DAC Meeting Updates - August 24, 2017

DAC meeting

August 24, 2017

1) CURES Act Mass Adjustment – 70.1% complete as of 8/18/2017

a. RARC code 689 on remittance advice identifies the adjustment

b. Status is on the home page of the website

2) New Medicare Cards

a. CMS has numerous reference documents on their website

b. CMS has been holding open door forums regarding the transition to the Medicare Beneficiary Identifier (MBI)

c. Transition period is April 1, 2018 – December 31, 2019 (Claims can be submitted with HICN or MBI)

d. No end to end testing, transition is the live testing period

e. After January 1, 2020, MBI is needed on all claims

f. MBI will be 11 characters in length

i. No special meaning to characters

ii. 0-9 and A to Z except S, L, O, I, B and Z

iii. 2nd, 5th, 8th, and 9th characters will always be a letter

iiii. Characters 1, 4, 7, 10, and 11 will always be a number

v. 3rd and 6th characters will be a letter or a number

g. October 2018 through the transition period, claim submitted with HICN, will be returned with both HICN and MBI on the remittance advice

3) Updated ABN Form

a. Required as of June 21, 2017 – CMS-R-131 (Exp. 03/2020)

b. Special instructions for Non-assigned claims

c. See the Noridian website for additional detail

4) National expansion of condition of payment prior authorization for HCPCS K0856 and K0861beginning 7/17/2017 (from 3/20/17 to July only MO in JD)

a. Separate from the PMD demo in effect until August 31, 2018

5) Target Probe and Educate (TPE) pilot

a. Began 7/3/2017

b. Goal – improve claims payment error rate and reduce volume of appeals through claim review and education

c. Suppliers will receive written notification

d. See the Noridian website for further details

6) Paper remits will be stopped for suppliers who have been receiving ERA for 45 days or more beginning January 2, 2018

7) Fall In-Person Seminars – it would be great to have the DAC represented

a. 10/4/2017 Commerce, CA 

b. 10/10/2017 St. Louis, MO