palmetto GBA, LLC. Moderator: Tammy Tucci Good afternoon, my name is (Chrissy) and I ll be your conference operator today. At this time, I would like to welcome everyone to the J15 CGS Part A Ask the Contractor Teleconference Call. All lines have been placed on mute to prevent any background noise. After the speakers remarks, there will be a question-and-answer session. If you would like to ask a question during this time, simply press star, then the number one on your telephone keypad. If you d like to withdraw your question, press the pound key. I would now like to turn the call over to Tammy Tucci. You may begin your conference. Thank you (Chrissy). Good afternoon and welcome to the CGS J15 Part A Ask the Contractor Teleconference for Ohio and Kentucky Part A providers and Jurisdiction 15. My name is Tammy Tucci of the Jurisdiction 15 Provider Outreach and Education Department and I will be your facilitator for today s call. I am joined today by a team of experts from across our Medicare organization. Together we will be providing you with transition information and taking your J15 related questions, once we get to the question-and-answer portion of our call. In our usual format, we are going to start with some J15 Part A news and reminders, then address some of your pre-submitted questions, and finally we will move on to the open question-and-answer portion of the call. Let s begin with our J15 Part A news and reminders is coming. Are you ready? You must comply with this important deadline to avoid delays in payments for Medicare fee for service claims after December 31, 2011; so right around the corner. You and your billing and software vendors must be ready to begin processing the Health Insurance Portability and Accountability Act, Version 5010, and D.O. production transactions by December 31, Beginning January 1, 2012, all electronic claims, eligibility, and claim status inquiries must use Versions 5010 and claims related transactions will no longer be accepted in Version The electronic remittance advice will only be available in the 5010 version. Paper submissions are not an option. Prepare now and be ready for the January 1, 2012 deadline. Important information on the revalidation of Medicare provider enrollment. The Centers for Medicare & Medicaid Services has reevaluated the revalidation requirement in the Affordable Care Act, and believe it affords the flexibility to extend the revalidation period for another two years. This will allow for a smoother process for provider and contractors. Revalidation notices will now be sent through March However, it s important to note, this does not affect those providers which have already received a revalidation notice. If you have received a revalidation notice from your contractor, please respond to the request by completing the application either through internet-based Provider Enrollment, Chain and Ownership System or PECOS or completing the appropriate 855 application form. CMS plans to post a list of providers who would sent request to revalidate. We will make an announcement via CMS listserv when this information is posted. If you are signed up for your Medicare contractor s listserv, you will get a notice that way. You may also sign up for a national listserv for your provider type by going to the CMS website. EDI Alert. Remits for check date 12/1/2011 have been restored and resent to Relay Health on Wednesday, December 7. Relay Health has confirmed receipt and is distributing these remits. Please contact Relay Health for missing remits for this check date.

2 Now I am going to go over our pre-submitted questions and answers. Please note that some of the pre-submitted questions received were Part D questions as opposed to Part A. Since this is the Part A J15 call, we will only respond to the Part A questions. The providers who submitted Part B questions will be contacted individually for response. The first question we received was can I get a clarification on the appropriate coding for iron sucrose, J1756. We have this item dropping for our outpatient hospital claims as J1756, but the wording on the LCD article appears to direct us to bill using C9399 for Part A outpatient hospital type of bill 13X. The attachment to this LCD, chemo and biological drug list shows J1756 needing specific diagnosis code. But it also refers to coding this medication as an unlisted medication instead of the more specific HCPCS that goes with this medication. C9399 is to be used for drugs and biologicals that do not have a HCPCS code. This code is the non-specific code used generally immediately after FDA approval of a drug or biological before a J or HCPCS code is assigned. The LCD article has been updated to reflect this, and we thank you for bringing this to our attention. Provider should always use the appropriate J-code when billing iron sucrose. So if there is a J-code available, please use that code and not the unlisted code. The next question we received was doing business as a centralized business office, we handle several different NPI numbers. However, today I was informed by the Kentucky call center representative that they are only allowed to take three accounts per individual provider. I had three different providers I was inquiring about. Therefore, I had to end each call and call back and wait again and again. This is very time consuming and counterproductive for staff. What is the reason behind this? And will this change in the near future? CGS is in the process of enhancing our inquiry tracking system that s used by the provider contact center. And with this enhancement we will begin being able to take multiple inquiries based on callers using multiple provider numbers. So please look for this change in the future. This brings us to our open question-and-answer session. I would like to open the lines for Q&A from the attendees on today s call. So (Chrissy) please remind the callers how they can get into the queue. Absolutely. If you would like to ask a question, please press star then the number one on your telephone keypad. If you would like to withdraw your question, press the pound key. We will pause for just a moment to compile the Q&A roster. Our first question comes from the line of (Roxiam Paul), your line is open. Yes. This is (Roxiam Paul) from Ohio Health. And my question being, when CGS first converted from NGS, we had several claims that were paid same date of service, same dollar amount were paid twice on specific remits. I have called in an action request and was just trying to figure out if NGS was going to retract the money themselves or if we should do a cancel bill? OK, that s a very good question. If you have identified an overpayment and you wish to go ahead and pay that back, you are welcome to go ahead and cancel the claim to make sure that the money is paid back. You don t have to wait for us to do anything on that. NGS wouldn t have any action on that, now that CGS has taken over that information, so if you want to go ahead and do that action, you can do that to repay the money. It was actually CGS to pay that as a duplicate. OK. And if it s CGS or NGS, either way you, under the system, the CGS system, you are able to go ahead in the system and make that cancellation and it will go to the system to make sure that that money is given back. OK. So go ahead and cancel those? Page 2

