10/26/2023 J6/JK Home Health POE Advisory Group Meeting

Meeting Minutes

Meeting Time: 1:00 p.m. ET

Member Attendees: Kenneth Allen, Gina Balkus, Dawn Beck, Vickie Brand, Dean Chalios, Sheila Clark, Patrick Conole, Kim Dallaire, Sharon Fries, Barb Hansen, Patrick Harrison, Brianna Lindell, Mary Lord, Rita Manaugh, Edward Martin, Christine Meny, Mary Jane Ruppert, Lisa Schweitzer, Kerry Stevenson, Jamie Thompson, Cindy Vanyi, Katie Wehri, Beth Werner

National Government Services Associates: Charity Bright, Alicia Forbes, Emily Fox-Squairs, Andrea Freibauer, Erin Musumeci, Christa Shipman

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I. Welcome

Andrea Freibauer and Erin Musumeci, NGS

Andrea and Erin welcomed all the attendees to the last Hospice POE AG of the year. Erin indicated that the meeting would be recorded to document attendance and transcription for the meeting minutes.

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II. PEX Updates

Alicia Forbes, NGS

Alicia demonstrated a new feature of our website, which is a table of contents which has links to jump to specific areas of the website. The links can be copy/pasted to share more easily. The link will take the user directly to the area on the website, although the website attestation may need to be agreed to if the user is not already logged into the website. Alicia asked the members if this was a feature that they liked and many members indicated they did. She also asked for feedback either during the meeting or if it could be sent later if members had any ideas for future updates or any questions on the website.

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III. NGSConnex Updates

Charity Bright, NGS

Charity shared a presentation that featured four existing areas of NGSConnex and what information was available within each area:

Eligibility Lookup – Medicare Advantage historical information (up to four years) can be found by entering the patient’s MBI, first name, last name and date of birth and then choosing Medicare Advantage from the left-side navigation bar (up to 4 years’ worth of data). This time of year is when members are allowed to change Medicare Advantage plans so agencies should not only be asking patients but also checking eligibility on a routine basis using NGSConnex. This section of NGSConnex has details on the patient’s HMO effective date, termination date, administering insurance company’s name, plan name and contract number, plan option code and description as well as the plan’s address, telephone number and web address. Even though when a patient is on hospice most of the time coverage reverts to Traditional Medicare, there are circumstances where the HMO would have to be billed so it is important to know how to find this information.
QMB – Although not applicable to hospice benefits, Charity reminded attendees that the 2024 Medicare deductibles for Part A ($1632) and Part B ($226) have been issued by CMS. If the patient is in a program, it’s important to verify if the patient is in a QMB program since providers cannot bill patients for cost-sharing amounts (se1128 [cms.gov]). Providers can check for a patient’s QMB effective and termination dates using the Qualified Medicare Beneficiary section of NGSConnex.
Hospice Notice of Elections – In this area, users can find all the hospice NOEs on record (not just the past four years) with the associated NOE date, date received, revocation date (when applicable), revocation indicator (when applicable) and associated NPI for the NOE.
Hospice Benefit Periods – In this area, users can find the benefit period number, start, and end date, dates of earliest and latest billing, number of days used and NPI associated with the patient’s benefit period for all the hospice benefit periods on record (not just the past four years).

Member Question – What credentials does a new provider need and the process to get access to get NGSConnex for the first time?

Charity responded that The NGSConnex User Guide has information on how to register for an account and how to manage that account. NGS is free, all you need is an email address. On the sign in page there is a link to Create an Account. There is a three-step process:

Create a User ID (must be four capital letters and three numbers) and password.
Enter your personal information – your name, phone number, email address, etc. NGS does not ask for your Social Security Number.
Enter your business information - NPI, PTAN, last four digits of your Tax ID, select type of information you want access to. If you are opting to be a Local Security Officer for your organization, you will need to enter a check or EFT that was issued by NGS within the last 90 days and the associated amount (for automated access) or if you do not have that information NGS will send you an authorization code in order to obtain access. If there is more than one provider account you need access to, once you register you can go under Manage Account to add more.

Member Question – Why was the hospice section split on NGSConnex?

