October 2018
New Medicare cards have started mailing to Colorado beneficiaries
Be on the lookout for scammers and fraudsters

As new Medicare cards arrive in Colorado, the Colorado Division of Insurance (DOI), the State Health Insurance Assistance Program (SHIP) and the Senior Medicare Patrol (SMP), caution that scammers and fraudsters are using this to take advantage of unsuspecting seniors.

"'New card, same guard' is what we're telling people," said Kimberly Latta, director of Colorado's SHIP / SMP programs. "Your Medicare card is key to your medical identity and we don't want people to give that key away. But we also want folks to be aware of these scams looking for money or bank information. We ask that people watch out for themselves and their loved ones."

Here are a few of the more common scams centered around the new cards that are being reported across the country. 
  • People contacting Medicare beneficiaries and asking them to pay for their new Medicare card. The new cards are being mailed automatically to Medicare beneficiaries. You don't have to request it, and you certainly do not have to pay an activation or process fee, or any kind of fee, for your new card. 
  • Someone calling who claims to be from Medicare and wants your Social Security number, your Medicare number or bank information. Know that Medicare will never initiate calls and won't ask for such personal information, and you don't need to provide this information to get your new card. If this happens, hang up. It's a scam. 
  • Threats to cancel Medicare benefits if you don't provide your information or pay for your new card. This is really just a more aggressive form of the first two scams. Again, hang up on anyone threatening you like this. 

If you or someone you know encounters one of these scams, or similar attempts, contact Colorado's Senior Medicare Patrol at 1-800-503-5190. This program helps people detect and deter suspected Medicare fraud and abuse. Visit the Senior Medicare Patrol and Medicare Fraud page on the Division of Insurance website for more information. And once you receive your new card and verify that the information on the card is correct, be sure to shred the old one -- don't just throw it in the trash.

Resources for the new Medicare Card

The Centers for Medicare and Medicaid Services continues to mail new Medicare cards to people with Medicare who live in Wave 6 states -- Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Texas, Utah, Washington and Wyoming. Wave 5 mailing has finished and Wave 7 has begun. The agency continues to mail new cards nationwide to people who are new to Medicare.

If someone with Medicare says they didn't get a card after their mailing wave ends, you should instruct them to:
  • Call 1-800-MEDICARE (1-800-633-4227) where the federal CMS can verify their identity, check their address and help them get their new card.
  • Continue to use their current card to get health care services until they get their new card.
Check this website as the mailings progress. Continue to direct Medicare patients to   Medicare.gov/NewCard  for information about the mailings and to sign up to get email about the status of card mailings.  Information on the transition to the new MBI:
Update: Performance feedback available for 2018 data submitted via claims

The QPP website has been updated so ECs who submit their Quality performance category data via claims can access performance feedback for 2018 on an ongoing basis.

If you're participating in MIPS as an individual clinician and you have chosen to use claims to submit Quality performance category data, you attach quality data codes (G-codes) to your claims throughout the 2018 performance year. Those who have been doing so can now login to the QPP website and review their performance feedback, which will be updated on a monthly basis.

For more information about submitting your Quality performance category data via claims, review the 2018 claims data submission fact sheet. For questions, contact the QPP service center:
Administrative simplification basics series: Eligibility/benefit transactions

Administrative simplification includes standards for administrative and financial electronic health care transactions. Widespread use of these standards -- where all trading partners use the same format and codes -- can lead to substantial savings for health care organizations.

Today, we'll review one of these transactions: eligibility/benefit inquiry and response paired transactions, also known as the X12 270/271 transaction sets.

Who uses eligibility/benefit transactions?

Eligibility/benefit transactions are used for:
  • Inquiries about eligibility/benefits, which can be sent from a health care provider to a health plan, or from one health plan to another 
  • Health plan responses to inquiries about eligibility/benefits
The goal of standardized eligibility/benefit transactions is to streamline communication about a patient's coverage information. Visit the eligibility/benefit page of the federal CMS Administrative Simplification website to learn more.
Speaking Out On Pain Management podcast - Two episodes available

Telligen presents the "Speaking Out On Pain Management podcast," taking listeners  into the world of chronic pain management to explore alternative treatments for chronic pain. Each episode offers a fresh perspective from doctors, nurses, counselors and everyday pain-sufferers on the front lines of treating and living with chronic pain. Two episodes are currently available. New episodes are posted the second Wednesday of each month until December. Telligen is the Quality Innovation Network for Colorado, Illinois and Iowa. Click here to listen to the first two episodes:
2019 flu, pneumococcal, and hepatitis B vaccine reimbursement

Novitas reminds practices to follow the 2018 administration fee information. They will update the 2019 administration fee information once it is released by the federal Centers for Medicare and Medicaid Services (CMS).

Payment rate is identical for all 3 administration codes.
  • G0008 - Administration of Influenza Virus Vaccine
  • G0009 - Administration of Pneumococcal Vaccine
  • G0010 - Administration of Hepatitis B Vaccine
Colorado - Entire State (01) - 21.13

Note: Centralized billers cannot bill for G0010. Please be sure to review the guidelines for Centralized Billers if you have questions about proper billing.
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Favorite Healthcare Staffing, our new Member Benefit Partner, provides discounted staffing and placement services to CMS members. Visit Favorite's CMS member site or call 720-210-9409.

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Take Credit Cards? Is Your Practice Ready for the Oct. 15 EMV Deadline?

Important! What your practice needs to know about switching to EMV: Click here.

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Buried in Credentialing and Enrollment paperwork? The new CMS Credentialing and Enrollment Services (powered by 3WON) saves you time and money by  automating your data and continuously updating and distributing it to all necessary parties. Visit   www.3won.com   or call 630-992-7777.
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