Welcome and Introduction
The meeting facilitator began the meeting with a note of thanks to everyone for taking time out to participate in the Second Quarter Meeting; then emphasized the goals of this meeting which is to provide timely, useful and relevant educational opportunities to our providers. Therefore, encourage the audience to address any concern, needs or ideas for future educational seminars and other initiatives.

Review of October 27, 2004 meeting minutes
Review of the prior minutes was noted. Minutes were accepted as written.

Medical Review Updates ~ Cindy Cote, Senior RN
RI Medicare website has been updated with more and useful information in an effort to help our provider community on different topics, such:

• Prepay Medicare Review Part B – Documentation Requirements. To assist and inform about documentation requirements to adjudicate claims and the medical review process. http://www.rimedicare.com/provider/mr/partB/prepay.asp
• Provider specific Audit-Critical Care Audit. To explain the reasons, purpose, and documentation requirements for each audit is in place.
• http://www.rimedicare.com/provider/mr/partB/prepay.asp
• Provider Specific Audit Critical Care Audit. To educate for documentation of critical care services requirements, as critical care codes and clinical information that should be included in the documentation.
• http://www.rimedicare.com/provider/mr/partB/critcare.asp
• Service Specific Audit. Data analysis results and requirements to comply with procedure code 11721.
• http://www.rimedicare.com/provider/mr/partB/debofnails.asp
• Part B Draft Local Coverage Determination. To be consistent with our educational goals and bring our medical community up to date regarding medical policies. The process to develop local coverage determination is an open and public process. We invite to our community to submit opinions or any other relevant information related to these drafts. Also, this is a good tool to keep you inform about new policies. For more details about draft, where to send comments, release and implementation please refer to the following link: http://www.rimedicare.com/provider/medpolb/drafts/default.asp

Cindy Cote asks the members for input on how to best communicate this information to our providers. Attendees do not have any suggestions at this time.

Medicare Contractor Provider Satisfaction Survey (MCPSS)
Beginning the fiscal year 2005 The Centers for Medicare & Medicaid Services (CMS) will conduct a survey designed to gauge provider satisfaction and perceptions about the services that contractors provide on a daily basis. The MCPSS main goals are:

• Measurement of provider satisfaction levels.
• Support and assist contractor to identify and implement process improvement initiatives
• Establish a standard of measurement performance

• General Update Workshops. These are half day workshops and include new changes for 2005 and general billing information, but does not include any specialty specific information. We have scheduled two sessions –morning & afternoon- on March 08, 2005 at Memorial Hospital and one session on March 09, 2005 at the Holiday Inn located in South Kingstown.
• Physical Therapy Workshops. These are half-day free workshops and will focus on medical necessity issues, documentation requirements, and common billing errors. We have scheduled two sessions – morning & afternoon- on March 10, 2005 at the Providence Holiday Inn.
• Fundamental of Medicare Part B. This is a full day of basic Medicare Part B Billing, such completing the CMS 1500 form, modifiers, understanding the Medicare Remittance Advice. We have scheduled one on April 14, 2005 at the Warwick Public Library and other on June 08, 2005 at the Holiday Inn Providence Downtown.

"Ask the Contractor" Teleconference
This new forum will allow providers to ask questions on Medicare changes and interact directly with representatives from various departments within our organization. We are planning on having our first ACT call on February 23, 2005.

We informed the members that we would be sending out a notification to providers and that they will be asked to send us their questions prior to the call. We proposed having future teleconferences geared to a particular specialty or a specific topic rather than open it up to all providers on any topic. The members agreed this would be a good idea to narrow the calls to a specific topic or specialty rather than making it too general.

Also, CMS invites you to participate in their Open Door Forum to discuss procedures, requirements and where your comments and suggestions are very welcome. Please refer to this link for registrations, topics, and scheduled. http://www.cms.hhs.gov/opendoor/

We also asked the members what day or time would be best for providers to call in. Michelle from A STAT Billing recommended having the calls on a Friday morning. They do the billing for many RI providers and feel this is a better day for many offices.

Frequently Asked Questions and Claim Submission Error
The members were informed that the data analysis for the period October thru December (Telephone Inquires) had to be recalculated because the figures were incorrect; therefore we could not report on that data today. For Duplicate denials, the figure had increased from 75,000 to 81,000. Carol discussed with members how we educate on duplicate denials at our workshops and asked if they had any suggestions on how we can further educate the providers. The members felt that some of the Medicare rejection reasons are not specific enough. They feel that many providers may not be able to identify the reason for denial therefore will continue to resubmit. Carol agreed that we may need to reiterate how to read reason/remark codes.

National Provider Identifier
Carol gave an overview of the proposed National Provider Identifier. Then, she asked the group for suggestions for education in this area. The members felt that this should be added as an education item at future Update and Fundamentals workshops.

1. We are in the process of identifying small providers by looking at several areas, such provider enrollment, data analysis, claims submission; in order to disseminate educational material that facilitate their increase in revenue. Any suggestions or ideas that help to achieve this task will be greatly appreciated. One member had brought up the fact that in RI many of our providers, which we consider large, may employ less than 10 employees. The members agreed that this initiative is geared to the small provider that are still filing on paper and have limited computer resources and no internet access. We asked that he members provide us with suggestions on educational topics that would be beneficial to small providers.
2. Dr. Mayo Gilson, Medical Director, is looking for a part time consultant for RI. Therefore, he asked the members if they know a provider that may be interested to contact him directly.

1. Chiropractic Specialty Seminar. We have free web-based training in this category and the Medical Director and staff are working in the recently updates.

   Feel free to visit our web training site at: http://www.rimedicare.com/provider/wbt/default.asp

   Christopher Gould, DC, representing the Chiropractic Society of RI made a suggestion based on feedback he received from his members. They would like to see more use of "examples" in workshop presentation and materials. This would be most help when educating in areas of documentation, and billing.

2. Ambulance Services Seminar. We are in the process to develop and implement seminar in this category at least one at year. However, education training could be available on the group practice site or on the RI Ambulance Association site.
3. Laboratory Services Seminar. A suggestion was made to have a laboratory services seminar. While there are no plans for a clinical laboratory workshop, we are open to meet with labs that may need further education.
4. Denial reasons guidelines. Members would like to see more detailed explanations regarding reason / remark codes. Further education in this area has been noted and will be covered in our upcoming workshops. Attendees recommended that we be sure to cover in our workshops.

• Schedule next meeting
  The next meeting will be held in Wednesday, April 20, 2005 at the same time and place.