Agencies receiving errors when accessing the Employee database in Main system HHC 3000 software will need the most current software version 6379 dated 11/07/2018.

Agencies receiving an error, invalid integer value when posting electronic remittances will need to update the Main office software to version 6309 dated 04/27/2018.

Medicare Final Claims denied with Group Code of CO and Claim Adjustment Reason Code 272 due to no OASIS record found at CMS per Palmetto cannot be resubmitted for payment.
If a denial is received agencies may attempt to appeal the denial if you have documentation to show that the information was sent.
Agencies should not submit final claims for assessments that are 30 days or more from the assessment completion date on the Claim until the OASIS Assessment has been Accepted at CMS. Agencies will need to monitor their CMS Validation Reports to ensure each assessment has been accepted. Please reference MLN Matters article Number SE17009 for additional information.
Following creation of the OASIS XML file and receipt of the CMS Validation Report, agencies can now filter the Create OASIS XML file grid by the CMS Sent date to ensure and document all assessments in the created file were accepted.
Agencies currently have available fields to mark when OASIS submissions have been accepted at CMS by monitoring CMS Validation Reports. Agencies can Mark Accepted via a check box or enter the OASIS Assessment ID from the CMS Validation report from the Create OASIS XML screen by selecting the Accepted button when the assessment is highlighted in the grid, or from the Changes screen accessible through the View button for the OASIS. The Accepted check mark and OASIS Assessment ID entered in the previously identified areas are visible to agency Billing Personnel in the Edit PPS billing screen for each assessment. The PPS Billing Screen will also contain a column displaying an entered OASIS Assessment ID.
Future enhancements to the software to prevent Final claim generation when there is no documentation of OASIS Assessment acceptance at CMS are planned.

Warning: US healthcare – There is a growing threat in global ransomware called “WannaCry”.

If you are currently a cloud customer, your HHC3000 is already protected against this threat.  Please note, this does not protect your agency’s computers or servers.  Only your hosted HHC3000 server  and it’s data are protected.

Please see the article below and protect your systems against this growing threat immediately!

Please click the link below for more information.

https://www.armor.com/protect-against-wannacry-ransomware/

Upon investigation CGS has also indicated claim processing issues and rejections for Final claims whose episode spanned  October 1, 2015.  CGS indicated any previously submitted claims that are currently listed in RTP for the  agency can be sent through for manual processing by selecting F9.  Any claims currently submitted will be manually processed by CGS and no further action will be required by the provider.

Palmetto has issued a notice regarding claim processing issues for Claims that spanned October 1, 2015.  Below is a direct quote from Palmetto.  It has been reported to Allegheny Software that claims are receiving the same Reason code from CGS.  We are currently  researching this report and what provider action is needed.

JM Home Health and HospiceClaims Payment Issues Log

HOME HEALTH ICD-10 REASON CODE 31276

Impact to Providers:
Palmetto GBA is researching home health (HH) final claims (type of bill 32X) with a THROUGH date on or after the October 1, 2015, that are incorrectly returning to the provider (RTP) with reason code 31276. The reason code narrative states “Outpatient claim contains an ICD-10 indicator of 9 and an ICD-10 diagnosis is present”.

Medicare Learning Network Articles SE1408 and SE1410 state that “Medicare requires the use of ICD-10 codes on HH claims and Requests for Anticipated Payment (RAPs)” with a THROUGH date on or after the October 1, 2015.

Status:
10/15/2015:
Home health claims with episodes that span October 1, 2015, are being incorrectly rejected/returned to providers. Medicare Administrative Contractors (MACs) are suspending these claims, including those already rejected/returned to providers. MACs are currently manually processing these suspended claims upon receipt, bypassing the edit causing the problem, until a system fix is implemented. No provider action is required; however, contact your MAC if you have questions.

10/14/2015: This issue is in research. Palmetto GBA will update this CPIL as soon as additional information is available.

Main and Clinical Software version updates performed on or after 8/18/15 will require additional restructuring for ICD 10 implementation.  This is a one time event.

Main office software updates may take up to an additional 30 minutes to perform the restructure.  Agencies with a large volume of comprehensive documentation may take up to 3 hours or more.  Please allow the additional time frame,  based upon the volume of documentation, to complete the update.  Once the responsible employee completes the update process, they must open the software.  Restructuring will then begin.  No other employee should open the software during the restructure.  Opening the software during the restructure will cause errors and require additional technical support.  Agencies utilizing the Clinical Point of Care software with the data pipe for data synchronization, will need to turn off the data pipe while the restructure is occurring.

Clinical software updates will also require restructuring.  Clinical software restructures may take up to 5 minutes to complete.  Clinicians will be asked to restructure upon opening the clinical software after the update to the current version number has been completed.  Clinicians should select the ‘YES’ option in the window with the prompt to restructure.

Agencies utilizing the Main office and Clinical Point of Care software in the managed hosting environment may see an employee has been assigned to an Assessment created in the Clinical Point of Care software within the last 2 days in error due to a bug in the system.  The issue has been corrected and will no longer occur with the software version agencies will be accessing 4/17/15.

Agency administrators may call Allegheny Software Publishers, Inc. for instructions on changing the Employee name to the correct employee for those assessments that have been assigned an incorrect employee.   Agency administrators must have Full Access system security to the software in order to perform the correction.

Agencies with Medicare Intermediary CGS will need to update the Main office software to version 5699 released 03/12/15.  2015 Transitional CBSA Codes will be utilized for Medicare claims.  Software changes were made previously to accommodate the Intermediary’s use of 2015 CBSA Codes.  The Intermediary has now converted its systems for use of the 2015 Transitional CBSA Codes.  If your agency has received claim rejections due to the CBSA Code, please update the Main office software to version 5699 and recreate the claim for submission which will attach the 2015 Transitional CBSA Codes.  If an urgent Medicare claim is required for submission prior to the ability to update the Main office software, agencies may select the check box “Use Transitional CBSA on 2015 claims”.  The check box can be found in the PPS tab in the Insurance data base when the applicable Insurance record is displayed.  Claims may then be recreated and submitted.  The check box will no longer be required after updating to Main office software version 5699.

Agencies creating Medicare PPS Billing claims will need to update to Main Office software  version 5676.  Updates have been made to the CBSA Code values.  We have been notified the 2015 Transitional Code Values as previously indicated will not be used for Medicare PPS claims.  The software will begin to utilized the 2015 CBSA Code value with update 5676 which will allow claims to be processed without errors.

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