Friday, October 6, 2017

Of Revalidations- Part II- Why So Much Personal Information?

Here we go again…

In this second part of our two-part series talking about the revalidation process, we focus on one of the biggest questions we receive here in our billing office…

“Why do I have to provide my personal information?

Let’s dig in and try to understand the why.

Of Revalidations- Part II- Why So Much Personal Information?

Congratulations!

So you say you’ve just been elected to the Board of Directors or you’ve become an Officer or both for your local EMS Agency.

Congratulations!

Now that you’ve become a Board member or you’ve been elected to an office you’ve been requested to provide some very personal information in that role as a key decision-maker for your organization.

As part of the revalidation mandate Medicare and Medicaid providers and suppliers of services, ambulances included, are required to report vital information about your agency. Included in that information is the identifying information for each person who holds a position of leadership- however that is defined for your organization.

So for each person who sits your agency’s board and holds an office as it pertains to EMS is required to provide Medicare and Medicaid with the following information…
  • Legal Name (First, Middle, Last)
  • Home Address (Medicare does not require but most State’s Medicaid programs do)
  • Social Security Number (and not just the last four digits either)
  • Date of Birth
  • State of Birth
  • Country of Birth (if born outside the United State of America)
  • For managers, the date the person took office
  • Position Held within the Organization
  • For-Profits must report ownership and also in some cases for States’ Medicaid family relationship to other owners

Ever heard of identity theft and privacy?

We’ve known of instances where some directors and principal officials flat out refuse to provide so much personal information. They typically ask something like; “Have you ever heard of identity theft and privacy?”

We get it. We’re all hesitant to release such personal information.

Some Directors and Officers balk because they feel that Big Brother is watching them.

Okay…that’s probably accurate. Certainly, everyone is worried about identity theft. We understand.

It’s why, here in our billing office, the persons involved in assisting clients in the revalidation tasks are staff members who have a proven track record of safe handling of personal and private information. Plus, the Medicare Administrative Contractor’s (MACs) or your State’s Medicaid Provider Enrollment/Credentialing Staff have been proven to be extremely discreet as required within their contractual relationship with the Federal Government.

What will Medicare/Medicaid do with my information?

Medicare and Medicaid will do the following with your information…
  1. Verify you are who you say you are
  2. Verify that you were never convicted of some financial crime or deception that cost the Medicare and Medicaid program dollars paid out inappropriately
    • This is accomplished by comparing your personal information against a database called the “Exclusion List.” It is a list of those persons who have defrauded the Medicare and Medicaid programs out of billing of dollars. The intent is for history to not repeat itself and more money is lost to fraud and abuse.
Once you have been vetted, your EMS Agency will be revalidated and your information will be nicely tucked away in a very secure place until your information or your Agency’s profile changes and an update must be made.

And if I don’t provide the information?

Failure to accurately report all persons that are the key decision-makers as part of your administration, be it members of your Board of Directors, elected officials, officers, managers…whatever applies to your situation can ultimately result in suspension or termination of your Medicare or Medicaid billing privileges which would be disastrous to any EMS agency.

It’s vitally important to complete all required information for the revalidation process in a timely fashion!

Post a Comment