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  Pacware News

 

Competitive Bidding... Is your company ready...?

07/01/2007.......Pacware is proud to announce its all new Competitive Bidding module, ready for use!

Pacware has completed its Competitive Bidding Module. It calculates the allowed charges and units for the top three HCPC's in each product category. It also calculates the total business you did per product category and the number of patients served. The geographic region is defined by a zip code list you enter. You can save the list for easy retrieval later. The module should make it much easier to complete your bid. If you have already completed your bid, it might be a good idea to run the module to check your calculations. We created the module from client input in multiple regions. As a result, it is the most useful competitive bidding preparation tool to date. The module is found under the Management System in Pacwin. Click here to check it out!

 

Please call in today to get your update with the all new competitive bidding module.

Our most current update is 1.20070708

 

 

 

 

CMS Approves Transition Timeline for DME MAC Jurisdiction C

02/28/2007.......CMS has approved CIGNA Government Services’ plan to assume full operation of the DME MAC Jurisdiction C contract on June 1, 2007

CIGNA Government Services, LLC, Nashville, Tennessee has received approval from The Centers for Medicare & Medicaid Services (CMS) to proceed with implementation of Jurisdiction C (formerly, DMERC Region C). CMS has approved CIGNA Government Services’ plan to assume full operation of the DME MAC Jurisdiction C contract on June 1, 2007. The transition of the contract will change where Medicare claims are processed for rental or purchase of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) for Medicare beneficiaries within the Jurisdiction C geographical area.

 

Jurisdiction C includes the states of Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia.

 

CIGNA Government Services is working very closely with Palmetto GBA (the outgoing DMERC Region C contractor) and National Government Services, Inc. (formerly AdminaStar Federal) to transition the Jurisdiction C workload in a timely and efficient manner.

 

A special Web site has been developed for the Jurisdiction C implementation. Providers and Suppliers are encouraged to visit http://www.cignagovernmentservices.com/transition frequently for updated implementation information. The Web site also includes an inquiry tool to allow you to submit questions online.

 

CIGNA Government Services will be issuing a series of implementation newsletters starting March 15, 2007. We will also conduct a series of Ask The Contractor Teleconferences (ACT) beginning in March. Details will be posted to the Web site and released via this ListServ.

 

 

 

"NEW"!!! Pacware Dashboard Utility

02/01/2007.......We now offer a graphical chart system for a quick reveiw of your sales & AR.

Pacware has developed a new utility to streamline your revenue and AR Collections. This utility is only avaible on the latest update from Pacware and can be found at the main menu.

 

Check out Pacware's dashboard function! Reveiw your Sales Summary by date range. Take a glimpse at your company's growth with Rental vs Sales charts, Total sales charts, New Referrals, and much more...

Click here to check out Pacwares new Dashboard Utility

 

 

 

 

DMERCS Interpreted CMS regulations differently regarding the new O2 CMNS

01/05/2007.......Pacware has developed a utility that will stop old formatted CMNS from transmitting.

The DMERC’s as of yet have not given us a time line as to when they will be able to accept both the old and new oxygen CMN’s. To prevent your cash flow from any interruptions, we have made a modification to the transmission preparation module. There is a new box that allows you to control whether you send the CMN’s on a batch. You can use this to submit claims that you have previously sent the CMN in on. Do not use this feature for claims that require CMN Revisions, Recerts, or a new CMN. Those claims will need to be in a separate batch. Use it only for claims that have good CMN’s on file with the DMERC. By selectively batching claims and using the no CMN option, you can get your batches to run through and receive a clean receipt listing.

 

 

 

 

DMERCS Interpreted CMS regulations differently regarding the new O2 CMNS

01/04/2007.......Pacware will inform of any new changes regarding this issue.

In the course of working with each region, we are finding that there is conflicting information between the regions on what is needed to successfully process claims that require CMN’s. Each DMERC has interpreted the CMS regulations differently. The DMERC’s have advised us that they are working on this problem. But as of yet, the DMERC’s have not given us a timeline as to when the problem will be fixed. Please be patient as we work through this problem with them. We will keep you, our valued customer, informed on the solution.

 

The claims most affected by this are Oxygen. Claims submitted for dates of service beyond 12/31/2006 that have an old CMN, should process without problems, provided that you have sent in a prior claim with the old CMN. Claims with dates of service prior to 1/01/2007 will be the most problematic until the DMERC’s make corrections to accommodate their previous instructions.

 

If you have an update prior to 1.20070101, please get an update. If you do not have the ability to download your own updates using PWUPDATE, please call and request to have that feature setup on your system. We may have to provide additional updates as the DMERC’s provide instructions on what they need to process the new and old CMN forms.

 

 

 

 

CODE RED: CMS SLASHES PMD PRICING

10/09/06.......The rehab industry predicts that CMS's new plan to slash pricing by up to 40%

CMS released its new prices for power wheelchairs and scooters last week. Within days, the industry had mounted a campaign to stop the agency's plans to implement the pricing Nov. 15. CMS also intends to implement new codes and coverage criteria on that day.

 

The industry suspected that CMS would slash pricing, especially for lower-end PMDs. But it was blown away by the magnitude of the "devastating" cuts: Under the new pricing, Medicare would reduce pricing for a certain standard power wheelchair from $5,500 to $3,900, said Eric Sokol, director of the Power Mobility Coalition, an association of rehab manufacturers and providers.

