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Will
there be any changes in the Medicare fee schedule
when WPS becomes the MAC? |
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No, the Medicare
fee schedule is location specific. The 2008 Medicare
fee schedule will remain the same for Kansas as it
was when Wheatlands was the MAC. |
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Will
providers be able to fax correspondence and
redeterminations to WPS customer service? If so,
what is the fax number? |
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No correspondence
or redetermination can be accepted by fax. |
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Currently
there is an "Issue Log" on the Kansas web site. Some
of these issues have been pending a long time. Is
WPS aware of this log? Is there or will there be a
WPS issues log? |
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Yes, WPS is aware of the
pending issues. The issues are being coordinated
between Wheatlands and WPS. There is no anticipation
of an issues log at this time. |
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Will WPS
maintain an "Issues" log on its website as
Wheatlands has done? |
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WPS will not
continue the "Issues" log. |
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How often
will the FAQs on the WPS web site be updated? |
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The web site is
updated 1 to 2 times per week, more often if
something is of particular urgency. However,
communication is reviewed by CMS prior to posting so
that process can take 10 days. |
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When
questions are submitted via e-mail through the web
site, will the sender be contacted directly or will
the answer be posted at the FAQ web site? How long
should it take to get an answer? When submitting a
question via internet is the sender given a
confirmation of some kind? |
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Responses to questions will be
made directly either by telephone or e-mail. If it
is a good, general question, it may be converted to
FAQ and posted on the web site. On average, answers
to e-mail questions are taking 10 days. Certain
questions, such as those related to policy, can take
longer because they must run through policy staff.
No confirmation e-mail generated to confirm receipt
of a question. |
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Will
there be state by state CACs (Carrier Advisory
Committee) or will there be one CAC representing the
entire J-5 area? |
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The CACs will be
organized on a state by state basis. |
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The
Kansas City Medical Management Association is
willing to pay expenses for a WPS representative to
speak at its "Clearinghouse Seminar" on May 15th and
16th and do a demo of the web site. Is this
possible? |
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WPS preferred
method of provider communication is through
electronic meetings. However, requests for WPS
representatives to do presentations on-site will be
considered on a case-by-case basis. (There will be a
WPS representative at the May 15th meeting.) |
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It has
been reported that there will be no state specific
representative. Currently Kansas representatives
offer provider education meetings at regular
intervals in several venues across the state. Will
WPS continue this type of face-to-face education? If
so, to whom should the request for education be
submitted? |
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CMS is pushing for MACs to
implement "self service technology" and reduce
face-to-face contact for cost reasons. The interface
between Kansas providers and WPS will be much
different than what Kansas providers had with
Wheatlands. It will be more technology driven using
"on-demand" media. Currently there are no plans for
regular face-to-face educational meetings in Kansas. |
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Does WPS
expect providers to rely solely on the web site for
information? Are there plans to proactively contact
provider offices in our jurisdiction? |
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WPS will work
with providers by providing educational content on
its web site and working with partners such as
KMGMA, GCKMMA and KMS to help spread information
(See the FAQ above.) |
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It is our
understanding that WPS will have Part A provider
representatives in Kansas City and in Omaha but no
Part B representatives. If this is true, can you
explain the WPS rationale for this? |
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The transition of
Part A business between Mutual of Omaha and WPS and
the Part B business between BCBS of KS and WPS is
entirely different. Mutual of Omaha was the only FI
that CMS gave the option to providers to select
Mutual of Omaha for their FI. Providers working with
Mutual of Omaha will cut over in a different manner.
It's a unique situation. |
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There is
unofficial information spreading that Part A
provider representatives will assume responsibility
for Part B provider issues. Is this accurate? |
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Basically, WPS
inherited staff from Mutual of Omaha in the KC area
and in Omaha. Over time, WPS expects this provider
outreach staff to become cross trained and work with
both Part A and Part B providers. |
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We have heard there
are "specialists" for each problem, ie: LCD
questions to Mr. A, coverage to Mr. B, and so on.
Will practices receive a direct dial directory or a
single number to customer service? |
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There are subject
matter experts, but the first lines of information
will be the web site and customer service. It is a
customer service function to respond to inquiries.
However, calls can be escalated by customer service
to higher levels. If there is a question beyond the
customer service level "Contact US" questions
submitted through the web site can be responded to
in 45 days. But it was advised to use the customer
service function first since many questions that
come to the "Contact Us" are better fielded by
customer service. |
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Is there
a limit to the number of questions or issues that
customer service will respond to with each call? |
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Yes, there is a
limit of three issues and/or claims per telephone
call. |
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Will
providers be able to request paper copies of
Communiques and fee schedules? If so, what are the
fees and how does one make request? |
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Providers can
request paper copies. The request would come to
customer service. Paper copies are free of charge if
a provider can demonstrate no access to the
internet. If this cannot be demonstrated, the fee
will be based upon the size of the document
requested. The full fee schedule is approximately
$15. A full year of Communiques is approximately
$60. |
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If a practice has
signed up with Wheatlands for an auto-offset to
recoup overpayments, will this preference
automatically transfer to WPS? If not, is this an
option with WPS and how does a provider communicate
this preference? |
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WPS can only set
up an offset for individual claims. At this time WPS
cannot tag provider files to offset all
overpayments. It will be done on a claim by claim
basis. |
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What is
the PTAN? |
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The provider's
legacy Medicare number is the Provider Transaction
Access Number, or PTAN. This change is cosmetic,
providers need only to realize that their legacy
Medicare provider number is now called their PTAN. |
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Wheatlands offered a CMS service whereby new
Medicare providers could ask to have their records
audited. Does WPS also have this service? |
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WPS does profile
new physicians to see if claims are denying but
there is no auditing service. |
