Hospice

Electronic Filing for Hospice Notices

Filing a Hospice Notice of Election (NOE)

Hospice

Today’s Presenters

� Corrinne Ball, RN, CPC, CAC, CACO

Provider Outreach and Education Consultant

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Hospice

Today’s Presentation

� Presentation is available on our website

� Go to https://www.NGSMedicare.com

� In the About Me drop down box, select your provider type and applicable state, click on Next, accept the Attestation. On the Welcome page, click the Educationtab, then Webinars, Teleconferences & Events

� Under the Register button for this event, you will see the Presentation link

� Materials from prior webinars are available

� Click the Education tab, then Past Events

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Hospice

Disclaimer

National Government Services, Inc. has produced this material as an

informational reference for providers furnishing services in our contract

jurisdiction. National Government Services employees, agents, and staff

make no representation, warranty, or guarantee that this compilation of

Medicare information is error-free and will bear no responsibility or

liability for the results or consequences of the use of this material.

Although every reasonable effort has been made to assure the accuracy

of the information within these pages at the time of publication, the

Medicare Program is constantly changing, and it is the responsibility of

each provider to remain abreast of the Medicare Program requirements.

Any regulations, policies and/or guidelines cited in this publication are

subject to change without further notice. Current Medicare regulations

can be found on the CMS website at https://www.cms.gov.

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Hospice

No Recording

� Attendees/providers are never permitted to

record (tape record or any other method) our

educational events

� This applies to our webinars, teleconferences, live events

and any other type of National Government Services

educational events

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Acronyms

� Acronyms used in this presentation can be

viewed on the NGSMedicare.com website. On

the Welcome page, click on Provider Resources > Acronyms.

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Objectives

� The objective is to provide education on

submitting the hospice notices via an electronic

interchange

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Hospice

Agenda

� CMS Change Request 10064

� Benefit of filing electronically

� Notice of election testing

� Data elements required on the electronic

submission of a hospice notice of election

� Correcting dates on the NOE or NOTR

� Resources

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Hospice

Electronic Notice of Election

� CR 10064- Accepting Hospice Notices of

Election via Electronic Data Interchange

� Transmittal 3866 dated September 26, 2017

� Effective Date: January 1, 2018

• Transactions received on or after January 2, 2018

• Submit notice for hospice electronically using the X12 837 v5010A2 Institutional transaction

• If you already submit claims electronically there is no special enrollment to submit the hospice notices electronically

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Hospice

Benefits of Filing Electronically

� Benefits of filing an 8XA electronically

� Eliminates the additional resource burden of manually

entering NOE data into DDE by having the required data

elements populated directly from the EMR to the electronic

standard format

� Reduces the potential human error of keying mistakes

� Hospices could export data from their electronic medical

record or other software system into the EDI format

without human intervention

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Hospice

Notice accepted via an electronic submission

� Bill types that will be accepted by electronic

submission of the 837I

� 8XA – notice of election (NOE)

� 8XB – Notice of termination Revocation (NOTR)

� 8XC – Change of hospice

� 8XD - Cancel a NOE

� 8XE – Change of ownership

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Hospice

Testing Prior to January 1, 2018

� You may test any time prior to January 1, 2018 for confirmation that you can submit the NOE electronically

� Send with ISA15=T

� You will receive a 999 acknowledgement and a 277CA response

� While a test DCN will be generated and reported on the 277CA the transaction will not be sent to the claims system for processing.

• No change from what you currently receive with claim submissions

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Hospice

Production Submission after January 1, 2018

� After January 1, 2018 the system will be in a production environment.

� Send with a ISA15=P

� Will receive a 999 acknowledgement within 1 minute

� When accepted by the system a 277CA will be produced with a DCN provided

� The DCN can be used to view the NOE in the claims system. The cutoff for submitting the file is the same as for the claims.

� The transaction can be sent in a batch.

�

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Hospice

Test Submission after January 1, 2018

� Test NOE claims can be sent as well for new

and/or current Submitters.

� Send with ISA15=T

� You will receive a 999 acknowledgement and a 277CA

response

� While a test DCN will be generated and reported on the

277CA the transaction will not be sent to the claims system

for processing.