 

Click on the link below to find out more information on this subject.

http://www.hmenews.com/index.php?p=article&id=hm200610ElT4rK

 

For more information on related topics and News, click the link below.

http://www.hmenews.com/index.php?p=depts&deptid=3

 

 

 

 

New HCFA 1500 Form Changes

7/25/06.......Our Programming department is aware of these new changes

The National Uniform Claim Committee has announced the approval of the revised version of the 1500 Health Insurance Claim Form (version 08/05) that accommodates the reporting of the National Provider Identifier. The Office of Management and Budget has approved the 1500 claim form under OMB No. 0938-0999 with an initial expiration date of June 30, 2007. CMS will begin the renewal process for the form in January 2007.

Health plans, clearinghouses, and other information support vendors should be ready to accept the revised 1500 claim form by Oct. 1, 2006. Providers can use either the current or revised versions from Oct. 1, 2006, to Feb. 1, 2007, after which the current version will be discontinued. For Medicare, the new Form CMS-1500 will be effective for optional use starting Jan. 2, 2007, through March 30, 2007, but will be required starting April 2, 2007. Read the announcement.

 

Below, you will find links to the new 1500 form changes. For a detailed list of changes click on link below

http://www.nucc.org/images/stories/PDF/final_1500_change_log.pdf

 

For a  view of the announcement of changes to come and a time line click on link below

http://www.hfma.org/hfmanews/PermaLink,guid,75ec063f-e605-4bab-b1d5-e22c30efc3f5.aspx

 

 

 

New DMRC Region D MAC Changes

7/21/06.......Contractor ID Changes Required for EDI Transactions
Noridian Administrative Services will become the Jurisdiction D DME MAC effective September 30, 2006. All trading partners submitting electronic files will be required to replace CIGNA’s contractor ID with NAS’ contractor ID, 19003. All transactions submitted through
5 PM EDT on September 28, 2006 must be submitted with CIGNA’s contractor ID, 05655.

 

Submitters will not be able to send any electronic transactions between 5:01 PM EDT to 6 PM EDT on September 28, to allow for system maintenance. All transactions submitted after 6 PM EDT on September 28 must be submitted using NAS’ contractor ID, 19003.

Please review the following electronic file references. These references indicate where you will need to change the contractor ID on transactions you will submit or where you can expect the new contractor ID to be populated on transactions you will receive.
Transactions collected after
6 PM EDT on September 28 through 5 PM EDT Friday, September 29 will be controlled into the system with the Friday,

September 29 date of receipt.

 

Submitters using ExpressPlus software will need to install a software upgrade to ensure the submission of the NAS contractor ID. This upgrade will be available via the CIGNA Government Services Web site at www.cignamedicare.com the date of availability is yet to be determined. Please be sure to install this upgrade after 5 PM EDT on Thursday, September 28 and before any subsequent transmissions.

Submitters desiring to test the contractor ID changes will be able to send test files via the current testing mechanism effective August 15, 2006. Please closely monitor reports produced in response to your test file submission to assure the accuracy of your file format and validity of contractor ID changes.

 

NAS will be working with CIGNA to contact several of the Jurisdiction D DME EDI trading partners. We will be contacting the largest clearinghouses and suppliers to proactively assist with any questions related to this implementation. Please continue to watch the NAS DME Web site, www.noridianmedicare.com for additional information.

 

    

 

Pacware Announces New Eligibility Status "ONLINE" 

7/13/06 .......We are now offering Medicare on-line eligibility in Pacwin

Our clients will pay Pacware $1600.00 for the initial setup and one year of service with Visionshare.  After the first year, our clients will be directly invoiced for approx. $700.00 by Visionshare.  Below is the process required for the client to setup the service.

  1. Each new eligibility customer needs to sign, notarize, and mail the Identity Verification Form to VisionShare.

  2. Each new eligibility customer needs to go through the CMS attestation process which essentially is their enrollment to obtain an EDI submitter ID for the MEIC.  This step usually takes the longest to complete and the EDI submitter ID is critical for us to properly configure the Pacware connection to the MEIC. Please confirm both your customers have gone through this process.

  3. MEIC Transaction Testing – After installing our software and your software, you will need to contact either Amy Coulter or Christine Fairchild at VisionShare and coordinate a time for the installation and configuration of our RT-Service product.  Once we have the application operational (we can send/receive ANSI files) then Amy or Christine schedules an online test with MEIC.  This involves resources from VisionShare, MEIC and Pacware and should only take 15-30 minutes.  It's basically a three-way conference call whereby Pacware sends a 270 transaction to the MEIC database and the MEIC folks observe the transaction to determine PASS or FAIL status.  If it passes, then Pacware gets a green light for production status and if it fails then there is some discussion about why it failed and what changes need to be made - typically to the format or data content.

Please check out our online Demonstration of how the Pacware "Online Eligibility works!!

Click here to see

 

  Web Changes

As you can see, Pacware Software has been given a new face lift to the previous website. Please take your time checking out all the latest and the greatest from Pacware Software. With new up-to-date features, four times more links and information,

-New links to resources,

-Managment tools,

-Hardware solutions,

-Tech support

Pacware's new website will ensure you will get what you need, +plus more! If you have "any" questions or comments about our new website, please click here!

 

  EDS News

June 2006

LCD Revision Summary for Spring 2006

Negative Pressure Wound Therapy Length of Need

Power Wheelchairs and POVs – Documentation Requirements

Subcutaneous Immune Globulin Added to External Infusion Pumps LCD

Wheelchair Seating – New Codes

 

 

 

Copyright © 2006 Pacware Software Development Inc.
All logos are Trademarks of their respective owners. Last modified: 11/12/07