3 Yes, ma am. OK, great. I have one more question. We had several appeals from NGS -- that were sent to NGS prior to the cut over sometimes months or we were in the process that NGS gave us activity numbers on appeals that they were working on or discrepancies, and then when we got converted to CGS, they had no documentation and no record of those claims. Got you. And we have had some providers inquire about situations like this where they submitted to NGS and then of course the activity numbers that you are referencing are NGS numbers. So we don t have we don t have anything that goes back to those numbers, but when you contact us with your provider number, we should be able to look up your appeal. But if we find that we do not have the appeal in the system, that has not come over to us, we are asking the providers resubmit at that point. If you contacted then to the provider contact center to check on the status of that, and find that you are told that we don t have it, then do go ahead and send that appeal in to the redetermination on that form and we will go ahead and start the process on that, just to assure that you get that in. One more question Tammy. I have faxed in for the J15 online inquiry services, some staff that may need now online access. And it was faxed like in November, and we have a confirmation that it was received, but nothing has been done. It s there a backlog of getting people online access? Now when you say online access, are you meaning to direct that entry? Yes ma am. OK. The Medicare online system. Got you. To my knowledge there is not a backlog with that. But if you have you contacted the EDI, the tech support number to see what the status is on your application? No, I have not. November 12. I would go ahead and contact them, the regular provider contact center is not going to able to look that up, but if you call the tech support EDI helpdesk they will be able to look up your applications and let you know where they are in the process of those. I know that it typically takes at least 20 days, but you are saying it s been longer than this. OK, yes. I would definitely contact them to see the status on that. OK, great. Thank you. Sure, you are welcome. Again, if you would like to ask a question, please press star one on your telephone keypad. Our next question comes from the line of (Liz Kraters). Your line is open. Hi this is (Liz) calling from Massac Memorial Metropolis. My question is I ve done some followup on a claim that NGS processed before the conversion. And I called CGS to see if there s some denied line items on the claim. And they had no record of the claim in their system. So is this an issue where we should try to identify other claims that didn t cross-over from NGS? Page 3

4 When when you say that they don t have any sign of that claim in the system, are you saying that when you go out into this (DDE) system, you are able to see it, but whenever you ve called into the contact center, they are not able to see the claim that you are speaking about? I haven t I haven t tried to look it up on the DDE system. I gave the lady on the phone I gave her the DCN number from NGS. And she couldn t pull that up. She couldn t pull up any records by the patient. The date of service. The date of service, right. OK. Looks like the claim didn t get into CGS system at all. I can t imagine that it didn t get into the system, but I can certainly check on that. If I can get your information, I will be glad to contact you after the call and I will work with claims with the claims area, with the claim that you are speaking off, and see if they can take a look at that to see what s going on. It could be a situation where the claim is offline. But I don t believe that it s a situation where the claim hasn t come over. We haven t experience anything like that. OK. OK. But I definitely want to follow-up with you. So, Liz, what s your good contact number for you , extension, 254. OK Liz, I will get back in touch with you and I will get that claim information (inaudible) about it. Thank you very much. We see no further questions in the queue at this moment. OK, well, I thank you very much for attending today s J15 Ask the Contractor Call. It s our first. We are going to be having them a little more frequently than quarterly since we are newly (inaudible) J15 and we wanted to get providers extra opportunity to talk with us face to face. Please remember that you have two options for submitting your questions ahead of time if you would like. You can send it on the website by actually clicking on the link to key in your question there, or you can use the format from the website and fax it in. Either way, we will get them. But I do want to thank you again and let you know when the next Ask the Contractor Teleconference is coming. So you can go ahead and mark your calendars now. It is scheduled for February the 8th, 2012, again from 2 o clock to 3:30 p.m. Eastern Standard Time. So please mark your calendars. If you are a member of the listserv, you will be sent a reminder about attending or if you want to go to website, you can take a look, and we already have the call-in number and confirmation number to attend. So I am going to turn the call back over to (Chrissy) and she has some polling questions for you, and again thank you for attending today. Ladies and gentlemen, if you would stay on the line, we would like to conduct a brief survey. Once the questions and responses are read, we ask that you choose the appropriate responses using your telephone keypad. Our first question is, the CGS representatives were prepared for the teleconference. Please press 1 for very satisfied, 2 for satisfied, 3 for neutral, 4 for dissatisfied, and 5 for very dissatisfied. We will pause for a moment to compile the polling results. Page 4

5 And our next question, the CGS representatives were clear in explaining answers to my questions and concerns. Again that s 1 for satisfied, 2 for very satisfied, 3 for neutral, 4 for dissatisfied, and 5 for very dissatisfied. Now the third question. The CGS representatives were knowledgeable in the subject matter. 1 for very satisfied, 2 for satisfied, 3 for neutral, 4 for dissatisfied, and 5 for very dissatisfied. And our final question. And it helped me understand the subject matter. 1 for very satisfied, 2 for satisfied, 3 for neutral, 4 for dissatisfied, and 5 for very dissatisfied. Ladies and gentlemen, this concludes today s survey. I will now turn the call over to the presenter. I will turn the call over to presenters for any closing remarks. Yes, thank you for attending today s call. Please remember to attend or mark your calendars to attend the February 8 call at 2 o clock Eastern Standard Time and we look forward to talking to you then. Have a great day. And this concludes today s conference call. You may now disconnect. - END - Page 5

CIGNA. Moderator: James Herren January 23, :00 p.m. CT

CIGNA. Moderator: James Herren January 23, :00 p.m. CT Page 1 CIGNA January 23, 2008 1:00 p.m. CT Operator: Ladies and gentlemen, thank you very much for holding and welcome to the CIGNA Specialty ACT calls. Just a reminder that today s call is being recorded.