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DDE/PPTN User ID Annual Recertification

September 18, 2016 by Jill Schuerman

DDE/PPTN User ID Annual Recertification Process with CGS.

If you are an active DDE/PPTN user and you do not receive an email by October 1, 2016, please contact the CGS EDI Helpdesk:

Each year, Medicare providers are required to certify their Direct Data Entry (DDE) and/or Professional Provider Telecommunication Network (PPTN) user access. If recertification information is not verified and returned timely as described below, your access will be terminated.

Beginning on September 21, 2016, CGS will email DDE/PPTN recertification notices to all active Part A, Part B and HHH DDE and PPTN ID recipients or the contact person. Emails will continue to be distributed over the next several weeks.

Recertification notices must be completed and faxed within three days of receipt of your email. The returned recertification notice must include any approved changes, an authorized signature and date. Note:  Name changes are not allowed for DDE/PPTN user IDs.

Please do not respond directly to the email. CGS will only process recertification notices faxed to:

Ohio Part A – 1.615.664.5945 Kentucky Part A – 1.615.664.5943
Ohio Part B – 1.615.664.5927 Kentucky Part A – 1.615.664.5917
Home Health & Hospice – 1.615.664.5947

If you are an active DDE/PPTN user and you do not receive an email by October 1, 2016, please contact the EDI Helpdesk:

Part A – 1.866.590.6703, option 2
Part B – 1.866.276.9558, option 2
HHH – 1.877.220.6289, option 2

Failure to respond to the recertification notice may result in the termination of a DDE/PPTN user ID. If your ID is revoked and/or terminated, you will need to apply for a new ID by completing the Online Inquiry Service form. The normal processing time to receive a new user ID is 20 business days.

If you have any questions concerning the recertification process, please contact the CGS J15 EDI department. 

Each year, Medicare providers are required to certify their Direct Data Entry (DDE) and/or Professional Provider Telecommunication Network (PPTN) user access. If recertification information is not verified and returned timely as described below, your access will be terminated.

Beginning on September 21, 2016, CGS will email DDE/PPTN recertification notices to all active Part A, Part B and HHH DDE and PPTN ID recipients or the contact person. Emails will continue to be distributed over the next several weeks.

Recertification notices must be completed and faxed within three days of receipt of your email. The returned recertification notice must include any approved changes, an authorized signature and date. Note:  Name changes are not allowed for DDE/PPTN user IDs.

Please do not respond directly to the email. CGS will only process recertification notices faxed to:

Ohio Part A – 1.615.664.5945 Kentucky Part A – 1.615.664.5943
Ohio Part B – 1.615.664.5927 Kentucky Part A – 1.615.664.5917
Home Health & Hospice – 1.615.664.5947

If you are an active DDE/PPTN user and you do not receive an email by October 1, 2016, please contact the EDI Helpdesk:

Part A – 1.866.590.6703, option 2
Part B – 1.866.276.9558, option 2
HHH – 1.877.220.6289, option 2

Failure to respond to the recertification notice may result in the termination of a DDE/PPTN user ID. If your ID is revoked and/or terminated, you will need to apply for a new ID by completing the Online Inquiry Service form. The normal processing time to receive a new user ID is 20 business days.

If you have any questions concerning the recertification process, please contact the CGS J15 EDI department.

 

Filed Under: Hospice Billing Information Tagged With: DDE/PPTN

RUN NEW HIQA ON ALL PATIENTS

August 28, 2016 by Jill Schuerman

All Providers should run HIQA’s on all current patients as soon as possible to see if they are affected by the following issue.  CMS has announced that there have been erroneous death terminations for over 3,000 beneficiaries on Aug. 10 and Aug. 11, 2016, as well as 300 Rep Payees.  If the Rep Payee has been terminated due to death, the beneficiary they represent has had their benefits suspended.

Click here for more information.

 

Filed Under: Hospice Billing Information Tagged With: HIQA

Changes to Codes – Billing for Late Recertifications

August 25, 2016 by Jill Schuerman

Effective Date:  January 1, 2017

Implementation Date: January 3, 2017

Occurrence span code 77 is currently used for both late re-certifications and late NOE’s, and the Medicare system is having difficulty distinguishing when the 27 certification date should fall within the 77 span dates or not.   Change Request (CR) 9590 creates a new condition code for hospices to use to identify when an occurrence span code 77 period is caused by a late recertification of the terminal illness.  Note that CR9590 creates no new policy.

The new condition code 85 is effective on January 1, 2017 and is defined “Delayed recertification of hospice terminal illness.” When hospices report this code, Medicare systems will ensure the occurrence code 27 date does not fall within the OSC 77 dates. Your 27 code date will be the actual recertification date, which should fall the date after the occurrence span with the 85 Code.

To review, go to:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3577CP.pdf

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9590.pdf

Filed Under: Hospice Billing Information Tagged With: Codes, Hospice Billing

Hospice Claim Adjustments

August 20, 2016 by Jill Schuerman

Hospice Claim Adjustments Will Correct Routine Home Care Day Count

Two recent systems issues caused routine home care days to be miscounted on hospice claims:

  • Systems were not counting days that should receive high routine home care payments if a revocation was posted on the benefit period before the final claim was submitted. A correction was implemented on May 9, 2016.
  • Systems were using the election date instead of the admission date when a prior hospice period was involved. A correction was implemented on July 25, 2016.
  • Medicare Administrative Contactors are adjusting hospice claims to correct payment. Hospices do not need to take any action.

 

https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Downloads/2016-08-18-eNews.pdf

Filed Under: Hospice Billing Information Tagged With: Hospice Claim Adjustments

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