Reimbursement Committee Minutes

April15, 2015

9:30am

  1. Call to Order
  2. Introductions

Chris Kisell, Barry Cargill, Laurie Mones, Kerri Allen, Kim Jenks, Mike Hall, Fred Lee, Amy Gil, Eric Stohl, Carly ????

  1. Acceptance of Minutes – No Comments
  2. Agenda Additions/Changes – Add Accomplishments
  3. Barry and Amy to work with BCBSM to facilitate detailed eligibility verification (Not Done).
  4. Cindy to resend Benchmarking Questionnaire (Done)
  5. Jan and Kerri to form questions regarding BCBSM issues and submit (Started)
  6. Kerri to send contact information for Lynn Hicks (Done).
  7. Chris to revise Private Duty Benchmarking form and send to Committees for completion (Done).
  8. Kerri to send Humana contact information to Mike (Done).
  9. Amy to give Mike dates for Billing Committee so he can try to get VA rep (Done)
  1. Reports
  2. Executive Director Report – Barry Cargill

Michigan Association for Home Care Annual Conference is May 13-16. Please check out the brochure. There is a big investment in this conference with a series of robust speakers.

There are 2 scholarships available and possibly 3. The application deadline for consideration is April 10th. It is free money for personnel that qualify and get chosen. Nominate today!

Michigan Association for Home Care is looking at Hospice Licensing. A survey every 3 years. Looking to get a break on the fees if an agency is accredited also.

Michigan hospice deficiencies have increased and is being looked at to see what is happening.

There is still progress with regard to the wage and hour exemption with live-ins.

Attended the NAHC Forum of States and hot topic were:

EMT beginning to penetrate homecare arena.

“Uber” Models trending in homecare.

  1. BCBSM Liaison Meeting – No new information – Reach out to contact your regional rep. first and then to the Association to get a solution.

Jan and Kerri are creating questions regarding issues of Out-of-State billing and payment along with P.D. not being able to get Weekend Authorizations.

If issues pile up then there will be a call for a Liaison meeting.

Questions should be submitted as they come in to .

  1. Billing Committee – Dawn Hyder, Amy Gil

April 23rd will be a teleconference meeting.

Topics will be the discussion. Always looking for possible speakers

Mike to investigate VA representative.

  1. NGS/CMS – Chris Kisell –

MM 9091 – Payments to Hospice Agencies That Do Not Submit Quality Data.

MM 9114 – Hospice Physician NPI On NOE

  1. Old Business
  2. Benchmarking Survey – Reviewed results of survey. See Survey Results.
  3. Private Duty Benchmarking –

Chris created the form and will revise based upon recommendations from the Private Duty Committee. When completed it will go out to the Private Duty and Reimbursment Committees. It will cover ALL of 2014 data. Jessup Group has received 5 reports from agencies.

  1. IACS – April 15th continue to use IACS
  2. PS&R – General consensus was that all Visits and Episodes are rolling into Part B.
  1. New Business
  2. Certified Benchmarking Results – Annual Conference

Agencies must turn in reports by May 1. It will be distributed at the Annual Conference and will be discussed at the June meeting.

  1. Reimbursement Accomplishments – Discussed what we thought were accomplishments for the year. This will be distributed at Annual Conference.
  2. PECOS – PECOS ID’s expire every 5 years. Discussed agencies processes for tracking and updating.
  1. General Business
  2. Payor Line Discussion
  3. Medicare – Nothing
  4. Medicare Advantage – Nothing
  5. Medicaid – Nothing
  6. BCBSM– Nothing
  7. Other Payors – the V.A. is at leat 60 days behind paying P.D. claims. Looking to have V.A. at the Billing Committee.

Aetna has issues as the rates are too low.

  1. Product Line Discussion
  2. Certified - Nothing
  3. Hospice - Nothing
  4. HME/Private Duty - Nothing
  1. To Do Items
  2. Barry and Amy to work with BCBSM to facilitate detailed eligibility verification.
  3. Jan and Kerri to form questions regarding Blue Cross Issues and Submit.
  4. Mike to try and get V.A. Representative to speak with Billing Committee.
  1. Next Meeting: June 17, 2015(Onsite)

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