August Manufacturer Webinar
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August Manufacturer Webinar Art Spaziano, Manager Palmetto GBA Medicare Part D, CGDP TPA
description
August Manufacturer Webinar. Art Spaziano, Manager Palmetto GBA Medicare Part D, CGDP TPA. Agenda. New Negative Amount Resolution Process Overview of the EFT distribution process Increase in incorrect payments to Sponsors Overview of the new Online Payment Confirmation application. - PowerPoint PPT Presentation
Transcript of August Manufacturer Webinar
August Manufacturer Webinar
Art Spaziano, ManagerPalmetto GBAMedicare Part D, CGDP TPA
• New Negative Amount Resolution Process
• Overview of the EFT distribution process
• Increase in incorrect payments to Sponsors
• Overview of the new Online Payment Confirmation application
AgendaAgenda
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New Negative Amount Resolution Process
Art Spaziano, ManagerPalmetto GBAMedicare Part D, CGDP TPA
• Manufacturer EFT data now being collected– All input needed by August 17th
• Complete EFT records to be distributed to Sponsors on August 25th
• Negative invoices distributed on October 17th
• Payments due 38 days later• Annual cycle begins in April of 2014
Current Status and PlanCurrent Status and Plan
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• Covered:–Negative balances due to deleted or
adjusted PDEs– Cumulative amounts as of Q2 2013
• Not Covered:– Amounts overpaid by Drug
Manufacturers and held by Sponsors• Repayment must occur via an independent
process
What’s Covered and Not Covered
What’s Covered and Not Covered
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Overview of the EFT Distribution Process
Lytarsha Jiles, Business AnalystPalmetto GBAMedicare Part D, CGDP TPA
• No Dependency on APPS• Opportunity to update each quarter• Reminders will be sent prior to each
update deadline• No update needed if there are no changes
• Full set of EFT records redistributed each quarter• Important for Manufacturers to download
this file each quarter• Granular description of changes issued
with each update
Sponsor EFT InformationSponsor EFT Information
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• Initial collection of data in process• 100% participation is needed
• Initial file will be distributed on August 25th• Opportunity to update each year
• Reminders will be sent prior to each update deadline
• No update needed if there are no changes• Full set of EFT records redistributed each year
• Important for Sponsors to download this file each quarter
• Granular description of changes issued with each update
Manufacturer EFT InformationManufacturer EFT Information
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Incorrect Payments to Sponsors
Anna Loveday, EDI Operations AssociatePalmetto GBAMedicare Part D, CGDP TPA
• Paying wrong amounts• Should be using field 11 from the TPACT record of
the Invoice
• Paying wrong sponsors• Internal payment processes need to be more
carefully managed• Manufacturers should always download the latest
EFT file
• Sponsors unsure how to allocate payments• EFT IDs should always accompany payment
Various Payment Issues on the Increase
Various Payment Issues on the Increase
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Manufacturer Online Payment Confirmation Overview
Diane Kreitz, Programmer / AnalystPalmetto GBAMedicare Part D, CGDP TPA
• A Web based tool for creating, editing and submitting payment confirmations• No need to edit flat files and submit via SFTP
• Readable invoices• Also provides a list of payments to be made, including
EFT ID
• Accessible via a new, secure Manufacturer’s Portal
• Manufacturers can choose to stay with flat files or switch to this new tool
Description and CapabilitiesDescription and Capabilities
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Logging InLogging In
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Menu ChoicesMenu Choices
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Invoice ListInvoice List
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EZ Payment ListEZ Payment List
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Invoice ListInvoice List
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Main ScreenMain Screen
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Entering Amounts PaidEntering Amounts Paid
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Confirming PaymentsConfirming Payments
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Transmitting ConfirmationTransmitting Confirmation
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Transmission ReceiptTransmission Receipt
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Status of ConfirmationsStatus of Confirmations
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• Portal credentials to be distributed this month
• Portal and application to be available later this month• Will be announced via ListServ
• Q2 2013 invoices will be accessible from the portal when they are distributed to mail boxes on August 31st
• Q2 2013 confirmations can be submitted any time thereafter
Next StepsNext Steps
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TPA Contact Information
Art Spaziano, ManagerPalmetto GBAMedicare Part D, CGDP TPA
Contacting the TPAContacting the TPA
• TPA website - http://tpadministrator.com• Phone
– Help Line: 1-877-534-2772 – Option 1– Hours: Monday thru Friday 8am to 7pm ET
• General email inquiries regarding the invoicing and payment process should be sent to [email protected]
• Webinar slides will be posted to the TPA website• Suggestions for future webinar topics should be sent to
[email protected] • Questions related to dispute files, EFT information, invoice
corrections http://tpadministrator.com – Website• [email protected] - Dispute support
documentation
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ResourcesResources
•Medicare Drug Benefit Group • Questions related to the Manufacturers Agreement, changes of
ownership, terminations, compliance / administrative-related issues, policy
• Email address is [email protected]
•Discount Program Manufacturer’s Page• http://www.cms.gov/Medicare/Prescription-Drug-Coverage/
PrescriptionDrugCovGenIn/index.html?redirect=/PrescriptionDrugCovGenIn/
•HPMS WebsiteUpdating CMS contact and labeler code changes• https://gateway.cms.gov - Website• [email protected] - Password Resets• [email protected] - Non-password access assistance
•Independent Review Entity (IRE) for Discount Program appeals.• https://cgdpappeals.provider-resources.com/Default.aspx - Website
