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AIAAOPA in Advance

Breaking News for O&P Professionals
April 3, 2007 ♦ Volume 11 Number 7
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O&P News
National Provider Identifier Clarification
O&P Resources from AOPA

2007 AOPA National Assembly
O&P News
First 10 Sites for Competitive Bidding are Released – and then Gone  
For a brief time on Friday, March 30, the list of the 10 Metropolitan Statistical Areas (MSAs) where the first phase of the Medicare DMEPOS Competitive Bidding Program will be implemented was published online.  Shortly after publication, the entire Web site of the contractor responsible for implementing the program was password protected, becoming inaccessible and the list of the 10 MSAs was no longer available.

AOPA obtained the list of the 10 MSAs originally listed on the Web site.  While unconfirmed, AOPA believes the information is valuable and most likely accurate.  AOPA will keep you informed of any changes to the 10 MSAs listed below.  The 10 MSAs listed on the Web site were:

Jurisdiction A
Pittsburgh , PA  

Jurisdiction B 
Cincinnati-Middletown, OH-KY-IN

Cleveland-Elyria-Mentor , OH  


Jurisdiction C 
Charlotte-Gastonia-Concord; NC-SC 
Dallas-Fort Worth- Arlington , TX  
Miami-Fort Lauderdale-Miami Beach , FL    
Orlando-Kissimmee , FL    
San Juan-Caguas-Guaynabo, PR

Jurisdiction D 
Kansas City , MO-KS  

Riverside-San Bernardino- Ontario , CA


We are still waiting for information regarding the type of off-the-shelf orthoses that will be included in the Competitive Bidding Program and the implementation schedule for the program itself.  AOPA will publish any additional information as it is received.

Questions regarding the DMEPOS Competitive Bidding Program should be directed to Kathy Dodson at (571) 431-0810 or kdodson@AOPAnet.org.

 

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Palmetto GBA to Provide SADMERC and NSC Services  
Until at least March 2008, Palmetto GBA will continue to perform its duties as the contractor responsible for the National Supplier Clearinghouse (NSC) and Statistical Analysis Durable Medical Equipment Regional Carrier (SADMERC).

The February 21, 2007 edition of AOPA In Advance reported that Palmetto GBA would not be eligible to hold the contract for these functions since they no longer held one of the four DME MAC contracts; however, CMS has since stated that solicitation to perform the function of the NSC and Data Analysis and Coding (formerly SADMERC) will not be restricted to current DME MAC contractors.

Questions regarding this issue can be directed to Joe McTernan at (571) 431-0811 or jmcternan@AOPAnet.org 

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“Early Boarding” offered to Providers in Va. and W.Va.
 Suppliers in Virginia and West Virginia will be moving from Jurisdiction B to Jurisdiction C effective June 1, 2007.

Starting now, an “early boarding” period has been established, so that Virginia and West Virginia providers may submit electronic claims to Palmetto GBA, the current Region C DMERC.

It is a good idea to take advantage of this early boarding process in order to establish an Electronic Data Interchange (EDI) connection with Palmetto GBS prior to the June 1, 2007 transition date. Palmetto will reroute the claims to Jurisdiction B for processing until the June 1 transition. After June 1, Palmetto will direct electronic claims to Jurisdiction C. The early boarding process is not expected to result in any claims processing delays.

Also as of June 1, 2007 CIGNA Government Services will assume responsibility as the Jurisdiction C DME MAC. Even so, Palmetto GBA will continue to provide Jurisdiction C EDI services as a subcontractor to CIGNA Government Services.

Palmetto GBA has sent a letter to all suppliers in Virginia and West Virginia explaining the details of the early boarding process. If you treat patients in one of these states and have not received a copy of the letter, you may download a copy (PDF format).

Questions regarding this issue can be directed to Joe McTernan at (571) 431-0811 or jmcternan@AOPAnet.org

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NY O&P Suppliers Get Overpayment Demand Letters from RAC
Overpayment demand letters were issued to some New York suppliers the week of March 19th by the Recovery Audit Contractor (RAC).
 
National Heritage Insurance Co. (NHIC), the DME MAC for Jurisdiction A, reported this information to suppliers to ensure that those affected were aware of the letters and to encourage them to respond promptly. Any inquiries about the letters must be sent directly to the RAC.
 
Medicare’s RAC program is determining whether spending more resources to ensure correct payments will protect Medicare from fraud. The program is currently operating only in California, Florida and New York. 
 
Questions?  Contact Daniel Gurley, Manager of Regulatory Affairs at dgurley@AOPAnet.org or (571) 431-0812.
 
 
National Provider Identifier Clarification
For DMEPOS suppliers, the National Provider Identifier (NPI) is assigned to the facility location, not the individual practitioner. Unless your business is organized as a sole proprietorship, you are not required to obtain a separate NPI for each practitioner employed by your business.
 
With the May 23, 2007 deadline for obtaining a NPI quickly approaching, it is important to know who is required to obtain a NPI number. 
 
Further, each practice location within a corporation must be identified as a subpart of the corporation, and therefore, each location must obtain and use its own unique NPI.
 
CMS has more information about the NPI on its Web site.
 

O&P Resources From AOPA 
April 19: Learn How to Minimize Claims Denials
Dial in to this AOPA Telephone Seminar on April 19 and learn how to minimize denials by avoiding simple, common mistakes. Learn more about:

- How to get your claims processed the first time they are submitted.
- When and where to include modifiers.
- How to protect your business from financial liability on denied claims.
- What to put in the HA0 record.
- What to ask for from the prescribing physician.

AOPA Medicare Telephone Seminar
April 19, 1:00–2:00 pm EST
1.5 CE credits per participant
$99 ($199 nonmembers), per telephone line
Register today!
The cost of this seminar includes an unlimited number of participants per telephone line.

Questions? Contact Heather Franklin at hfranklin@AOPAnet.org or (571) 431-0876, ext. 205.
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Code with Confidence: Purchase 2007 AOPA Coding Products
Do you own AOPA's 2007 coding products?  O&P businesses nationwide rely on AOPA coding products to improve their coding and billing efficiency. 
 
The 2007 CodingPro software, Illustrated Guide, and Quick Coder can be purchased by AOPA members for a discount at www.AOPAnet.org or by calling (571) 431-0865.

The CodingPro software enables you to generate Medicare-compliant prescriptions, import your own fee schedules, create supporting documents for your claims submissions, print them for your records and even save them in Microsoft Word™, all with the functionality of a database.
The Illustrated Guide is a print "picture book" of the official Medicare descriptors and gives you an easy-to-understand AOPA interpretation of each code.
The Quick Coder includes all HCPCS code changes for 2007 on laminated cards that are durable, long lasting, and convenient to store.

Purchase all three products as a set or individually.  AOPA MEMBERS: be sure to log in to get your discount!  Questions? Call the AOPA Bookstore at (571) 431-0865. 
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Earn 21 CE credits at AOPA Seminars in Newark and Indianapolis
Register today to attend these recently-announced seminars:

 
 
April 10-11: Las Vegas
June 6-7:    Newark, N.J.
Oct. 16-17: Indianapolis
 
April 12: Las Vegas
June 8:  Newark, N.J.
Oct. 18: Indianapolis
 
 
Las Vegas: Attendees may register on-site at Bally’s Las Vegas. Hotel reservations are subject to availability.
 
Newark: The special room rate at the Marriott Newark Airport Hotel is $169 if attendees make their reservations before May 16. Also, registration pricing increases from $525 to $550 for members after May 16, so register now!  
 
Indianapolis: The special room rate at the Hyatt Regency Indianapolis is $169 if attendees make their reservations before Sep. 24. Also, registration pricing increases from $525 to $550 for members after Sep. 24, so register now!  
 
Visit www.AOPAnet.org to register or contact Heather Franklin at hfranklin@AOPAnet.org or (571) 431-0876, ext. 205.
 
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Don’t Miss the ONLY O&P Buyer’s Guide!
Suppliers, showcase your products in the only O&P Buyer’s Guide and get a FREE Web site listing in the O&P Yellow Pages! Plus, get FREE distribution at the Amputee Coalition of America (ACA) Meeting in Atlanta , June 15-17! 

In the June issue of the O&P Almanac, the O&P Buyer’s Guide is the biggest advertising opportunity of the year. Reach over 16,000 O&P practitioners, facility owners and health care professionals in the U.S. and abroad.

E-mail images (.jpg format at 300 dpi) and text to jkingery@AOPAnet.org by April 10. Please complete the 2007 Buyer's Guide order form and fax it to Jennifer Kingery at (571) 431-0899 to reserve your space.
  
Display ads are also available in the O&P Buyer’s Guide (deadline is May 9). For more information, contact Amy Clontz at (888) 557-7277 and select option 2 or e-mail aclontz@AOPAnet.org.

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2007 AOPA National Assembly
Exhibit Space Going Fast at the AOPA Assembly
The exhibit hall is already 85 percent sold out for the 2007 AOPA National Assembly in Las Vegas, Sept. 17–20. Don’t miss this chance to showcase your company’s products and services at the premier O&P event of the year!

For more information or to exhibit, contact Kelly O’Neill at koneill@AOPAnet.org or (571) 431-0852.

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O&P Insider's Track 
The Only Up-to-the Minute O&P Newsline
People In the News
AOPA employees recently toured a Washington, D.C.-based O&P facility to learn more about what practitioners and technicians do on a daily basis and the technology that goes into fabricating and fitting prostheses and orthoses. All AOPA employees are offered this opportunity annually to expand their understanding of the O&P business and to improve their ability to provide service and support to members.

Businesses In the News
The Louisiana Association of Orthotist and Prosthetist has changed the dates of its state meeting from June 7–9 to July 12–14, due to construction delays at the Shreveport Convention Center. The meeting will still follow the original, daily schedule.

Ohio Willow Wood of Mt. Sterling, Ohio, has become a gold level sponsor of the Orthotic & Prosthetic Assistance Fund (OPAF) with its $10,000 contribution.
 
Snell Prosthetic & Orthotic Laboratory of Little Rock, Ark., was recently honored as a finalist in Arkansas Business of the Year Awards. A field of over 200 nominees were considered.


In Memoriam 

William L. Bartels, CO, of Gaston , Ore. , has died. The AOPA past president owned and operated William L. Bartels Orthopedic and Prosthetic Appliances Inc. from 1953 to 1992 before his retirement. Bartels is survived by his wife Gloria, his son William and his daughters Kathryn and Linda.  

Harry J. Lawall Sr., CP, of Philadelphia passed away on March 15. He founded Harry J. Lawall & Sons in 1977 with his son, Harry J. Lawall Jr. Over the years, his business expanded to include Lawall Prosthetics/Orthotics and Lawall at Hershey that encompassed 17 patient care centers throughout Pennsylvania , New Jersey and Delaware with a staff of over 200 people. In all, five sons and a granddaughter of Lawall are working in O&P.
Lawall is survived by his wife Rosemary, nine children and 30 grandchildren. 

Send Us Your News!
New employee? New office? Tell us! Share your news with the over 15,000 readers of the O&P Almanac and AOPA In Advance newsletter. E-mail Jacob Strauss at jstrauss@AOPAnet.org.