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Home My WebLink About235004 07/16/14 CITY OF CARMEL, INDIANA VENDOR: 367102 ONE CIVIC SQUARE W P S MEDICARE CHECK AMOUNT: $*******160.00* x ,q; CARMEL, INDIANA 46032 FINANCE DEPARTMENT CHECK NUMBER: 235004 PO BOX 1602 CHECK DATE: 07/16/14 OMAHA NE 68101 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4357004 160.00 EXTERNAL INSTRUCT FEE Harrington, Michelle From: Provider Outreach and Education <surveymail@wpsic.com> Sent: Friday, May 30, 2014 3:55 PM To: Harrington, Michelle Subject: Thank you for registering for A Day with Medicare A Day with Medicare WPS Medicare is pleased to announce a full day educational event designed for providers and suppliers of all types. The multi-breakout sessions will allow providers to pick topics they are interested in. This exciting program includes both Part A and Part B topics. • General session breakout sessions • Meet with WPS Medicare Staff Tuesday October 7, 2014 from 8:00 AM to 4:30 PM CDT Caribbean Cove Hotel & Conference Center 3850 DePauw Blvd Indianapolis, IN 46268 Thank you again for registering for our event. This email is confirmation of your successful registration. If any of the information displayed below is incorrect, please contact us as soon as possible. Please print a copy of each attendee's ticket and include it with the payment. You may mail one check for multiple attendees. View and print my ticket(s) To add your ticket to Passbook, open this email on your Passbook enabled device. Add to Passbook Personal Information First Name: Michelle Last Name: Harrington Email Address: mharrington carmeIJn.gov Business Information Company: CITY OF CARMEL FIRE DEPARTMENT Job Title: EMS BILLING ADMINISTRATOR Address 1: 2 CIVIC SQUARE City: CARMEL State: Indiana ZIP Code: 46032 Phone: 317-571-2604 Fax: 317-571-2660 Provider Number 317470 Are you a Part A or Part B biller? Part B - Billing on a CMS-1500 or its electronic equivalent i I Session Selection Session 1 Medicare Part B Appeals Process Part 1 - Part B Session 2 If you selected Outpatient Part 2 of Part B Appeals Therapy or Part B Appeals in session 1, you must select part 2 of session 1. Session 3 Let's Work Together to Lower CERT Part B Errors:Why It Matters! - Part B Session 4 If you selected Evaulation Let's Examine Part B CERT Errors: A Closer Look- Part and Management in session 3, you must B select part 2 of session 3. Colleague Information First Name: Sowmya Last Name: Udayan Email Address: SUDAYAN(dCARMEL.IN.GOV Session 1 Part B Appeals Part 1 - Part B Session 2 If you selected Outpatient Part 2 of Part B Appeals Therapy or Part B Appeals in session 1, you must select part 2 of session 1. Session 3 CMS Secure Net Access Portal (C-SNAP) - Part A or B Sesssion 4 If you selected Evaulation Let's Examine Part B CERT Errors: A Closer Look- Part and Management in session 3, you must B select part 2 of session 3. Payment Method: Check Please make check payable to: WPS Medicare Attn: Finance Department P.O. Box 2430 Omaha, NE 68103 Payment Summary Name. Tl!pe Quantity Fee. Total - -- Michelle Harrington Event fee 1 $80.00 _ $80.00 Sowmya Udayan Event fee 1 $80.00 $80.00 Total $160.00 Contact Provider Outreach and Education WPS Medicare 618-998-5240 survey mail(cD-wpsic.com Add to Calendar Go to event page This email was sent to mharrington(o)-carmel.in.gov by surveymail a(�wpsic.com because you registered for A Day with Medicare. Click here if you no longer wish to receive emails z VOUCHER NO. WARRANT NO. --- -- --- ALLOWED 20 WPS Medicare ' Finance Department IN SUM OF$ PO Box 1602 -- Omaha, NE 68101 $160.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-570.04 $160.00 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except jUL 28% Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whorn, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) $160.00 1 hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer