Front of mind: Round 2

Monday, November 21, 2011

ATLANTA - What are the lessons learned from Round 1 of competitive bidding? Be accurate and be timely, says Mark Higley, vice president of development for The VGM Group.

Higley outlined tips for providers in Round 2 in a jam-packed session at Medtrade in October.

One tip on how to be accurate: Get a copy of your 855S form and make sure it's up to date. It sounds like a no-brainer, but Higley said a whopping 40% of providers who submitted bids for Round 1 were disqualified due to clerical errors on the enrollment form--things like the wrong name or the wrong social security number.

Providers can be timely by doing things like figuring out who will register to submit the bid now, even though registration isn't open yet. Higley said some providers submitted "panic bids" because they waited too long to make these decisions.

Other tips Higley shared with the audience: Download the affected zip codes (the metropolitan statistical areas and the competitive bid areas don't match up exactly, he said); learn the licensing requirements in the bid areas ("Licensure was a killer in the first round, especially respiratory licensing," he said); and submit only the required financial documentation--nothing more, nothing less ("Don't do anything to confuse these poor people," he said).

As for where the Round 2 single payment amounts will fall, Higley said he doesn't think there'll be as big of a reduction this time around. The original Round 1 came in at 26% below the current fee schedule; the red-bid came in at 32%.

"Will we get to 32% this time?" Higley said. "I don't think so. This is opinion only, but I think we'll see 25%. (But) it's not my suggestion that you bid that."