RA Newsletter New Mexico Medicaid January 15, 2013 ** NEW** New Mexico Medicaid New HIPAA In This Issue ** NEW** New Mexico Medicaid New HIPAA Electronic Transactions ** NEW** NCCI (National Corrective Coding Initiative) ** NEW** Basic Billing Webcast NM Medicaid EHR Incentive Attention Anesthesia Services Providers Electronic Transactions As of January 1, 2013 New Mexico Medicaid supports electronic eligibility and claim inquiry transactions that are fully 5010 and HIPAA Operating Rule compliant.The 270/271 and 276/277 transactions offer more detailed information than was previously available to New Mexico providers in a nationally accepted electronic format. Providers are encouraged to take immediate advantage of the new transactions. The two new Companion Guides for the 270/271 (Eligibility/Response) and the 276/277 (Claim Status inquiry/Response) are available on the State’s HSD website at: http://www.hsd.state.nm.us/mad/5010HIPAAforNMMedicaidP roviders.html Or, they can be located by clicking on the link from the New Mexico Medicaid Portal: https://nmmedicaid.acsinc.com/nm/general/loadstatic.do?page=HIPAAInformation.ht m For more information or to sign up for the new transactions please contact the New Mexico HIPAA Helpdesk at 1-800-2997304. ** NEW** NCCI (National Corrective Coding Initiative) Call Satisfaction Survey Effective January 1, 2013, when calling the Xerox helpdesks, providers will be asked if they would be interested in participating in a short customer service satisfaction survey. If the provider would like to participate, the helpdesk representative will connect you to the automated survey. If you have questions regarding this, please contact Xerox at 800- 299-7304. 1 NCCI is a CMS program that consists of coding policies and edits. NCCI edits are used in both Medicaid and Medicare. It is important that providers understand that there are significant differences between the Medicaid NCCI program and the Medicare NCCI program. Providers are encouraged to visit the Medicaid.gov NCCI Program website, at the below link. This website contains important information and updates on the program along with the PTP and MUE edit files, so providers may review the correct coding guidelines for specific procedure codes if they so wish. http://www.medicaid.gov/Medicaid-CHIP-ProgramInformation/By-Topics/Data-and-Systems/National-CorrectCoding-Initiative.html Basic Billing Training Webcast Tuesday, February 12, 2013 Xerox will be conducting a basic billing webcast on Tuesday, February 12, 2013. Any provider many attend any session listed below. Please review the Introduction to Medicaid Training, on the New Mexico Medicaid Web Portal before attending these sessions. Providers do not need to sign up prior to this webcast. Please follow the instructions below, to attend. Please contact the Provider Relations Helpdesk at 800- 299-7304 with any questions. 10:00am-10:45am Medicaid School Based Basic Billing / Provider Enrollment Questions 11:00am-12:00pm New Electronic Transactions (Please include individuals that process electronic claims) 1:30pm-2:30pm CMS-1500 Basic Billing 3:00pm-3:45pm UB-04 Basic Billing Meeting Information Go to: https://acs-inc.webex.com/acs-inc/j.php?ED=183144697&UID=1341065822&PW=NOWRiYTFhMDNm&RT=MiM1 Meeting Number: 792106532 Enter your name and email address Enter the meeting password: 3890454 Click “Join” Follow the instructions that appear on the screen To join the teleconference (Audio): Conference toll-free phone number: 1.877.931.2768 Participant access code: 3890454 Be sure to log in and call in so you have both the video and audio portion at the same time. Enter the meeting password: 3890454 Click “Join” Follow the instructions that appear on the screen To join the teleconference (Audio): Conference toll-free phone number: 1.877.931.2768 Participant access code: 3890454 Be sure to log in and call in so you have both the video and audio portion at the same time. Technical Support If you have a technical issue logging in or during the WebEx sessions, contact the support desk at: Verizon Net Tech 1.800.475.5500 Choose option 1 for Net Services Then option 2 for Net Technical Assistance 2 NM MEDICAID EHR INCENTIVE PROGRAM UPDATES for information on how to count Medicaid and Needy Individuals encounters, and how to calculate individual and group patient volume. $ 46.8 Million Paid in NM Medicaid EHR Incentive Payments Get Paid for 2012 The New Mexico Medicaid EHR Incentive Program has paid out $ 46.8 million to 961 Eligible Professionals and 29 Eligible Hospitals through the end of December 2012. The New Mexico Medicaid Electronic Health Records (EHR) Incentive Payment Program would like to remind Eligible Hospitals and Eligible Professionals of the key attestation dates for Program Year 2012. The dates apply to providers who are participating in the program for the first time and attesting to Adopt, Implement or Upgrade (AIU) certified EHR technology, and to providers who have successfully completed AIU and are attesting to Meaningful Use. For a one-page summary of basic EHR Incentive Program information, click on the applicable link below: EHR Program Basics for Eligible Professionals EHR Program Basics for Eligible Hospitals For program eligibility and registration information, visit the New Mexico Provider Outreach Page at http://nm.arraincentive.com/ . Medicaid EHR Dates for Eligible Professionals March 1, 2013 – Last day for Eligible Professionals to attest to receive an incentive payment for