• NSA I-Tact

  12.01.23 Work Group B AI Notes

  Posted by name on December 1, 2023 at 4:59 pm

  I-Tact Workgroup B AI Minutes
  December 1, 2023

  AI meeting summary:

  • Ed Gaines mentions that Jen Brown circulated a spreadsheet on new batching proposals. They discuss different batch options, including 8-4 and 8-5 in the batch, increasing batching to 90 days, and batching all E/M codes together. They also mention addressing limitations on batch numbers and reducing cooling periods.

  • Stephanie Caruso mentions that the portal for batched claims is set to reopen on 12/15, earlier than expected. She raises questions about submitting claims under old guidance and the time frame for submission. Shanna expresses concern about insurance companies exploiting the reopening of the portal and asks for Bob’s thoughts. Ed Gaines plans to email Bob and others regarding this issue. The discussion then shifts to timelines, grace periods, and compliance with existing rules. Stephanie confirms that the timeline remains unchanged but acknowledges lack of enforcement. They speculate that a 20-day submission period may be intentionally short, considering people won’t be able to submit everything in time. A meeting with OMB is mentioned regarding batching rules in admin fee final rule. Ed presents his revised comment bullet points on remittance advice codes and penalties discussed in their previous letter to Becerra from September 15th.

  • Ed Gaines discusses Jen’s decision to go with 8-4 and 8-5 mentioning that critical care was not mentioned but he will inform her. There is a discussion about the majority of codes being related to critical care. Stephanie Caruso asks about including ancillary codes in billing, and Ed explains they have talked about including ancillary procedures like EKG and laceration repair. They discuss the issue of batching codes and express their pushback against certain comments made by others. The transcript also touches on the impact of surprise billings on financial performance and patient protection, as well as advocacy efforts through social media.

  • Kathryn Beard expresses frustration with the lowest common denominator approach and lack of helpfulness in dealing with ideas. Ed Gaines agrees and finds the proposed 20-day timeline unreasonable, especially during the holiday season. They also discuss concerns about manually entering claims on the clunky portal and how it will impact processing timelines. Ed Gaines plans to ask Jim Bobek about handling an influx of claims during a workshop, while Shanna suggests reaching out to him prior to get his perspective. The team agrees that the process is unfair for everyone involved, including health plans. They humorously reference Christmas Vacation and end the conversation by discussing a football game between Alabama and Georgia.

  Action items:

  Ed Gaines:

  1. Review Jen Brown’s spreadsheet on new batching (04:43-04:49).

  5. Bring up Jen Brown’s spreadsheet during the discussion (05:01-05:06).

  6. Address the issue of the limit on the number of claims in the batching proposal (10:31-10:37).

  7. Address the issue of the limit on the time period for batching in the batching proposal (10:31-10:37).

  8. Send an email to Jeff Davis, Bob Jasek and others to comment on the opening of the portal for batch claims and the 20-day deadline (31:30-32:01).

  9. Circulate a list of questions to Stephanie Caruso, Jen Brown, and others regarding the opening of the portal for batch claims (45:30-46:00).

  10. Include Stephanie Caruso’s question about how the IDEs are planning to handle the deluge of claims in his email to Jeff Davis, Bob Jasek and others (45:30-46:00).

  11. Request comments from Jeff Davis on the opening of the portal for batch claims (46:14-46:16).

  Stephanie Caruso:

  1. Raise concerns about the 20-day deadline for submitting the backlog of batches during the discussion (41:50-42:05).

  Greg:

  1. Root for Georgia during the game (47:32-47:34).

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