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Third Party Payer Handouts

 

Conference Handouts will be posted as received by the presenters to this page. Please check back to download any presentations that will be made available before the conference. Thank you!

Mary Muchow, Wisconsin Physician’s Service

Jorri Smith and Sam Bartholomew, Priority Health

Bruce Maki, Altarum

Ken Axtell, McLaren Health Plan

Charles Bono, Blue Cross Blue Shield

Nicole McCutcheon & Marnithia Walker, Medicare Plus Blue

Here are some of the answers we received for your Medicare questions posed during the conference.

Thank you again for attending Third Party Payer Day 2019!

 

Q: Will new MBIs will be issued to beneficiaries under certain circumstances?

A: In this week’s CMS MLN Connects newsletter, there is a link to Medicare Learning Network Matters article, SE18006, New Medicare Beneficiary Identifier (MBI) Get It, Use It. SE18006 discusses issuing new Medicare Beneficiary Identifiers (MBIs) to Medicare beneficiaries. The article addresses various scenarios for reporting the old or the new MBI. Use the link below to access the full article.

Article SE18006

 

Q: Regarding the MBI lookup, available on the WPS GHA transaction portal, will that tool be going away? A lot of our patients are transient and do not get their mail or they do not understand what they have been sent and have said they throw away their mail. This tool has been extremely helpful in these cases.

A: There are no plans to remove the MBI lookup. It was CMS that mandated that every MAC make this tool available on the MAC transactional portal.

 

Q: We have multiple users ties to the same PTAN. Is there a way to direct the demand letters to a single user vs. every single user?

A: Unfortunately there is nothing that can be done to push letters for specific PTANs to certain users. The Portal is built with the NPI being the primary key. So all users with access to the NPI, regardless of PTAN, will receive the notifications and be able to view the letters.

 

Legislative Updates

Health Alliance Plan - Briena Mowen

Availity - Leah Olivolo

Sarah Ryden - Meridian

Medicaid State of Michigan - Jonathan Bair & Darlene Bruner-Embry

Aetna - Kiley Radel

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