• No change from what you currently receive with claim submissions

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Hospice

Data Elements Required for an

Electronic NOE Submission

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Hospice

Reminders for an Electronic NOE Submission

� When submitting an electronic notice of election (NOE) there are required fields for an 837I transmission that are not required on an NOE submitted via DDE

� If the required 837I fields are not completed the NOE will reject

� All NOEs must be sent with Medicare as primary payer

� Entering invalid IDs will cause the NOE to reject

� Some loops require specific coding or the NOE will reject

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Hospice

Reminders for an Electronic NOE Submission

� Medicare encourages hospice to submit groups of NOEs in separate batch transmission from groups of claims

� All NOEs no matter how they are submitted are subject to the timely filing requirements

� Within 5 days of admission

� NOE timeliness will continue to be determined by the receipt date of the NOE that has processed and finalized in a paid status

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Hospice

Reminders for an Electronic NOE Submission

� NOE exceptional circumstance process has not

changed

� Late NOE will still require the claim(s) to be

submitted with an OSC 77, KX modifier and

remarks

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Hospice

Electronic NOE Field Descriptors with

837I Requirements

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Hospice

Electronic NOE Field Descriptors Required

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FieldDescriptor

DDE EDI Codes Notes/Comments

Type of

Admission

Required Enter a valid Type of Admission

Code (1-9)

Admission

Source Code

Required 1 Enter the Source of Admission

with the default value of “1.”

Patient Status

Code

Required 30 Enter the patient discharge status

code with the default value of

“30.”

Revenue Code Required 650 Enter the default revenue code

0650.

Hospice

Electronic NOE Field Descriptors Required

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FieldDescriptor

DDE EDI Codes Notes/Comments

HCPCs Required Q5009 Enter the default HCPCS code

Q5009

Service Date Required Enter the service date that

matches the “From” date in the

Statement Covers Period.

Total Units Required 1 Enter the default total units of “1”

Hospice

Electronic NOE Field Descriptors Required

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FieldDescriptor

DDE EDI Codes Notes/Comments

Total Charges Required 0.00 NOEs are submitted with a zero

charge amount

Hospice

After January 1, 2018Correcting a date on an NOE and NOTR

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Hospice

Correcting an Admission Date on an NOE After January 1, 2018

� Correct an election date

� Use occurrence code 56 and report condition code D0

• If both codes are not reported together, the NOE will be returned to the provider.

• Report the correct election date in the “from” and admission date fields

• The OC 56 date will be the incorrectly reported date of admission

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Hospice

Correcting Admission Date on the NOE after 01/01/2018

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� MAP1711 M E D I C A R E A O N L I N E S Y S T E M CLAIM PAGE 01

� SC INST CLAIM ENTRY SV:

� HIC XXXXXXXXXA TOB 8XA S/LOC S B0100 OSCAR XXXXXX UB-FORM

� NPI XXXXXXXXX TRANS HOSP PROV PROCESS NEW HIC

� PAT. CNTL#: TAX#/SUB: TAXO.CD:

� STMT DATES FROM 030815 TO 000000 DAYS COV N-C CO LTR

� LAST PATIENT FIRST IMA MI DOB 01161932

� ADDR 1 12345 BUSY DR 2 ANYTOWN CA

� 3 4

� 5 6

� ZIP XXXXXXXXX SEX F MS ADMIT DATE 070817 HR 00 TYPE SRC D HM STAT

� COND CODES 01 D0 02 03 04 05 06 07 08 09 10

� OCC CDS/DATE 01 27 070817 02 56 070717 03 04 05

� 06 07 08 09 10

� SPAN CODES/DATES 01 02 03

� 04 05 06 07

� 08 09 10 FAC.ZIP XXXXXXXXX

� DCN

� V A L U E C O D E S - A M O U N T S - A N S I MSP APP IND

� 01 02 03

� 04 05 06

� 07 08 09

� <== REASON CODES

� PRESS PF3-EXIT PF5-SCROLL BKWD PF6-SCROLL FWD PF8-NEXT

Hospice

Correcting a Revocation Date on an NOTR After January 1, 2018

� Correct a revocation date on an NOTR

� Use occurrence code 56 and report condition code D0

• If both codes are not reported together, the NOE will be returned to the provider.

