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Latest Updates on CMS Billing Changes: NPI, CCN, UB-04, 1500, No-Pay
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NPI
As of May 23, 2007, the NPI (National Provider Identifier) will be the only acceptable provider identification on HIPAA standard transactions for electronic claims and remittance advice. Until then, CMS recommends using both the current number and the NPI -- not the NPI alone.
CMS Certification Number
Effective immediately the Medicare/Medicaid Provider Number will be renamed the CMS Certification Number (CCN) to avoid confusion with the NPI. The CCN will be used in survey and assessment-related activities. The Medicare Provider Number was also known as the Online Survey, Certification, Reporting (OSCAR), Medicare Identification, and provider number.
UB-04
SNF's paper Medicare billing form, the UB-92, has been revised and renamed UB-04. The UB-04 reports the NPI and a legacy identifier. The UB-04 can be used beginning in March per the CMS Open Door Forum of March 28, 2007.
A printing problem has arisen with the UB-04 because it is wider than the UB-92. Some providers are finding that the whole form does not print from their laser printer. A possible solution is to set the margins to .2 inches, however some printers will not support that small a margin. To print the form in full, you may need to use a laser printer capable of edge-to-edge printing, such as a Xerox Phaser 4500 or an HP 9000.
Keane Care Clients: We have adjusted the printer setup for VistaKEANE Resident Account Management to a negative number so it prints acceptably.
1500
The CMS-1500 paper billing form was also modified to accept the NPI. CMS has extended the acceptance period of the revised form beyond the original April 1, 2007 deadline because some forms available are incorrectly formatted. The older format will be accepted until the situation is resolved and contractors will be so directed.
CMS' 1500 Website has full information.
http://www.cms.hhs.gov/ElectronicBillingEDITrans/16_1500.asp
No-Pay Bills
CMS has prepared a quick reference chart to assist with determining when Medicare No-Pay bills are required. Download it from the SNF Open Door Forum Website (click on Skilled Nursing in the leftside bar):
http://www.cms.hhs.gov/OpenDoorForums/
CMS has compiled lists of common Medicare billing errors and billing tips that include background information and references. The document is MLN Matters SE0712, available at
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0712.pdf
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Keane NetSolutions eCharting with eMAR/eTAR
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Keane Care is pleased to announce an addition to our Keane NetSolutions Clinical system -- eCharting with eMAR/eTAR to replace paper forms on medication carts. It does more than eliminate yellow stickies, flipping pages, and writing on the back of forms. It:
- Identifies late or missed deliveries
- Stays current with order updates
- Generates valuable reports
- Requires notes for PRN orders and late, missed, or held deliveries
"With resident safety a top priority for all providers, Keane NetSolutions eCharting offers a point-of-care system that reduces risk by providing more information at the time of service and encouraging more complete documentation," says Jeff Jordan, Keane Care Managing Director.
When eMAR/eTAR is accessed on Tablet PCs with wireless connections it provides point-of-service charting and network connection. Caregivers have instant access to the latest information, such as an order change or cancellation. Supervisors can see at a glance any irregularities in order administration.
For more information on Keane NetSolutions eCharting, visit www.keanecare.com or www.keanecare.com/demo/echarting2.pdf
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STRIVE Project
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As an update to its 1997 time studies that were used to set the RUG-III weights, CMS has set up the STRIVE (Staff Time and Resource Intensity Verification) project. It began in July 2006 and the data collection portion of the project will continue through summer 2007 and involve facilities in 14 states.
Visit the STRIVE Website for compete information (click on STRIVE in the left navigation bar).
www.qtso.com/
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New Assessment in the Works: PAC
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The Deficit Reduction Act of 2005 mandated a demonstration to support post-acute care payment reform. The proposed Post-Acute Care Assessment would be part of that effort.
An Open Door Forum call was held in December 2006 to receive comments from the four PAC provider settings covered by Medicare: Skilled Nursing Facilities, Home Health, Long-Term Care Hospitals, and Inpatient Rehabilitation Facilities. Each of these settings already has an assessment tool but the tools do not share data and they work on different timeframes.
The assessment process would start with hospital discharge and the assessment tool would be completed at each setting as the patient moves from one to another. A paper with more information is available here:
www.cms.hhs.gov/SNFPPS/Downloads/pac_reform_plan_2006.pdf
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MACs -- the new FIs
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The first award for a Medicare Administrative Contractor (MAC) was made to Noridian Administrative Services (NAS). NAS will serve as the first point of contact for processing and payment of Medicare A/B claims for providers in the states of AZ, MT, ND, SD, UT, and WY.
Contracts for MACs will replace current fiscal intermediary contracts nationwide on a schedule extending to October 2011.
Medlearn Matters 0642 covers MACs; find it here:
www.cms.hhs.gov/MLNMattersArticles/downloads/SE0642.pdf
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Keane Client Conference & LTC Users' Group
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Keane Care clients are invited to attend the annual conference to network with peers across the country and learn more about their software. The 2007 conference will be held August 12-15 at JW Marriot Las Vegas Resort and Spa in Las Vegas. For more information visit the clients-only area of our Website (password required).
The Keane LTC Users' Group invites staff from all facilities using Keane Care systems to participate in their organization. Their annual meeting will be held at the Keane Client Conference.
The mission of the Keane LTC Users' Group is to provide input to ensure all the products used by Keane Long-Term Care clients meet the ongoing requirements of the post-acute care community. The Users' Group is a self-governing body, independent of Keane.
Membership in the Users' Group is free and individuals determine their level of involvement.
Sign Up Now at the Keane Insider, the clients-only area of the Keane Website (password required).
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