“ Welcome to Jurisdiction 10” Workshop Presented by Cahaba Government Benefit Administrators ®, LLC J 10 A/B MAC Provider Outreach and Education April 21,

Meeting Agenda  History of Cahaba  Medicare Contracting Reform  J10 Transition Georgia Dark Day Provider Enrollment Medical Review Medicare Secondary Payer Electronic Data Interchange (EDI) Provider Contact Center Medicare Resources 2

The History of Cahaba GBA ®,LLC 3

Alabama Part A and Part B since 1966 Cahaba GBA Expansion 4

Georgia Part B Awarded 1996 Cahaba GBA Expansion 5

Iowa and South Dakota Part A including RHHI Awarded

Mississippi Part B Awarded 2000 Mississippi Part B Awarded 2000 Cahaba GBA Expansion 7

Cahaba Government Benefit Administrators ®, LLC  Part A Intermediary for AL  Part B Carrier for AL, GA & MS  Part A RHHI for 16 Northern/Midwest states  600+ employees  Three (3) office locations: Birmingham, AL; Savannah, GA; Des Moines, IA  Corporate office located in Birmingham, Alabama 8

Medicare Modernization Act Signed into law on December 8, 2003 Largest amendment to the Social Security Act since the inception of Medicare Provides several administrative, operational and functional changes Includes CMS’ vision for contractor reform 9

Title XVIII 1816 and 1842 of SSA Beneficiary and provider multiple contractors Either party can terminate Contracts and agreements year to year MAC Section 1874a of SSA Single contractor for beneficiary and provider Only government may terminate Contracts will last a maximum of five years 10 Evolution of Medicare Contracting Reform

Medicare Administrative Contractors A/B Jurisdiction Map 11

Jurisdiction 10 MAC Award  Cahaba GBA awarded contract on January 7, 2009  New Jurisdictions to Cahaba GA Part A TN Part A and B  Awaiting notification on the MS Part B workload 12

WHAT SHOULD I DO BEFORE CUTOVER? 13 FISCAL INTERMEDIARY TO A/B MAC

Transfer of Georgia Data  Dark day on May 4, 2009  Customer Service and claims system will not be available  Normal business operations will resume on May 5, J10 Transition

Daily Payment Cycle  Payments made on a daily basis  First payment processed May 4, 2009  PIP payments paid bi-weekly 15 J10 Transition

Provider Enrollment CMS 588 Electronic Funds Transfer  New CMS 588 form MUST be completed  Original signature is required  Acknowledgement letter will be sent  Download form at: J10 Transition 16 Submit forms to: Provider Enrollment PO Box Birmingham, AL

Medical Review  Future Effective Local Coverage Determinations (LCDs)  No Intermediary Advisory Committee meeting  View LCDs at 17 J10 Transition

Medicare Secondary Payer (MSP) Contact COBC regarding MSP issues or TTY/TDD: MSP Admission Questionnairewww.cms.hhs.gov/ProviderServices/Downloads/pro_othertool.pdf 18 J10 Transition

Vehicles of Communication  J10 Transition Newsline  Listserv messages  Face-to-Face events  Open Door Forums (ODF)  POE Advisory Group meeting 19 J10 Transition

Stay Connected 20

Electronic Data Interchange (EDI)  New FISS and DDE passwords and IDs not required  Third party vendors  IVANS ext  VisionShare  Other approved vendors 21 J10 Transition

Electronic Data Interchange  Cahaba Secure File Transfer Protocol Server (FTP) ftp instructions.pdf  New Submitter IDs and Password Letters mailed April 1, 2009  Testing not required 22 J10 Transition

Electronic Data Interchange (EDI) Help Desk Support Telephone Us Fax Us Us Write Us Cahaba GBA EDI Services PO Box Birmingham, AL

Provider Contact Center  Enterprise Call Center Birmingham, Alabama Savannah, GA  Voice Response Enhancement or IVR System Speech recognition coming soon  Medicare Beneficiary – Medicare ( ) 24 J10 Transition

CMS Resources  Medicare Administrative Contractor  MLN Matters Article SE  Change Request  CMS Change Request J10 Transition

Questions Please complete your general inquiry feedback form. 26

Thank You! 27 Cahaba GBA, LLC J10 A/B MAC