Gear Up for the July 1 MAC Transition – Tips for a Smooth Conversion

We are in the final stretch of the great DME MAC transition of 2016.  On July 1st the MACs will be shifting from four contractors (NHIC, National Government Services, CGS, and Noridian) to just two contractors (CGS and Noridian). The jurisdictions themselves will remain intact and will continue as jurisdictions A, B, C and D; but they will be administered by two contractors instead of four.
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As with any transition (especially one of this magnitude), there are lots of supplier questions:

• Should we expect changes with how our claims are processed?
• Will the same issues be audited under the new contractors?
• Will my payments be delayed or interrupted?
• Where will I send my claims?

Suppliers should be reassured by the fact that all of these contractors have both lost and gained contracts and have experience with what works and doesn’t in these migrations.  Lessons that have been learned over the years will benefit suppliers in this particular shift.  The prevailing contractors CGS and Noridian are moving forward purposefully and are keeping suppliers informed of upcoming changes along the way. 

While we do anticipate a smooth transition for both Jurisdictions, suppliers must be attuned to changes they must make internally to stay in concert with the MAC migration.  At critical junctures, suppliers will be responsible for updating their billing software and processing guidelines to avoid claim processing issues and revenue bottlenecks.
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Suppliers can mitigate this risk by following these simple steps:

1. Sign up for the list serves.
   • CGS: http://www.cgsmedicare.com/medicare_dynamic/ls/001.asp
   • Noridian:https://naslists.noridian.com/list/subscribe.html?mContainer=2&mOwner=G30392x2n39372t36
2. Monitor the implementation webpages for any posted changes.
   • CGS http://cgsmedicare.com/jb/index.html
   • Noridian https://med.noridianmedicare.com/web/jadme
3. Follow instructions provided by the MAC to update billing systems in a timely fashion.
4. Proactively scan incoming documentation to ensure related responses (ADRs, redeterminations) are routed to the proper address.
5. Communicate with your staff to be on the lookout for any unusual occurrences over the months of June and July.

 
The best way to ensure your operations continue without issue is to be proactive and resist the urge to keep the auto-pilot engaged during this transition.