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New MAC meets with the ISMA
e-Reports, June 11, 2012
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The ISMA is helping smooth the transition to the new Medicare administrative contractor (MAC), Wisconsin Physician Services (WPS), coming Aug. 20. After that date, National Government Services (NGS) will no longer handle your Medicare claims; WPS will be responsible for all claims communication, appeals, audits – and more.

WPS answers key questions

Coalition members posed questions you likely have as well. Here’s a sampling; also read the May 11 Medicare/Medicaid Coalition Report.

What kind of changes can we expect with local coverage determinations (LCDs)?

Our LCDs are available now for physician review.

Will audits continue during the crossover?

A 180-day blackout period will be in effect for audits—90 days before and 90 days after the cutover. Your RAC contractor will not change.

Will there be dates when we will not get paid?

There will be days when you will receive no payment, but some amounts will be paid early, keeping reimbursement the same.

Will everyone need a new electronic submitter ID?

No, a new ID will be necessary only in some unique situations.

In May, key WPS staff spent two days at the ISMA, meeting on the second day with Medicare Coalition attendees representing ISMA physician practices.

With that, WPS officials shared background on their organization.

An introduction to WPS
The Medicare division of WPS, a 65-year-old business based in Madison, Wisc., is one of the largest contractors with the Centers for Medicare & Medicaid Services (CMS). In 2011, they processed more than 158.4 million claims for $38.1 billion in benefits. The company started as a Part B carrier in 1966 and today serves as the MAC for CMS Jurisdiction 5 (J5) – Iowa, Kansas, Missouri and Nebraska.

The TRICARE division of WPS administers three federal contracts to serve the U.S. and around the globe. The company also handles Legacy Part A and B contracts.

A not-for-profit, WPS said its mission is to provide service and value considered by its customers to be the very best. Last year, WPS earned the CMS Provider Customer Service Program of the Year Award.

Joy Newby, LPN, CPC, with Joy Newby & Associates, went through a transition to WPS with J5. She told coalition members there was “not even a hiccup” in the process.

Opportunities to learn
WPS will hold forums, so you can learn about the company and view demonstrations of the WPS website and web-based self-service tool, C-SNAP.

Please register online at:

Fort Wayne, June 7

9 a.m. to 3 p.m. Local Time
Grand Wayne Center
120 W. Jefferson Blvd
(260) 426-4100

Indianapolis, June 8

9 a.m. to 3 p.m. Local Time
Indianapolis Marriott Downtown
350 W. Maryland St.
(317) 822-3500

The WPS website is available 24-hours a day with education and implementation sections to help you through the transition. New information will be added regularly, and webinars will be presented and available on demand.

Teleconferences will be offered from June through August to discuss claims, medical review, audits – and more. WPS staff will participate at meetings of the Physician Outreach and Education Advisory Group, retaining current members and welcoming new ones. To join, send a message through the “contact us” portion of the WPS website.

An eNews listserv will function as a key communication tool, bringing you updates regularly. Visit the WPS website and sign up to have news sent directly to your email.

“It’s vital that you sign up for this e-News listserve,” said Jeri Biedenkopf, R.N., ISMA practice manager, who noted you can continue to contact her with your questions.

What does moving to WPS involve?

Checklist now:

  1. Complete and send CMS-588 EFT authorization form by June 30.
  2. Sign up for the J8 Implementation eNews listserv.
  3. Visit the WPS J8 website.

Checklist at changeover:

  1. Sign up for the C-SNAP Internet provider portal.
  2. Distribute the WPS telephone numbers, addresses to staff.
  3. Update your current Medicare contractor number to the new J8 contractor number if you submit claims electronically.

For a more detailed checklist, see here.

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