Delaware Medical Group Management Association Meeting March 21

Delaware Medical Group Management Association Meeting March 21, 2012 1

New Name – Novitas Solutions, Inc. Ø Effective January 1, 2012, Diversified Service Options, Inc. acquired Highmark Medicare Services Ø Diversified Service Options, Inc. is a wholly-owned subsidiary of Blue Cross Blue Shield of Florida Ø As a result of this sale, Highmark Medicare Services changed its name to Novitas Solutions, Inc. Ø Transfer of ownership will be seamless to our customers; same addresses, phone numbers, etc. Ø Novitas migrated the current Highmark Medicare Services website to our new Novitas Solutions website Ø www. novitas-solutions. com Ø We are targeting completing our name change to all active webpage content by March 30, 2012 2

Novitas’ Role as a Medicare Administrative Contractor (MAC) Ø Novitas will remain the J 12 MAC Ø Novitas was recently awarded the JH contract Ø Ø Ø The decision was protested The protest was recently dismissed The stop work order was lifted Work has begun to transition this workload to Novitas No interruption to the J 12 contract 3

Round II – A/B MAC Jurisdictions Medicare Administrative Contractor Map JF JE JK JG JF JI JL JM JH JJ JN 4

J 12 CERT Data 5

5010 Transition Ø The version 5010 discretionary period was extended through June 30 th Ø Full version 5010 compliance is defined as submitting and receiving only version 5010 transactions Ø All Part A and Part B providers, billing services, and clearinghouses that are currently billing version 5010 for 837 transactions are strongly encouraged to migrate to version 5010 for Electronic Remittance Advice (ERA) (835) transactions before March 31, 2012 Ø Verify that your ERA software is version 5010 compliant Ø The free PC-Print (Part A), free Medicare Remit Easy Print (Part B) and PC- ACE Pro 32 software version 5010 compliant Ø After verifying your software is 5010 compliant, submit a Version 5010 Migration Form to transition to version 5010 electronic remittance advice 6

5010 Transition (cont’d) Ø Effective April 1, 2012, for Medicare Part B electronic remittance advice receivers, to ensure that the ERA matches your EFT/check amount, we will allow only one receiver of electronic remittance per NPI/legacy ID regardless of whether the provider submits their inbound files under different sender IDs Ø A letter was sent to all identified EDI trading partners on March 1, 2012. If you received this letter, please follow the instructions on the bottom of the letter and return the information requested as soon as possible. Ø EDI Services implemented a new fax number for submitting enrollment forms and general correspondence Ø 1 -877 -439 -5479 7

ICD-10 Medical Coding Ø Compliance Deadline: October 1, 2013 Ø Suggestions: ü Identify current systems using ICD-9 codes § Clinical Documentation § Encounter Forms/Superbills § Practice Management System § Electronic Health Record System § Contracts § Public Health and Quality Reporting Protocols ü Talk with practice management system vendor about version 5010 and ICD-10 codes ü Discuss implementation plans with your clearinghouses, billing services, and payers to ensure a smooth transition ü Assess staff training needs ü Conduct test transactions using version 5010/ICD-10 codes with payers and clearinghouses Keep Up To Date: Visit the CMS website at www. cms. gov/ICD 10 to receive timely information about the upcoming version 5010 and ICD-10 transitions 8

Provider Portal – Coming Soon Ø Benefits and Eligibility: ü Includes inquiry capability for benefits and eligibility information ü Provides a survey tool that will capture provider feedback that will be used to further enhance the portal Ø Claim Inquiry ü Includes multiple search criteria features 9

Provider Portal (cont’d) Ø Clerical Reopenings ü Allows for the correction of clerical errors ü Provides the ability to monitor the status of the corrected claim following an overnight cycle Ø Claim Submission ü Allows gateway entry of the electronic HIPAA 837 transactions ü Provides a claim screen for direct data entry Ø Mailboxing/Remittance Request ü Allows for users to retrieve PDF quality documents (i. e. , Remittance, ERA statements, acknowledgement reports, etc. ) 10

Provider Portal Benefits Ø Allows for 24/7 Access Ø Eliminates Telephone Wait Time Ø Provides Significant Automation Ø Includes Faster/Varied EDI Submission Capabilities 11

Provider Enrollment Services – Revalidation Effort Ø Affordable Care Act requires revalidation – Section 6401 (a) Ø All providers/suppliers enrolled with Medicare prior to March 25, 2011 must revalidate their enrollment information when notified by their Medicare Administrative Contractor (MAC) Ø Once notification is received from Highmark Medicare Services: ü Update enrollment through Internet-based Provider Enrollment Chain and Ownership System (PECOS) at https: //pecos. cms. hhs. gov or complete the 855 form; ü Sign the certification statement on the application; ü If applicable, pay fee through pay. gov; and ü Mail supporting documents and certification statement to Highmark Medicare Services Ø Reference MLN Matters Article: SE 1126 Revised 12

Provider Enrollment–Recent Enhancements Ø E-signature (Part A and Part B) Ø Internet-based PECOS now allows providers and suppliers to sign Medicare enrollment applications electronically Ø This feature does not change who is required to sign the application Ø Fast-Track View (Part A and Part B) Ø Provides the ability to view all enrollment information on one screen Ø Ø Reduces data entry and duplication of data for all change of information applications If information is correct, “click and submit” application without stepping through entire application process 13

Provider Enrollment–Coming in April 2012 Ø My Enrollments Page (Part A and Part B) Ø A search/filter feature to filter enrollments by: Ø Medicare ID Ø NPI Ø Tax ID Ø Supplier Type Ø Enrollment Status Ø Enrollment information will be displayed automatically: Ø Ø Ø Enrollment Type Enrollment Status Medicare ID Practice locations Date Revalidation Notice sent 14

Contact Information Laura Minter J 12 Project Manager Phone: (717) 302 -4120 Fax: (717) 302 -4165 Laura. Minter@highmarkmedicareservices. com 15

Questions? 16