Calendar Year 2012 under the NM Medicaid EHR Incentive Program. Medicaid Enrollment Review – MAD 220 Form Eligible Professionals (EPs) participating in the NM Medicaid EHR Incentive Program and EHR practice administrators coordinating EHR attestation on behalf of EPs are advised that the Medicaid Enrollment of each EP attesting in the NM Medicaid EHR Program needs to be reviewed to determine if a MAD 220 Form is needed for the State to issue the incentive payment. During the CMS Registration and Attestation System process, an EP has the option of paying himself/herself the incentive or assigning the payment to a business, group practice or clinic in which the EP practices. If the EHR payment has been assigned in a manner not currently captured in the NM Medicaid Computer Payment System, completion of a MAD 220 Form may be necessary so the state can issue the incentive payment as assigned by the EP. 1. Click on Enrollment Review to determine if the EP needs to complete the MAD 220 Form to enable the state to make the EHR payment as assigned. The MAD 220 Form is also available at this site. For assistance with the MAD 220 Form, call 1-800-299-7304. Choose option 5, then choose option 2. For more information and to register, visit the New Mexico State Level Registry (SLR) Provider Outreach Page at http://nm.arraincentive.com “Group Administrator” to the Rescue – Eligible Professionals If you have been tasked with coordinating registration and attestation for multiple providers who are eligible for the New Mexico Medicaid EHR Incentive Program, the Group Administrator function in the New Mexico State Level Registry (NM SLR) will rescue you from duplicative data entry, save you valuable time, and help you expedite payments for your group. Group Administrator is a “must use” function for any practice or clinic: whose eligible professionals (EPs) choose to use Group Patient Volume as proxy for the EPs in the group; and/or will have one representative entering data in the NM SLR on behalf of two or more EPs. Calculating Patient Volume for Eligible Professionals When attesting for each Payment Year, Eligible Professionals (EPs) must meet a minimum 30% Medicaid patient volume threshold for all patient encounters over a continuous 90-day Representative Period in the prior calendar year. EPs practicing predominantly at a FQHC or a RHC may use Needy Individuals encounters to meet the 30% patient volume threshold. Under certain conditions, EPs may choose to use their group patient volume as proxy for their individual patient volume. To expedite payment, assure that the patient volume calculation is correct. Click on Patient Volume for Eligible Professionals 3 Group Administrator is the only approved method by the NM Medicaid EHR Incentive Program for someone other than the eligible professional to enter the data for attestation. Sign Up for a “Group Administrator” Demonstration If you would like the NM Medicaid EHR Incentive Program to conduct a walk-through demonstration on how to use the Group Administrator function in the NM SLR for you and your group practice or clinic, email Valorie Vigil, EHR Program Communications Manager, at Valorie.Vigil@state.nm.us. Attention Anesthesia Services Providers: Mass Adjustments are underway for claims with dates of service 12/01/2010 through 02/28/2012, and will be showing up on your Remittance Advice throughout the next few weeks. Please be aware there were several claims that made it through our first wave of adjustments which may have underpaid due to an incorrect units conversion. If these claim adjustments appeared on your 11/30/12 remit, these claims will be identified and readjusted at the appropriate unit amount. Upon completing the adjustments for dates of service through 02/28/2011, the claims for dates of service 03/01/2011 through 10/13/2011 will be submitted for adjustment. This will complete the mass adjustment project related to the anesthesia services program policy and reimbursement methodology changes that were implemented 12/01/2010. Thank you for your patience during this process. Electronic Funds Transfer (EFT) is required As stated in section NMAC 8.302.29, the Human Service Division, Medical Assistance Division policy requires payment to be made only via electronic funds transfer (EFT). NM PR Support Emails It only takes 4 steps: Step 1: Log in to the New Mexico Medicaid Portal as the Master Administrator. (In the Links on the left hand side, click on Email/EFT Administration) Step 2: Enter your EIN or SSN in the marked box. Step 3: You will need to fill in the following: - Account Type - Account Number - Bank Routing Transit Number - Email Address Step 4: You will then receive a confirmation of completion. For additional assistance please contact the HIPAA helpdesk at 800-299-7304. 4 Provider sends escalation (with corresponding Call Reference Numbers) emails to NMPRSupport@XEROX.com 1 business day – Email received, response sent to provider (see below) 2-3 business days – provider receives inquiry status If the provider does not receive a response/ status update, the provider may call in with the CRN (Call Reference Number). Provider Relations Specialist will provide status of inquiry Status – Not Started, In Progress or Completed THANKS FOR READING THE NEW MEXICO MEDICAID NEWSLETTER If you would like to receive this newsletter by email, send request to NMPRSupport@XEROX.com and we will add you to the list. For Web Portal, PayerPath & EDI issues, email: HIPAAHelpdesk@XEROX.com