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“ Welcome to Jurisdiction 10” Workshop

“ Welcome to Jurisdiction 10” Workshop. Presented by Cahaba Government Benefit Administrators ® , LLC J 10 A/B MAC Provider Outreach and Education April 21, 2009. Meeting Agenda. History of Cahaba Medicare Contracting Reform J10 Transition Georgia Dark Day Provider Enrollment

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“ Welcome to Jurisdiction 10” Workshop

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  1. “Welcome to Jurisdiction 10” Workshop Presented by Cahaba Government Benefit Administrators®, LLC J 10 A/B MAC Provider Outreach and Education April 21, 2009

  2. Meeting Agenda • History of Cahaba • Medicare Contracting Reform • J10 Transition • Georgia Dark Day • Provider Enrollment • Medical Review • Medicare Secondary Payer • Electronic Data Interchange (EDI) • Provider Contact Center • Medicare Resources

  3. The History of Cahaba GBA® ,LLC

  4. Alabama Part A and Part B since 1966 Cahaba GBA Expansion

  5. Georgia Part B Awarded 1996 Cahaba GBA Expansion

  6. Cahaba GBA Expansion Iowa and South Dakota Part A including RHHI Awarded 1999

  7. Mississippi Part B Awarded 2000 Cahaba GBA Expansion

  8. Cahaba Government Benefit Administrators®, LLC • Part A Intermediary for AL • Part B Carrier for AL, GA & MS • Part A RHHI for 16 Northern/Midwest states • 600+ employees • Three (3) office locations: Birmingham, AL; Savannah, GA; Des Moines, IA • Corporate office located in Birmingham, Alabama

  9. Medicare Modernization Act • Signed into law on December 8, 2003 • Largest amendment to the Social Security Act since the inception of Medicare • Provides several administrative, operational and functional changes • Includes CMS’ vision for contractor reform

  10. Evolution of Medicare Contracting Reform MAC • Section 1874a of SSA • Single contractor for beneficiary and provider • Only government may terminate • Contracts will last a maximum of five years Title XVIII • 1816 and 1842 of SSA • Beneficiary and provider multiple contractors • Either party can terminate • Contracts and agreements year to year

  11. Medicare Administrative Contractors A/B Jurisdiction Map

  12. Jurisdiction 10 MAC Award • Cahaba GBA awarded contract on January 7, 2009 • New Jurisdictions to Cahaba • GA Part A • TN Part A and B • Awaiting notification on the MS Part B workload

  13. FISCAL INTERMEDIARY TO What should I do Before Cutover? A/B MAC

  14. Transfer of Georgia Data • Dark day on May 4, 2009 • Customer Service and claims system will not be available • Normal business operations will resume on May 5, 2009 J10 Transition

  15. Daily Payment Cycle • Payments made on a daily basis • First payment processed May 4, 2009 • PIP payments paid bi-weekly J10 Transition

  16. Provider Enrollment CMS 588 Electronic Funds Transfer • New CMS 588 form MUST be completed • Original signature is required • Acknowledgement letter will be sent • Download form at: www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf • Submit forms to: • Provider Enrollment • PO Box 830867 • Birmingham, AL 35283-0867 J10 Transition

  17. Medical Review • Future Effective Local Coverage Determinations (LCDs) • No Intermediary Advisory Committee meeting • View LCDs at www.cahabagba.com/j10/lcds.htm J10 Transition

  18. Medicare Secondary Payer (MSP) Contact COBC regarding MSP issues 1-800-999-1118 or TTY/TDD: 1-800-318-8782 MSP Admission Questionnaire www.cms.hhs.gov/ProviderServices/Downloads/pro_othertool.pdf J10 Transition

  19. Vehicles of Communication • J10 Transition Newsline • Listserv messages • Face-to-Face events • Open Door Forums (ODF) • POE Advisory Group meeting J10 Transition

  20. Stay Connected www.cahabagba.com/j10

  21. Electronic Data Interchange (EDI) • New FISS and DDE passwords and IDs not required • Third party vendors • IVANS • 1-800-548-2690 ext. 3750 • VisionShare • 1-888-895-2649 • Other approved vendors J10 Transition

  22. Electronic Data Interchange • Cahaba Secure File Transfer Protocol Server (FTP) www.cahabagba.com/j10/edi/edi ftp instructions.pdf • New Submitter IDs and Password • Letters mailed April 1, 2009 • Testing not required J10 Transition

  23. Electronic Data Interchange (EDI)

  24. Provider Contact Center • Enterprise Call Center • Birmingham, Alabama • Savannah, GA • Voice Response Enhancement or IVR System • Speech recognition coming soon • Medicare Beneficiary – 1 800 Medicare (633-4227) J10 Transition

  25. CMS Resources • Medicare Administrative Contractor www.cms.hhs.gov/MedicareContractingReform • MLN Matters Article SE0837 www.cms.hhs.gov/MLNMattersArticles/downloads/SE0837.pdf • Change Request 6436 www.cms.hhs.gov/transmittals/downloads/R467OTN/pdf • CMS Change Request 5979 www.cms.hhs.gov/Transmittals/downloads/R33OTN.pdf J10 Transition

  26. Questions Please complete your general inquiry feedback form.

  27. Thank You! Cahaba GBA, LLC J10 A/B MAC

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