• Report the correct revocation date in the “through” date field

• The OC 56 date will be the incorrectly reported date of revocation

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Hospice

Correcting Revocation Date on the NOTR after 01/01/2018

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MAP 1711 M E D I C A R E A O N L I N E S Y S T E M CLAIM PAGE 01

SC INST CLAIM ENTRY SV:

HIC 123456789A TOB 812 S/LOC S B0100 OSCAR 0515XX UB-FORM

NPI XXXXXXXXX TRANS HOSP PROV PROCESS NEW HIC

PAT. CNTL#: TAX#/SUB: TAXO.CD:

STMT DATES FROM 040617 TO 042017 DAYS COV N-C CO LTR

LAST SMITH FIRST H MI DOB 01011920

ADDR 1 12345 BUSY DR 2 ANYTOWN CA

3 4

5 6

ZIP 92629 SEX M MS ADMIT DATE 0040617 HR 00 TYPE SRC D HM STAT

COND CODES 01 DO 02 03 04 05 06 07 08 09 10

OCC CDS/DATE 01 56 042217 02 03 04 05

06 07 08 09 10

SPAN CODES/DATES 01 02 03

04 05 06 07

08 09 10 FAC.ZIP 98765

DCN

V A L U E C O D E S - A M O U N T S - A N S I MSP APP IND

01 02 03

04 05 06

07 08 09

<== REASON CODES

Report the correct date of

discharge or revocation

OC 56- report the erroneous date

of discharge reported on the

original NOTR

CC- D0 must be

present when using OC

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Hospice

Resources

� Change Request 10064, transmittal 3866-Accepting Hospice Notices of Election via Electronic Data Interchange

� https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3866CP.pdf

� CMS Companion Guide

� https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/Hospice/Downloads/Companion-Guide-Electronic-Notices-Election.pdf

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Hospice

CERT A/B MAC Outreach & Education Task Force

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Hospice

CERT A/B MAC Outreach & Education Task Force

� The goal of the A/B MAC Outreach & Education Task Force is to ensure consistent communication and education to reduce the Medicare Part A and Part B error rates.

� A joint collaboration of the A/B MACs to communicate national issues of concern regarding improper payments to the Medicare Program.

� Partnership to educate Medicare providers on widespread topics affecting most providers and complement ongoing efforts of CMS, the MLN and the MACs individual error-reduction activities within its jurisdictions

� Disclaimer: The CERT A/B MAC Outreach & Education Task Force is independent from the CMS CERT team and CERT contractors, which are responsible for calculation of the Medicare fee-for-service improper payment rate.

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Hospice

CERT A/B MAC Outreach & Education Task Force

� CMS works closely with the CERT A/B MAC Task Force and the CERT DME MAC Outreach & Education Task Force � CMS has a web page dedicated to education developed by the CERT

A/B MAC Outreach & Education Task Force

• https://www.cms.gov/Medicare/Medicare-Contracting/FFSProvCustSvcGen/CERT-Outreach-and-Education-Task-Force.html

� NGS CERT Task Force Web Page � Go to our website, https://www.NGSMedicare.com; in the About Me

drop down box, select your provider type and applicable state, click on Next, accept the Attestation. Choose the Medical Policy & Review tab, then choose CERT, the CERT Task Force link is located to the right of the web page.

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Hospice

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Hospice

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Hospice

Medicare University

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� Educational opportunities available

� Computer-based training courses

� Teleconferences, webinars, live seminars/face-to-face

training

� Self-report attendance

� Website

� http://www.MedicareUniversity.com

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Hospice

Medicare University Self-Reporting Instructions

� Log on to National Government Services’

Medicare University � http://www.MedicareUniversity.com

• Topic = Enter title of webinar

• Medicare University Credits (MUCs) = Enter number

• Catalog Number = To be provided

• Course Code = To be provided

� Visit our website for step-by-step self-reporting instructions.

• Click on the Education tab, then the Medicare University Course List tab,

click on the Get Credit link. This will open the Get Credit for Completed Courses web page.

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Hospice

Continuing Education Credits

� All National Government Services Part A and Part B

Provider Outreach and Education attendees can

now receive one CEU from AAPC for every hour of

National Government Services education received.

� If you are accredited with a professional

organization other than AAPC, and you plan to

request continuing education credit, please contact

your organization not National Government

Services with your questions concerning CEUs.

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Hospice

Thank You!

� Follow-up email

� Attendees will be provided a Medicare University Course

Code

� Questions?

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