Medicare transition update September 16, 2013, marked the transition to the new Medicare Administrative Contractor, Noridian. In the first few days, the California Medical Association (CMA) heard about only minor problems with technology, including phone systems that went up and went down, a few issues with the online provider service tool and problems with printing of -PDF files from the Noridian website. Most issues have been resolved. Traffic on the Noridian Provider Contact Center phone line is high, as expected. Wait times are sometimes four to five minutes, but practices report satisfaction with ... September 25, 2013 Medicare Medicare, Noridian, Insurance/Reimbursement 0 0 Comment Read More »
PQRS administrative claims-based reporting deadline is October 15 Physicians who do not successfully participate in the Physician Quality Reporting System (PQRS) this year will be subject to PQRS payment penalties starting in 2015. PQRS is a Centers for Medicare and Medicaid Services (CMS) quality reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals. Physicians who do not report on at least one individual measure in 2013 or elect to participate in the administrative claims reporting option will receive a 1.5 percent payment penalty in 2015. The penalty ... September 20, 2013 General Medicare, Physicians Quality Reporting System, PQRS, Centers for Medicare and Medicaid Services, Insurance/Reimbursement 0 0 Comment Read More »
Medicare transition to Noridian is just a week away! We are just one week away from the September 16 cutover date from Palmetto to the new Medicare Part B fee-for-service contractor, Noridian. Although efforts have been made to minimize the burden to practices and to ensure that physicians continue to receive their Medicare payments in a timely fashion after the transition, there are a number of things physicians should be aware of, including: Last day to submit to Palmetto: September 11, 2013 is the last day providers may submit electronic claims to Palmetto (2:00 p.m. cutoff time), and the ... September 10, 2013 Medicare Medicare, Medicare Transition, Noridian, Palmetto, Insurance/Reimbursement 0 0 Comment Read More »
Medicare transition is less than two weeks away September 16, 2013, is the cutover date for transition of the Medicare Part B fee-for-service contractor from Palmetto GBA to Noridian. Although efforts have been made to minimize the burden to practices and to ensure that physicians continue to receive their Medicare payments in a timely fashion after the transition, physician practices will have to make some changes in their processes, including but not limited to the following: •Electronic claim submitters must change the contractor ID (payor ID) on their transmissions. The new ID for the Northern California jurisdiction is ... September 3, 2013 Medicare Insurance/Reimbursement, Medicare Transition, Medicare, Noridian 0 0 Comment Read More »
Medicare transition is three weeks away September 16, 2013, is the cutover date for transition of the Medicare Part B fee-for-service contractor from Palmetto GBA to Noridian. Although every effort has been made to minimize the burden to practices and to ensure that physicians continue to receive their Medicare payments in a timely fashion after the transition, physician practices will have to make some changes in their processes. Practices are encouraged to review the resources available to you to ensure you are aware of and prepared for the transition. Physician practices that submit their claims electronically, ... August 26, 2013 Medicare Medicare, Medicare Transition, Noridian, Insurance/Reimbursement 0 0 Comment Read More »
State delays duals pilot project until April 1 The California Department of Health Care Services (DHCS) announced today that it would delay by three months implementation of the state's "pilot project" to redesign care for Medicare/Medi-Cal dual eligibles. The program, called CalMediConnect, is now expected to begin no earlier than April 2014. The project was authorized by the Assembly in July 2012 in an effort to save money and better coordinate care for the state’s low-income seniors and persons with disabilities. The program begins with a three-year demonstration project that would see a large portion of the state's ... August 15, 2013 Managed Care, Medi-Cal, Medicare DHCS, Medi-Cal, Medicare, Dual Eligible, Insurance/Reimbursement 0 0 Comment Read More »
Learn about Noridian's Provider Portal, Endeavor One of the frequently asked questions on the Medicare transition is whether or not Noridian has a product similar to Palmetto’s Online Provider Services (OPS) portal. Noridian does have a similar provider portal called Endeavor. Noridian is conducting web-based workshops on Endeavor. This Medicare Part A and B workshop will be conducted through a web-based training tool that requires an Internet connection. The training will last approximately one hour, including time for questions. Physicians interested in Endeavor are encouraged to attend one of the following workshops: Aug. ... August 7, 2013 Medicare Medicare Transition, Noridian, Webinars, Medicare 0 0 Comment Read More »
Resources to assist physicians with the Medicare contractor transition Goal: Provide members with information and resources to prepare their practices for the transition of Medicare contractors from Palmetto to Noridian on September 16 (Part B). Current CMA Resources 1. CMA’s Medicare Transition webpage – CMA has created a dedicated Medicare transition webpage, www.cmanet.org/medicare-transition, offering practices the ability to access updates and important information regarding the transition in one easy-to-access to location. All resources related to the Medicare transition will be accessible through this site. 2. CMA’s Medicare Transition Guide: What physicians need to know – This guide, which members can download free ... August 1, 2013 Medicare Medicare Contractors, Noridian, Palmetto, Medicare 0 0 Comment Read More »
Medicare locality reform ("The California GPCI Fix") clears House Congressional Committee as part of the Medicare SGR overhaul legislation On July 31, the House Energy and Commerce Committee voted unanimously to approve a BIPARTISAN Medicare Sustainable Growth Rate (SGR) overhaul legislation, H.R. 2810. Included in the bill is the CMA-sponsored California Medicare locality reform known as the “California GPCI Fix.” The California locality provision is a compromise between Committee Chairman Fred Upton (R-MI) and Ranking Democrat Henry Waxman (D-CA) who insisted the California update be part of the committee bill. It is based on legislation by Congressman Sam Farr (D-Santa Cruz/Monterey) and Darrell Issa (R-San Diego) who are ... July 31, 2013 Medicare California GPCI Fix, SGR, Sustainable Growth Rate, Medicare 0 0 Comment Read More »
CMA urges CMS to postpone changes to QIO program The Centers for Medicare and Medicaid Services (CMS) recently called for public comments on how it can best organize the national cadre of Medicare Quality Improvement Organization (QIO) contractors. The mission of the QIO program is to improve the effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. Currently, CMS contracts with one organization in each state to serve as that state's QIO contractor. QIOs are private, mostly not-for-profit organizations, staffed by physicians and other health care professionals who are trained to review medical care, help beneficiaries with ... July 25, 2013 Medicare Centers for Medicare and Medicaid Services, Insurance/Reimbursement, Quality of Care, Medicare 0 0 Comment Read More »
