7 Tips to Completing the Medicare Revalidation Application

Paperwork: the dreaded word! Everyone hates paperwork but, with the tightening of Medicare security to prevent fraud, this has meant an increased amount of paperwork.

Medicare revalidations come up every 3-5 years, depending on many factors. As your revalidation notices come in the mail (or email), don’t ignore them.

You get a 3-month warning before your Medicare enrollment expires, and if you don’t get the paperwork in and approved by the deadline, your claims will be denied. Depending on your payer mix, this is going to affect your revenue for the month. It may also cause a gap in coverage as Medicare may not backdate your application to the expiration date of your previous enrollment.

A benefit of having a lockbox service, as provided by Omni, is that we receive a copy of these notices as well and can remind our clients in case they were accidentally missed.

The last thing you want to deal with is a returned Medicare revalidation application because you haven’t filled out a section correctly. Here are 7 tips to keep in mind as you complete the Medicare revalidation paperwork:

Tip #1:

MedicareDid you know you can complete your Medicare revalidation application online at https://pecos.cms.hhs.gov/? It’s faster and easier, with basic checks to make sure you are completing everything before submitting the paperwork.

Why do it online, you ask?

  • Processing time is 45 days vs. the 60 days for paper
  • You must pay the fee through PECOS anyway, why not just complete the application while you’re there?
  • There are basic checks to make sure you are including all the relevant information before the application is submitted, reducing the back-and-forth with Medicare
  • You can update and/or edit information easily without having to redo the entire application. This is especially time-saving if you have already revalidated previously via PECOS, as you can simply update the information, without having to redo the entire application.

*Note: if your service shares a Tax ID with another department, be sure to register as a new user.

Tip #2:

Make sure the legal business name of your service matches corresponding IRS documents. If your service has changed its name, it needs to be updated with IRS before the changed name can be reported to Medicare.

 

Tip #3:

If the Delegated Officials or Authorized Officials have changed since your last Medicare revalidation, they need to be updated on your revalidation application. An authorized official is an appointed official who has the legal authority to enroll and make changes or updates to your service’s status in the Medicare program. A Delegated Official is a person delegated by the Authorized official to make changes and updates to the Medicare enrollment. As of the latest application, third party organizations (such as a billing service) cannot be Delegated Officials.

 

Tip #4:

Remember to complete vehicle information and provide a copy of vehicle registration for each ambulance in Section D. Some CMS providers also require a copy of your State EMS board vehicle license and DMV registration for each ambulance if issued.

 

Tip #5:

Items to include with revalidation:

  • Copy of NPPES or NPI letter with number
  • Copy of current state license
  • Copy of CLIA certification
  • Letter from IRS confirming your tax identification number.
  • Copy of liability insurance policy.
  • Copy of your Medicare revalidation notice
  • Copy of Board of EMS vehicle license and DMV registration for each ambulance
  • Copy of an attestation from government entities and tribal organizations accepting financial responsibility
  • If filing on paper, make sure to include:
    • Copy of PECOS payment
    • Signed certification statement

 

Tip #6:

If you are using a billing service such as Omni, be sure to complete Section 8. Make sure you get the correct name from your billing entity that matches their IRS tax forms. You may also add them as the contact person in Section 13 so they can contact Medicare about revalidation questions.

 

Tip #7:

If sending on paper, check, check, and re-check that all relevant sections have been filled out, signed AND dated by ALL required parties. Consider doing the application via PECOS online to at least make sure that all sections have been completed.

 

Other resources:

  • Medicare Revalidation Application Checklist
  • Webinars and How-To Guides on filling out the Medicare Revalidation application online at the bottom of the following page: Internet Based PECOS
  • Omni provides guidance to our clients on the entire revalidation process
  • A nice resource for checking whether your Medicare revalidation is due soon is CMS.gov/revalidation. If your Medicare revalidation is due within 3 months, the website will list the due date. Otherwise, it will list the status as TBA.

 

Grant Helferich is employed as the Director of Client Performance and Training with Omni EMS Billing in Wichita, Kansas. He is a former member of the KEMSA Board and has also served as the treasurer and president of the KEMSA Administrator’s Society. He was certified as an EMT, EMT-I, M.I.C.T. , and T.O. II. Grant has worked EMS for over 35 years in roles such as an EMT, EMT-I, M.I.C.T., Field Supervisor, Flight Paramedic, Cardiovascular Specialist, Assistant Director, and Director of EMS.

 

3 Reasons to Become Best Friends with Your Local Hospital Contacts

3 Reasons to Become Best Friends with Your Local Hospital Contacts

You know that person at the local hospital registration desk that you exchange two words with when you transport a patient? Take some time to get to know him or her. Ask about their kids and family. Joke around. Take them some snacks from work. Here are 3 reasons to keep in touch with contacts at the hospitals to which you typically transport your patients:

 

#1. Hospitals can be a good source of patient information

Busy crew members may not necessarily have the time or the ability to gather patient demographic and insurance information from the patient. This is where hospital facesheets come in handy – they may have more accurate information about the patient than any verbal information you may have received.

If nothing else, it can be a good backup resource to make sure the information you received from the patient is accurate.

