Question 1:
Will Centers for Medicare & Medicaid Services (CMS) require all providers to e-Prescribe?
Answer:
No. However, providers that do not e-Prescribe by 2012 will receive reduced payments. As outlined in the presentation on slide 24, eligible professionals who are not e-Prescribing in 2012 will be paid a reduction in the Medicare Physician Fee Schedule (MPFS). CMS will provide exemptions on a case-by-case basis when compliance would result in significant hardship. CMS will define what constitutes ‘significant hardship’ as the deadline approaches.
Question 2:
We are seeing a great deal of remittances with the remark code MA04 on our Medicare Secondary Payer (MSP) Claims. What do we need to do to resolve this?
Answer:
According to the Washington Publishing Company, the remittance advice remark code is defined as MA04 - ‘Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible.’
The claim was rejected as stated above. Check the claim to ensure that the information was present and valid. If the information was submitted, double-check the information submitted to ensure it matches information from the primary payer remittance advice. If the information was correct per your records, contact our Provider Contact Center at (866) 332-7025 for additional assistance.
Question 3:
Does CMS require the actual provider to complete his or her own Medicare 855 enrollment application online or is staff also allowed to complete the form?
Answer:
While many practices employ credentialing staff to complete and maintain their enrollment files with payers, CMS strongly encourages providers themselves to maintain their own Medicare enrollment information.
The Web site's home page on CMS Internet based Provider Enrollment, Chain and Ownership System (PECOS) states:
‘The physician or non-physician practitioner assumes full and complete liability for new and updated Medicare enrollment information that is transmitted to the enrollment contractor via Internet-based PECOS once the enrollment contractor receives the signed and dated Certification Statement. In addition, the physician or non-physician practitioner is responsible for any unauthorized disclosure of information furnished for the Medicare enrollment process.’