Qs from the floor….
Q: Education – how will you do this? Group – through hospital associations. We are forbiden to provide education to providers. Q: How do we define “new issues” that have to be reviewed by CMS? All issues, even those that came to light in the demonsttartion project, must go through the “new issue” review.
Q: Subcontractors? Region C Viant is only subcontractor. Region A We are responsible for all activities but we have the most subcontractors (3) Region B PRG Schultz is only subcontractor. Region D PRG Schultz is the only subcontractor.
Q: Will contact information be customized on day 1? A: Yes.Forms will be introduced during outreach education. Go to www.racb.com for region B sign up. Solicitation of information will go to hospitals’ Compliance Officers
Q:When will websites be ready. This requires CMS approval and will be up during the summer.
Q:How do you make coding decisions? Coders can disagree. A: Region C Make suer your coders are current and certified. Region D We funnell specialties (like orthopaedics) to coders in that specialty
Q: WIll you link hospital claims to doctors claims (like observation.)
A: Group Yes.
Q: Will hysicians be involved in every medical necessity decision. Group: No. That is not a CMS requiremen
Q:How will you handle the volume of calls and appeals? A: Region A We anticipate the volume. Our strategy is to make sure that everything is so “clean” that there won’t be much room to appeal.!!!!!!!!!!!!!!!!!!