Industry Notes:
Medicare Contractor Customer Service Aims To Improve
Published on Thu Sep 30, 2004
Scathing GAO report produces results - but will they make a difference? Get ready for an about face from your Medicare contractor's customer service center. You can now expect concrete improvements under a new customer-service program that's slated to begin Jan. 1.
A scathing August report by the Government Accountability Office (GAO-04-669) said that after performing hundreds of test calls to 34 contractor call centers, only 4 percent of the responses received were correct and complete.
Here are the changes you can expect: * Provider self-service technology tools: With these changes, you'll get interactive voice response units for telephone inquiries, improved Web site options, and electronic copies of provider bulletins that the Centers for Medicare & Medicaid Services will publish and post quarterly.
* Provider contact center improvements: CMS promises an inquiry tracking and triage process, as well as better staffing and training of customer service reps.
* Provider outreach and education: This includes training tailored for small providers, "ask-the-contractor" teleconferences (ACT), and initiatives aimed at reducing the claims error rate.
Two Southern states are grappling with their home care needs.
Tennessee is finally taking applicants for the state's home care waiver program approved in October 2003. The state is offering 2,700 slots in the program that furnishes homemaker services, personal-care services, minor home modifications, personal emergency response systems, home-delivered meals, case management and limited institutional respite care, on a first-come, first-served basis, reports the Knoxville News-Sentinel.
But the program has some steep requirements. Besides being Medicaid-eligible, participants in the program must have a caregiver in the home 24 hours a day and must see a physician every 60 days.
Tennessee ranks 49th in the nation on home care versus nursing home spending, the paper says. The program originally had trouble finding nursing homes that would agree to furnish the inpatient respite care the program requires.
Meanwhile, South Carolina residents face lengthy waiting lists to access Medicaid home care benefits. About 3,000 elderly residents are waiting for home care services, The (Columbia, SC) State reports. That's down from a list of 4,000 in 1997 but only 1,100 in 1999.
Another 1,700 severely disabled residents are on a waiting list for home care services - up from 970 waiting last year, the paper says.
State officials worry they will be sued under the Supreme Court's 1999 Olmstead decision requiring care in the community, they say.
CMS' proposed regulation requiring physicians to examine home medical equipment users face to face before prescribing HME is riddled with problems, the Power Mobility Coalition says in comments on the rule (see Eli's HCW, Vol. XIII, No. 30, p. 235). PMC targets problems with the suggested timeline; the requirement that the practitioner visit cannot be for the sole purpose of obtaining durable medical equipment; the [...]
