MANAGEMENT UPDATE: CMS Sets Up Physician Communications Protocol

When dealing with Medicare, providers may often believe they are being left out in the cold. Not only are there a billion regulatory requirements to keep track of, but understanding and adapting the program's constant changes require more hours than there are in a day.
As promised in the Nov. 1, 2002, Final Rule, the Centers for Medicare & Medicaid Services has put into place a provider communications (PCOM) program designed to educate and train providers to effectively understand the Medicare program and manage related matters appropriately to ensure accurate billing.
CMS provided this directive to fiscal intermediaries (FIs) through a detailed outline of the expected PCOM program contents intended to meet the broad, yet basic informational needs of current Medicare providers as well as to provide training and consulting for new Medicare providers. The scope of PCOM is to identify and address issues that are of concern to the broad provider audience.
A big part of PCOM's focus is to develop a provider service plan that outlines the strategies, projected activities, efforts, and approaches that will be used to support provider communications. Specifically, FIs are expected to offer the following to help providers:


- Provider inquiry analysis produce a monthly list of the most frequently asked questions (FAQs) and areas of concern/confusion for providers. Outreach and educational efforts must be developed and implemented to address the needs of providers as identified by this program.


- Provider data analysis produce a monthly list of the most frequent, collective claims submission errors from all providers. Claims submission errors result in rejected, denied, or incorrectly paid claims. Outreach and educational efforts must be developed and implemented to address the needs of providers as identified by this program.


- Seminars/workshops educational events hold seminars, workshops, classes, or other face-to-face meetings to educate and train providers about the Medicare program and billing issues. If their facilities permit, FIs are encouraged to host Medicare Learning Network satellite broadcasts for providers in their service area.


- Bulletins/newslettersprint and distribute regular provider bulletins/newsletters, at least quarterly, which contain program and billing information. Any newly created bulletins/ newsletters must be posted on the FI's Web site. Providers should obtain electronic copies of bulletins/newsletters and other notices through the FI's Web site, if possible. If providers are interested in obtaining additional paper copies on a regular basis, FIs are permitted to charge a fee.


- New technologies/electronic media use new technologies and electronic media as an efficient, timely, and cost-effective means of disseminating Medicare provider information.


- Provider-education Web siteoffer a provider-education Web site where providers may find any article posted within the "What's New" or similarly titled section of the site. The articles will remain on the [...]

- Published on 2003-03-01