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Palmetto GBA intends to demonstrate its commitment to our partnership by sharing with you the process improvements we implement based on your feedback. We value your comments and opinions, and have provided a number of ways for you to reach out to us, including the Provider Experience Survey. In addition to the direct feedback we regularly receive from our providers, we will be conducting quarterly focus groups, Ask-the-Contractor Teleconferences (ACTs) and Provider Outreach and Education Advisory Groups (POE-AGs) in order to uncover areas that are ripe for improvement. By working together we can enhance your experience and elevate the level of service, education, information and transparency you have come to expect from Palmetto GBA.

We value your feedback and your suggestions and we look forward to a culture of continual improvement in the way we conduct business and serve our providers. Because you have taken the time to provide feedback, Palmetto GBA has taken action to implement the following enhancements:

  • Added ability for users to view their account administrators in the My Account feature in eServices
  • Added ability to view appeal dismissal letters for Part A providers in eServices
  • View overpayment balance information via our eServices online portal. The portal will display real-time status of your accounts receivable (AR) or demand letter balances to include the principal AR balance, interest AR balance and total AR balance.
  • A link to descriptions for some denial code descriptions were added to help providers determine why the services denied
  • eAudit dropdown choice enhancement. This new enhancements only shows the choices available for each line of business.
  • Added Target Probe and Educate (TPE) result letters to be available as greenmail in the portal
  • Enhanced new account registration to leverage EDI enrollment process. The link to portal registration, along with an access code, is now sent in the EDI enrollment packet.
  • Use the Outpatient Prior Authorization (OPA) status tool to retrieve the status of your prior authorization request. Status information is updated approximately 24 hours after each transaction. The status results displayed are sorted by most current.
  • The Overpayment Interest Rate Calculator may be used to determine how much interest you have accrued on an unpaid overpayment by using the demand letter
  • Added new Part A appeals statuses for level 1 (redetermination) and level 2 (reconsideration) appeals: final affirmation, reopened, pending, etc.
  • eServices displays the start and end dates and billing National Provider Identifier (NPI) for inpatient hospital and skilled nursing facility (SNF) stays
  • When using the MBI Lookup Tool to obtain a Medicare Beneficiary Identifier (MBI) for a deceased beneficiary, eServices will now look back up to four years of the date of death
  • The patient’s current status, which identifies if they were discharged or still a patient, will now display in the eServices portal. Information is available once it has been reported through the patient’s master record.
  • Palmetto GBA’s Outpatient Department Prior Authorization Calculator will help you determine the time you have remaining to perform the approved procedure before the authorization expires
  • Extended the length of the second level appeals form email field in eServices
  • Google Authentication is now available to provide an immediate multi-factor authentication code to expedite your log in to eServices. This is in response to feedback provided from the website surveys.
  • Palmetto GBA is pleased to announce that eServices has been enhanced with the addition of new appeals features. Part A and HHH providers that are actively using eServices and have access to the Claims Inquiry tab can get up-to-date appeals status, view and download decision letters, and more. Please contact your eServices administrator for access to the Claims Inquiry tab if you do not already have access. Do you want to learn about all of the new appeals enhancements? View our on-demand webcast to learn more.
  • There are new enhancements to the claims section our eServices portal. Through application programming interface (API) integration, our eServices platform now integrates with the Part A and HHH claims system and is able to display multiple new features, making it faster and easier for you to review your claims. Our enhanced customer experience includes:
    • Improved provider experience and daily operations by providing faster Part A and HHH claim searches
    • New and improved user interface including claim search, claim detail and claim Summary screens
    • Enhanced claim lookup, now including Medicare Beneficiary Identifier (MBI) or claim number search with optional date range criteria — HICNs on claims with DOS prior to 1/1/20 are still accepted
    • Additional data elements on claim detail lines
    • Remit link added to Claim Summary and Claim Detail screens — eliminates additional clicks to go back to Eligibility screen for remit information
