“Welcome to Jurisdiction 10” Workshop

Presented by Cahaba Government Benefit Administrators®, LLC

J 10 A/B MAC

Provider Outreach and EducationApril 21, 2009

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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

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The History of Cahaba GBA® ,LLC

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Alabama Part A and Part B

since 1966

Cahaba GBA Expansion

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Georgia Part B Awarded 1996

Cahaba GBA Expansion

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Cahaba GBA Expansion

Iowa and South Dakota Part A including

RHHI Awarded 1999

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Mississippi Part B

Awarded 2000

Cahaba GBA Expansion

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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 8

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

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Title XVIII• 1816 and 1842 of

SSA• Beneficiary and

provider multiple contractors

• Either party can terminate

• Contracts and agreements year to year

MAC• Section 1874a of

SSA• Single contractor

for beneficiary and provider

• Only government may terminate

• Contracts will last a maximum of five years

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Evolution of Medicare Contracting Reform

Medicare Administrative Contractors

A/B Jurisdiction Map 11

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

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WHAT SHOULD I DO BEFORE CUTOVER?

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FISCAL INTERMEDIARY

TO

A/B MAC

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

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Daily Payment Cycle

Payments made on a daily basis

First payment processed May 4, 2009

PIP payments paid bi-weekly

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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

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Submit forms to:Provider Enrollment

PO Box 830867Birmingham, AL 35283-0867

Medical Review

Future Effective Local Coverage Determinations (LCDs)

No Intermediary Advisory Committee meeting

View LCDs at www.cahabagba.com/j10/lcds.htm

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Medicare Secondary Payer (MSP)

Contact COBC regarding MSP issues

1-800-999-1118 or

TTY/TDD: 1-800-318-8782

MSP Admission Questionnairewww.cms.hhs.gov/ProviderServices/Downloads/pro_othertool.pdf

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Vehicles of Communication

J10 Transition Newsline

Listserv messages

Face-to-Face events

Open Door Forums (ODF)

POE Advisory Group meeting

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Stay Connected www.cahabagba.com/j10

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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

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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

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Electronic Data Interchange (EDI)

Help Desk SupportTelephone Us 866-582-3253

Fax Us 205 402-5706

Email Us PartAEDIServices@cahabagba.com

Write Us Cahaba GBAEDI Services

PO Box 12967Birmingham, AL 35202

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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)

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CMS Resources

Medicare Administrative Contractorwww.cms.hhs.gov/MedicareContractingReform

MLN Matters Article SE0837www.cms.hhs.gov/MLNMattersArticles/downloads/SE0837.pdf

Change Request 6436www.cms.hhs.gov/transmittals/downloads/R467OTN/pdf

CMS Change Request 5979www.cms.hhs.gov/Transmittals/downloads/R33OTN.pdf

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Questions

Please complete your general inquiry feedback form.

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Thank You!

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Cahaba GBA, LLCJ10 A/B MAC