The current software update on the internet fixes the issues with the H485 document.  The version number will still show 5271 but the fixes are included.

The new H485 document that was included in update version 5271 had two problems.  The feature that allowed users to import from a prior H485 was either not showing or not working.  In addition when tabbing from field to field in the diagnosis fields the skip pattern was out of order.  We have fixed the bugs but unfortunately we had one of our “lesser” servers go down late yesterday which has delayed our ability to put the updates out on the internet.  We should have this fixed very soon.  In the meantime we have place a file HHCCAuto2010ng.exe at

http://files.hhc3000.com/installs/HHCCAuto2010ng.exe

that if copied into your software folder will correct the problem.   The H485 document worked correctly from the clinical side but had the mentioned problems from the main system side.  We apologize for the problems this has caused.

Version 5271, which we plan to make available on tonight’s update, will include several changes to the H485 Plan of Care.  These changes are the result of adding features that will allow the form to also be used for Hospice.

In the past we have maintained two separate screen versions of the H485 Plan of Care input screens (two different software programs).  One software version was used for the clinical software and one software version for the main system.  It has been extremely difficult in the past to keep the two versions consistent with which fields and options were available on the screens.  In the future the H485 screens in the main system will be the same screens that show in the clinical software which will allow us to only have to maintain one copy of the H485 source code.  We made changes to the clinical version to make sure it has all of the features that the main system screens had.

We have also rearranged the screen layout to incorporate the changes needed for Hospice along with adding a new alternative format option for Hospice that affects how the H485 prints.  We have also added some new check boxes in areas such as DME and supplies, that were available in assessments but not available in the H485.

Finally, most of our users are now using what we call the free form generic H485, but we have been maintaining the old H485/H487 format that breaks up many sections of the H485 and displays the remainder on the H487.  Users like the newer free form generic version because the sections do not split and sections like medications don’t have to be squeezed into a very small space. The new format also allows us to incorporate the Face-to-Face features. We maintained the old format because a few of our users felt that it was the “official” approved version.  CMS discontinued the requirement that that form had to be used several years ago.  We no long plan to support the old H485/H487 version which means that version is now obsolete when it comes to the additional fields we have just added.  The new fields will only show on the current formats.

We will appreciate any comments you may want to pass along to us concerning these changes.  Thanks.

The document log listing in clinical notebooks is sometimes showing Skilled Nursing Visit Assessment for visits that are not skilled nursing visits but actually could be something different such as PT progress notes etc.  The note itself is correct, but the listing of documents that the user scrolls down displays incorrectly.  We have found what was causing this and it is apparent that it has been happening for a while.  We have corrected the problem which will prevent it from happening on future documents but will not correct what displays for current documents.  The fix will be available on version 5271 which will be available tonight.  We will try to create a cleanup utility and will let you know when it is available.

In version 5270 we have modified this report to include the start of care date, transfer date, # days since the start of care, and the source of admission.

We have finished the changes needed for the CMS requirements that all PPS claims as of July 1, 2013,  include a revenue service line record showing the patient place of service information.  Any time the place of service changes for a patient CMS wants to see another revenue service line record. These changes will be available on tonight’s update, version 5268, but will not be included on claims until July 1st.

In order to accomplish these changes we recently we had added fields in the PPS Billing Information screen for OASIS assessments to indicate the initial place of service HCPCS code along with two sets of date and HCPCS code fields for changes in place of service.  (The date of the initial place of service is always the same as the first billable visit).  There are three valid options for these place of service HCPCS codes; Q5001 – patient’s home/residence, Q5002 – assisted living facility, Q5009 – place not other specified.

Since that time we have been asked to include a default initial place of service HCPCS field in patient demographics to use in case the user forgets to indicate in the OASIS billing record.  We have added that field and have placed it on the insurance tab under patients.  PPS billing will use that code of nothing has been setup in the PPS Billing Information screen for any OASIS assessment for that patient.  In addition, if no initial place of service has been established in either location we will default to using Q5001.  It will be the agency responsibility to make changes if Q5001 is not appropriate.

Following the CMS guidelines as noted above, revenue service lines with the appropriate HCPCS codes will be added to the claim to indicate the initial place of service and for any additional changes to the place of service.  The revenue code used on each of these revenue service lines need to be the same as a revenue code used on an actual visit for same day as the place of service record.  The system will look for a visit on the same day in order to obtain a revenue code.  The billing amount is to be $.01.  The units will be 1.

These additional revenue service lines will begin to appear on claims generated after July 1, 2013.  By default the place of service lines will appear for all insurance companies when doing PPS billing. If you determine that you have an insurance company that wants you to exclude them there is a new check box under Insurance / PPS to exclude PPS place of service records.

If you are using SHP as your OASIS review software and have had problems getting the case manage to export to SHP you will need to get version 5267  which will be available Monday, June 10th after 5:30 PM.

If the new Control Panel screen cuts off on the right hand side you will need to get version 5266.

We have been making a lot of changes to the view screen found in patient activities.  Now when you view an OASIS record or a visit, there is a new button on the bottom of the screen called “Changes.”  This button for OASIS will let you change a couple fields on the OASIS that pertain more to billing rather than the assessment questions.  Most notable is the ability to check or uncheck the PPS Billable question that sometimes gets checked when it shouldn’t be.  We plan to add the certification dates in the near future.  On visits it will let users change things like the service code, supervisory visit performed, therapy assessment performed etc.

We tried to incorporate the fields that sometimes need changed without having to clear the electronic approval and then re-approve. Again, we are focusing on things geared more towards billing than the assessment.

We also had to fix a few bugs concerning date fields not appearing or saving.

There have been several enhancements to the Control Board (formerly call PPS Control Board) found in patient activities.  We changed the name because the control record options found at the top of the screen now also includes non-PPS H485 records and Hospice certification periods.  There is also a button on the visit screen labeled C.I.S. which stands for create initial schedules.  It’s a screen designed to allow the user to fill in a couple of fields and then just check the dates they want to create visits.  This is not geared so much for ongoing changes but is geared for changes early on in the certification period.

We have gotten extremely positive feedback from users concerning this new screen.  As always we appreciate your suggestions on how to make this feature better.

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