Fractional Mileage for Medicare Part B EMS Providers
CMS mileage ruling
On November 29th CMS published the Final Rule for the new Medicare Fractional Mileage policy scheduled to take effect January 1, 2011.
In order to comply with the new rule, for trips involving Medicare payment with dates of service on or after 01/01/2011, providers must report mileage to the nearest tenth of a mile. The policy will apply to all claims with mileage up to 100 loaded miles. Any trips above 100 loaded miles should still be reported by rounding to the next whole number.
Examples:
100.1 = 101 loaded miles (still round up mileage over 100 to the next whole number)
99.9 = 99.9 loaded miles (report fractional mileage to the nearest tenth for 100 or less miles)
25.23 = 25.3 loaded miles (round up the hundredths place to the next tenths number)
Additional information regarding this new rule can be found under the CMS 2010 transmittals: Transmittal 2103 (CR7065)
We have been advised by CMS that most of the Medicare contractors have until January 3, 2011 to start accepting the new format. This most likely won't be an issue for providers, as January 1st-2nd fall on a holiday weekend - but we still wanted to make you aware of the timeline. Gateway EDI, which is the clearinghouse we use to submit claims electronically, has also advised that they will be ready to accept fractional mileage by January 1, 2011. They plan to issue a notice later this month.
What happens next?
MICS Update
Colleton Software has completed the necessary software updates to ensure that our customers can successfully report fractional mileage and our billing software will be updated on the 20th of December. Internal testing is done and you should have been contacted either by email or by phone to schedule the update. If you have not been contacted please give us a call at 843-549-3444 or email Josh Wilson at JLIB_HTML_CLOAKING .
The Next Generation of MICS
Work continues on the next generation MICS product. We have entered the final stages of programming and testing and will start to set the beta test schedule in January. We have had a few set backs along the way but we look forward to the successful completion of our newest product in the first quarter of 2011. Our team thanks you for your patience and understanding while we work through the challenges of developing this new product.
Colleton Software Newsletter
Dear Colleton Software Client,
I wanted to take this opportunity to address the status of Colleton Software's new MICS product.
Over the past 18 months we have invested well over half a million dollars and countless hours in the development of the new MICS product. We have worked hard to implement many new features and have dedicated our company to making the best possible product for our clients.
Our initial goal was to finish the software during the last quarter of the 2010 and announce the availability of the software on January 1st, 2011. The number one concern and priority for the software was that it operated correctly, maintained state and federal NEMSIS compliance, and continue to maximize the successful revenue collections for the county.
During the development of the software we have been presented with a number of challenges. We have had to make numerous revisions to our software development schedule due to these changes. Again at the front of all the work and development is the requirement to maintain 100% state and national compliance.
Today the software has been completed and we are in the initial stages of beta testing. The software currently runs Electronic Patient Care Reports completely and accurately. We are testing as many possible different calls and scenarios as we conceivably can. We are using many current clients to assist us in this task.
We are currently working on a few minor final mandatory requirements to complete the project.
2) Local Forms and Reports - We are working to improve the reports that are available to the MICS administrators. Our goal with the reports function is to continually provide more information and add features requested by our clients.
3) Migration of Existing Data - A final stage of development is to take your existing data and merge into the new program and new database. It is a very difficult part of the programming stage. We want the final product to include all historical data and allow our clients continually access to all data.
4) Finally, internally we are setting procedures and developing extracts from the software that will allow us a seamless transition to the new software. We are dedicated and committed to maintaining your revenue stream without interruption. Colleton Software will not release the new software until we are sure beyond a shadow of a doubt that we can continually provide the best service and revenue returns to our loyal clients.
Over the next few weeks we will finish these aspects of the project. Simultaneously we are vigorously testing the software to insure the product works as promised and meet all criteria. We have 2 different organizations testing for us and are using their feedback to continually improve the product.
Colleton Software is committed to providing all of our clients with the new software as soon as we are 100% certain that the software works correctly and will provide a seamless transition for our clients.
Medicare News
Cigna continues transition to PGBA
Colleton Software continues to work with Cigna and PGBA to complete all of the required paperwork for the NC Medicare transition. By September of 2011 all NC Medicare providers will switch from Cigna to PGBA as their Medicare intermediary. The process has begun and has been going smoothly, so when you receive paperwork from us please sign and return as quickly as possible to avoid any interruption in Medicare payments. South Carolina and Georgia clients are not affected by this change.
Changes to your EMS service
Notifications to Medicare
Please remember when ever you make changes in your service like adding new transport vehicles, moving to a new address, adding a new location where vehicles are located or any other changes you need to notify Mary Sparks in our office so she can update your 855-B Medicare application. Also you will be notified by your billing clerk at least 30 days before your state license expires, so please fax or mail us the new license as soon as your receive it in order to avoid any revenue disruptions.
Retroactive Medicare Payments
Medicare payments being adjusted from 2010
Medicare has started adjusting 2010 Medicare payments so you will see remits in your posting packets that show adjusted 2010 payments as well as the additional amounts that Medicare has paid on each claim from 2010. The adjustments are $5-$10 per claim and should continue for the next few weeks. The adjustments will show up as negative payments and then adjusted payments for each 2010 claim.
This is only part of Medicare's process to correct the payment amounts and they are not recouping payments, but rather making the appropriate adjustments. These adjustments are actually producing small additional payments to you.
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