Complete Story
 

07/03/2019

WPS Recent Oncology Related News

Part A, Part B and Part A/B News



WPS



WPS Articles From The Past Couple of Weeks that may be of Interest to Oncology:

 

WPS PART A-Outpatient Hospital Only

System Edits Will Be Activated for OPPS Providers with Multiple Service Locations

On July 1, 2019, CMS will begin enforcing edit requirements for Outpatient Prospective Payment System (OPPS) providers with multiple service locations submitting claims to Medicare. These are not new requirements. CMS discussed these requirements in Change Requests (CRs) 9613 and 9907, both of which were effective on January 1, 2017.  
 
Claims will Return-to-Provider (RTP) if:
  • The service location and information in the Provider Enrollment, Chain and Ownership System (PECOS) do not match exactly, and/or
  • The correct modifier is not reported on the claim.
For more information about this edit, see the full article on our website.


WPS PART B-Private Practice Only

Nothing at this time.


WPS PART A & PART B

New for Clerical Error Reopening (CER) in the WPS GHA Portal
  
We have received numerous requests from our portal users to be able to perform CERs on more than five line claims. We have enhanced the portal and beginning Wednesday, July 3, 2019, you will be able to complete CERs for six or more lines in the portal.



Avoid Overpayment Processing Delays 

When providers need to refund money to WPS GHA, they can avoid delays by using the eRefunds or Overpayment Claim Adjustment (OCA) features in the WPS GHA portal. These tools allow our Payment Recovery unit to process overpayments and refunds quickly and efficiently while avoiding the usual delays that come with mailing or faxing paper forms. We encourage providers to use the features of the WPS GHA portal whenever possible.
 
Occasionally, providers may not be able to use the WPS GHA portal to notify us about the overpayments or refunds they need to send to Medicare. Providers can avoid unnecessary delays by using the correct form in these situations. To notify WPS GHA of an overpayment or to initiate a refund, providers should complete the Overpayment Notification/Refund Form. This is the only form providers should use to report an overpayment to WPS GHA.
 
Some providers attempt to report overpayments using our Immediate Recoupment or our Overpayment Inquiry forms. Providers should not use these forms to report an overpayment or notify Medicare that a refund is due. Using these forms incorrectly will result in delays in processing the overpayment or refund request.
 
For more information about our Payment Recovery forms and instructions for completing them, see How to Avoid Overpayment Processing Delays on our website.



Draft LCD Open Meeting and Open Comment Period; We Want Your Comments: May 30, 2019 through July 14, 2019

On Tuesday, June 18, 2019, at 1:00 p.m. CST (2:00 p.m. EST), WPS GHA will hold Draft Local Coverage Determinations (LCD) Open Meetings for persons wishing to provide input concerning LCDs that are currently in the development process.
 
We will post the Draft LCDs to the Proposed/Draft Local Coverage Determination (LCD) page on May 30, 2019. The Open Comment period will begin on that date. We will accept comments until July 14, 2019.
 
For more information about the meeting and the comment period, see the full article on our website.
 
Note: This meeting is not the official Contractor Advisory Committee meeting.


MEDICARE HOT LINKS

Medicare Part B Fee Schedule

Addendum B Update (HOPPS Fee Schedule for Services & Drugs)

Current ASP Drug Pricing Files

Quarterly Updated to CCI Edits



2019 FINAL RULES

Physician Fee Schedule

Physician Fee Schedule Fact Sheet

HOPPS

HOPPS Fact Sheet

QPP Fact Sheet

E/M Payment Amounts Charts



 

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