Suzanna Astros, Education Specialist, RI Medicare Services
Cindy Cote, RN, Medical Review Nurse ,RI Medicare Services
Carol DeMelo, Provider Education Representative, RI Medicare Services
Linda Geoghegan, R.N., Compliance, University Medicine Foundation
Greg Hart, Provider Services, Arkansas Blue Cross
Lori Langevin, Provider Education Representative, RI Medicare Services
Carol Muller, Urgent Medical Care
Michele Paolino, University Medicine Foundation
Parker J. Staples, Medical Director, RI Medicare Services
Julie Sylvestre, Comprehensive Practice Management
Kelly Vaughn, EDI Analyst, Arkansas Blue cross
Andrea Zito, RN, Medical Review Nurse, RI Medicare Services

Introductions: Carol DeMelo introduced two new members, Carol Muller and Paula Wallusi from Urgent Medical Care.

1. Review of 11/17/03 Meeting minutes and old business
   Nothing to report

2. Part B Contractor Transition Issues
   
   Kelly Vaughn from Arkansas Blue Cross reviewed the EDI requirements
   Kelly-Arkansas BCBS emphasized in the following topics.
   • Capacity of the e-mail voices has been upgraded & two specialist representatives have been assigned to EDI voice mail box in an effort to give an answer as quickly as possible.
   • Kelly brought up the problem that RI electronic providers encountered with submitting the incorrect information in the BAO record field 9.
   • She stressed that providers should contact the EDI area if they are experiencing any problems.
   • A handout was given to the group to explain what information needs to be in those fields for NSF and ANSI.
   • Kelly also reminded the group of the EDI Conference call every Wednesday.
   • Greg added that an issue log has been developed to document problems reported on the calls but to date the attendance has been Part A providers only.
      
3. Claims(suspended
   
   Carol informed the group that we have been receiving a good number of electronic claims with incorrect information in the MSP \electronic fields.

   Providers are reporting patient paid amts (copay) in these fields causing the claim to suspend. Currently, the claim is being fixed in house. I advised the group that we will be contacting some of the providers by phone but will start to reject the claims as of 5/1/04.

   An article will be published upon approval to alert providers.

   The group agreed that 5/1/04 was a fair date.
    

4. Transition Workshops
   • The group discussed the upcoming workshops for March & April. Suzanna Astros passed out the evaluation analysis.
   • They agreed that the workshops were necessary, especially for the Medical Manager sites. Since the 90 day extension to submit to RI Blue cross will be over 5/1/04, the workshops will help in answering any last minute questions and remind them that they must be able to separate their Medicare claims and send to Arkansas.
   • It was also mentioned that many RI BCBS Medical Manager sites attending the recent workshops had indicated they have signed up with Web MD.
   • Carol DeMelo Informed the group that a Lucy Sorvino, from Web MD attended the 2/25/04 workshop.
   • Lucy is the liason between Arkansas BCBS and Web MD .
   • Greg Hart mentioned that we will be hosting specialty workshops later in the year.
      
5. Medical Review
   
   Cindy Cote reviewed the coding guidelines for Aranesp and EPO from CR 3037 and the proper documentation that needs to be submitted.
    
6. Open Discussion
   • Julie Sylvestre indicated that Provider Enrollment applications are still pending and asked if we could check into this. Out of 17 applications that were pending prior to transition only 2 had been completed.
   • The members also agreed they are experiencing the same problem and can not get through to the Provider Enrollment line in Baton Rouge to check status because the line is constantly busy.
   • Carol agreed that this was an issue that that was reported by providers at the 2/25/04 workshops also.
   • Greg addressed this issue by informing the group that the last week in January they were on a new enrollment system which set them behind in addition to moving pending files from RI to LA.
   • Greg also informed the group that they are keeping a pending workload log and the pending figures have been going down since transition.
   • Julie president of the MGMA suggested that Merle address this issue at the MGMA Conference on March 18^th.

The meeting adjourned at 10:30a.m.