Charity responded that all the information related to eligibility is provided to NGSConnex by CMS through the HETS contractor. A few months ago, the determination was made to split the information to make it easier for the providers to view so NGSConnex was mandated by the HETS quarterly release to split it out and provide separately. If this is something providers don’t like, we can take that feedback to the HETS contractor. The member responded that they liked the change.

Visual IVR – Prior to the meeting, members were sent information on a new self-service concept we have initiated called the Visual (system) IVR. The Visual IVR came about due to feedback that when providers are using the traditional IVR sometimes get frustrated because when they are entering information through their telephone or speaking to the system, information is not always captured correctly. Once implemented, we will be working to integrate the Visual IVR with the traditional IVR to provide the best service.

Members who had reviewed the mockup of the Visual IVR had positive feedback and thought it would be helpful. Charity indicated that now the Visual IVR only has eligibility information, so additional suggestions and feedback are appreciated. Suggestions can be sent to the NGSHHHPOE@elevancehealth.com mailbox.

Virtual IVR Suggestions:

In the phone and address section, can filters be added (such as hospice and the state) to narrow down the list to be more user friendly.
- Charity responded that she would bring this back for consideration.
Under training, there is no section for TPE. Can this be added or even a pertinent job aids list?
- Charity responded that she would bring this back for consideration.
How difficult would it be to have some kind of lookup tool where providers can enter their NPI and patient’s MBI number to determine the status of their current TPE audit or appeal?
- Charity responded that this information is currently available in NGSConnex portal under the ADR and Appeals sections, but she will bring this idea back for consideration to also incorporate into the Visual IVR.

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IV. Review of POE AG Recommendations

Andrea Freibauer and Erin Musumeci, NGS

Andrea and Erin reviewed the 2023 Hospice Advisory Recommendations Log and entries from the previous meeting on 6/14/2023. AG recommendations and feedback on all 2023 education, whether completed or just a suggestion was reviewed along with the status for each along with an explanation if it could not be accommodated/done.

POE AG members were also asked for any additional suggestions/recommendations for education for 2024 during this meeting. Those suggestions will continue to be logged and tracked in the Hospice Advisory Recommendation Log. Members were reminded to send any additional topics or suggestions for podcast topics, articles, YouTube videos, handouts, webinars, etc. to our shared team mailbox at NGSHHHPOE@elevancehealth.com.

Andrea reminded members that Medicare Administrative Contractors (MACs) are required to follow certain regulations for POE AGs as detailed in the Beneficiary and Provider Communications Manual (cms.gov) 100-09, Chapter 6, Section 20.6.1. To ensure that National Government Services complies, we are requesting that POE AG members complete a survey form each year which was emailed to all members prior to the meeting. Any members who did not receive the form, please let us know by sending an email to NGSHHHPOE@elevancehealth.com and we will send it out. We would like to get responses in the next few weeks as we plan next year.

The form requests feedback on items such as hospice education (topics, materials, timing of sessions, type of education), Ask the Contractor Meetings (focus areas, timing/frequency, size, provider types), Provider Contact Center Training (internal training topics, best/worst days and times for PCC closures to train staff) and POE AG meetings (meeting topics, best/worst days and times for meeting).

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V. Completed and Upcoming Education

Andrea Freibauer and Erin Musumeci, NGS

Andrea will continue to work on the hospice billing education series, there will be one or two more forthcoming in the next few months. Andrea and Erin have been traveling to conferences the past few months. Erin will be focusing more on YouTube videos, job aids and podcasts for 2024 to better meet the needs of clinical staff.

Member question – How many months do associations need to send the Education Request Form in to the NGSHHHPOE@elevancehealth.com mailbox?

Erin suggested at least 60-day notice as it states on the form, however the sooner you can submit, the better.

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VI. Other Updates and Reminders

Andrea Freibauer and Erin Musumeci, NGS

The MAC HHH Collaborative Summit dates are now confirmed and will be held during the first week in October 2024 at the Flamingo Hotel in Las Vegas, NV. That will be the last time we will be doing the Summit in Las Vegas, as we plan on moving it around the country in future years to better accommodate providers.

Andrea reminded members that we now have podcasts and asked for feedback, members responded positively. She also stated that HHH POE staff are always looking for topic suggestions. Planned upcoming sessions are Provider Enrollment and Audit and Reimbursement.

Meeting adjourned. Members will be sent 2024 POE AG dates in the near future.

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