 

#2. Hospitals can fax facesheets to your service

A good relationship with a contact at the hospital will help facilitate a negotiation where you can have the hospital fax you facesheets of the patients you transport to their facility, after-the-fact. This will give the hospital a chance to verify and provide more complete patient information, as well as remove the necessity of your crew members waiting at the hospital for the facesheets.

 

#3. Increase referrals through your contacts

If you have a good relationship with your hospital contact, sometimes it might lead to more referrals for your service. As they know you and can put a face to the name of your service, they are more likely to remember your service when a situation arises and a referral is needed.

 

Grant Helferich is employed as the Director of Client Performance and Training with Omni EMS Billing in Wichita, Kansas. He is a former member of the KEMSA Board and has also served as the treasurer and president of the KEMSA Administrator’s Society. He was certified as an EMT, EMT-I, M.I.C.T. , and T.O. II. Grant has worked EMS for over 35 years in roles such as an EMT, EMT-I, M.I.C.T., Field Supervisor, Flight Paramedic, Cardiovascular Specialist, Assistant Director, and Director of EMS.
Be Prepared! Here’s 4 Tips to Handle Changes to Medicare Cards in 2018

Be Prepared! Here’s 4 Tips to Handle Changes to Medicare Cards in 2018

Changes are coming to Medicare on April 2018. As we mentioned in our previous article, CMS will be issuing new Medicare cards to patients that replace social security numbers with a new Medicare Beneficiary Identifier (MBI) number.

medicare

Courtesy of medicare.gov

This change is going to affect all providers, including EMS providers. It’s always better to be proactive than reactive, so follow these 4 tips to help your service be better prepared for the changes.

#1. Talk to the patient

Never underestimate information you can get from a patient first-hand. Don’t only rely on the hospital face sheet to get you the required information. Ask your patient when they are in the back of the ambulance or the nursing facility if they have received the new Medicare card. If they haven’t, this is a chance to educate the patient in case they were not aware of the change. If possible, get a copy of the Medicare card.

#2. Educate the staff

It’s important that this information be equally circulated throughout your service. Your staff are in the optimal position to get this information directly from the patient. If they are all equally informed about the Medicare card change, they can ensure that the Medicare information is gathered on the first attempt. If the patient is unaware of the change, your staff are also in an optimal position to educate the patient and get them prepared for the change.

#3. Get a copy of the patient’s ID

If possible, get a copy of the patient’s driver’s license or State ID. This will serve as a good supplemental patient information source, especially if the patient does not have their new Medicare card.

#4. Hand out information with HIPAA

When handing out your HIPAA policy to patients, you can add a small leaflet informing the patient to keep an eye out for the new Medicare cards that will be coming by mail.

 

Grant Helferich is employed as the Director of Client Performance and Training with Omni EMS Billing in Wichita, Kansas. He is a former member of the KEMSA Board and has also served as the treasurer and president of the KEMSA Administrator’s Society. He was certified as an EMT, EMT-I, M.I.C.T. , and T.O. II. Grant has worked EMS for over 35 years in roles such as an EMT, EMT-I, M.I.C.T., Field Supervisor, Flight Paramedic, Cardiovascular Specialist, Assistant Director, and Director of EMS.
5 Patient Demographics that Need to be Included in PCRs

5 Patient Demographics that Need to be Included in PCRs

Having good patient demographics in patient care reports is the core to being able to bill claims accurately and efficiently. Watch the video to learn about the 5 most important patient demographics you need to provide in PCRs.

Note: In 2018, Medicare will no longer use social security numbers on Medicare cards and will be issuing brand new identifier numbers. Be prepared to switch out from using the old numbers to the new ones in your systems.

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Q&A session with Grant Helferich: HIPAA Awareness

Q&A session with Grant Helferich: HIPAA Awareness

 HIPAA

 

HIPAA has been the elephant in the room that no one really wants to talk about. When HIPAA was first enacted, audits and fines were rare. However, with the government outsourcing audits, HIPAA violations have undergone much more scrutiny with ever-increasing fines for violators.

 

Grant Helferich, Omni’s Director of Client Performance and Training, recently attended a seminar on continued HIPAA compliance. As you can see in his picture above, he takes HIPAA very seriously! He provides a few simple tips to staying HIPAA compliant in the following Q & A session:

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Billing a transport as ALS even though ALS services weren’t provided

Billing a transport as ALS even though ALS services weren’t provided

Did you know? In limited circumstances, Medicare allows services to bill a transport as an ALS transport even though ALS services were not provided, as long as proper documentation is included in the PCR, including:

  • Dispatch protocols
  • Reason for dispatch
  • an ALS assessment

Watch the video to learn more about billing a transport as an ALS transport under these circumstances.

*If video quality is low, you can improve it by clicking on the gear icon at the lower right side of the YouTube screen and choosing a higher quality*

 

Grant Helferich is employed as the Director of Client Performance and Training with Omni EMS Billing in Wichita, Kansas. He is a former member of the KEMSA Board and has also served as the treasurer and president of the KEMSA Administrator’s Society. He was certified as an EMT, EMT-I, M.I.C.T. , and T.O. II. Grant has worked EMS for over 35 years in roles such as an EMT, EMT-I, M.I.C.T., Field Supervisor, Flight Paramedic, Cardiovascular Specialist, Assistant Director, and Director of EMS.