    • Account-linking functionality
    • Sorting feature for fields to sort claim data
    • Dynamic text box added to Claim Search screen to display important messages, updates and information to providers, when applicable
  • Palmetto GBA has implemented new “Disable User” functionality in eServices that will disable a user who has been inactive for 30 days, instead of terminating their User ID. Administrators will now be able to enable the user up to 120 days after 30 days of inactivity. If the user ID is not enabled within this time, the account will be terminated. We will send notification to providers through a series of periodic emails (up to the 120-day limit) to remind the user of their status and provide instructions to re-enable eServices IDs.
  • In addition to PDF (.pdf) files, providers are now able to submit MS Excel (.xls, .xlsx) files when submitting eCheck attachments in eServices
  • eServices Part A providers can now view additional denial and reason code information for Part A claims on the Claims tab
  • eServices profile verification has been extended from 90 to 250 days, allowing more time for you to complete this process. During this time, please make sure that all eServices user ID profiles are up to date to avoid interruption or deactivation.
  • We added a Check Eligibility button to the MBI Lookup tab in eServices in order to save you time when checking a beneficiary’s Medicare eligibility. With the MBI Lookup tab open, you will find the Check Eligibility button at the bottom of your screen.
  • Palmetto GBA continues to develop tools to improve service and efficiency, and our new eTicket is no exception. eTicket will save you time when contacting the Provider Contact Center (PCC) about a particular issue on multiple occasions. When you speak to a customer care representative by phone, a numeric inquiry number or eTicket is generated which provides a reference to the subject matter of your conversation with our PCC. When you call us with additional follow-up questions or for more information specific to a prior call, you can input your eTicket number into the IVR. Upon being transferred to a service representative, your topic of inquiry and data related to your previous call with Palmetto GBA will automatically be presented on the service representative’s screen, expediting their ability to serve you. Learn more with the Save Time with eTicket Module.
  • In response to provider feedback, we have updated the LCDs and Related Articles tables to designate which contract (Part A, Part B, Home Health or Hospice) they apply to
  • We have extended the time that a multi-factor authentication (MFA) code can be used. Providers are now able to use their MFA codes for up to 12 hours. This allows providers to simply reuse the last valid code issued. An MFA code will expire 12 hours from the time it was requested or when a new MFA code is generated.
  • 340B Drug Program Reimbursement Calculator: The 340B Drug Pricing Program allows certain hospitals and other healthcare providers to purchase drugs and biologicals (other than vaccines) that are administered in a hospital outpatient department from drug manufacturers at discounted prices. Our interactive 340B Drug Program Reimbursement Calculation Tool will assist you in determining the expected reimbursement amount.
  • ePass: Authentication is required before Palmetto GBA is authorized to discuss Medicare information with a provider. The ePass is an 8-digit code providers can elect to receive, per each NPI and PTAN combination, following their first-time authentication when they call the Provider Contact Center (PCC). The goal of the ePass is to ease provider burden by eliminating the need to repeatedly authenticate each time you contact the PCC in a given day.
  • Experience improvements when calling our contact center:
    • Added the ability to select to go straight to a Customer Service Advocate (CSA) in the main menu
    • Minimized the number of up front messages played
    • Allowed CSAs to handle multiple inquiries per call
    • Reviewing top inquiry data and identifying providers to proactively schedule concierge appointments
  • Providers are able to give immediate feedback on their customer service experience with Palmetto GBA through our Provider Experience survey
  • Providers are now mailed credit balance report reminder letters in order to reduce the number placed on payment withhold for failure to submit
  • Providers can now easily access their remits straight from the eServices claim status screen
  • For your convenience, all Part A providers enrolled in eServices will automatically receive their Additional Documentation Request (ADR) letters by eDelivery. For a short period of time you will still continue to receive both the mailed hardcopy ADR and the eDelivery electronic ADR in eServices. We will notify you when the hardcopy mailings will be discontinued.
  • Educational modules and tools were added in 2018:

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