Available with Main office software version 5882 dated 12-17-15, the software now has the ability to generate 1095-C forms.  A new button is now available in the Payroll module labeled 1095-C Forms which will allow agencies to set up the required data for each eligible employee and generate the 1095-c form.  Upon accessing the 1095-C button the screen will display a list of agency employees.  Agencies must next indicate which employees will be included.  As each employee is highlighted in the grid on the left side of the screen, the check box on the right under the Employee 1095-C information labeled “1095-C needed” must be checked.  Once eligible employees are marked use the filter at the top of the screen to display only eligible employees by marking the check box ‘1095-C Needed’ and selecting the green Apply Filters button.

Each eligible employee must have the tax year populated and the Plan start month.  If this will be the same for all eligible agency employees then the date can be entered in the Posting Defaults section Tax Y/E.  Selection of the lightning bolt button will post the date to all marked eligible employees.

Each eligible employee will be required to have entered modifiers and dollar amounts for required lines 14, 15, and 16 of the 1095-C form.  Agencies will use either a 12 month default (labeled as All 12 Months in the screen) or will post the line items by individual month in the Employee 1095-C Information section of the screen.   Per 1095-C instructions if the ‘All 12 Months’ fields are used then By Month posting should not be completed.  If both fields have been entered in the software, the software will default to use the ‘By Month’ entries on the 1095-C form.

The Posting Defaults section holds data entry fields for posting All 12 Months.  The Post button will populate the same information to all marked eligible employees.  Alternatively, if the default ‘All 12 Months’ is populated in the Posting Defaults section which may be correct for some eligible employees but not all, the arrow button available beside the  ‘All 12 Months’ data entry fields in the Employee 1095-C Information section can be selected.  The software will populate the ‘All 12 Months’ data to the specific highlighted employee only.

Agencies may post the required data by individual month for marked employees.  If the default By Month data is populated in the Posting Defaults section, the arrow button may be selected next to the month in the Employee 1095-C Information section to populate the default data for that month for the employee.   The software does also allow for direct data entry into each month.

Report parameters at the bottom of the screen provide options to perform.  Ensure the Report Tax Year End is entered and matches the Tax Year entered on each eligible employee.  Under ‘Operation to Perform’ the option Listing will display the 1095-C information in listing format to allow for verification all data entry is complete and correct.  The Software provides an option to print an individual employees 1095-C form or 1095-C forms for a batch of all eligible employees.

Agencies will need Main Office software version 5882 dated 12-17-15 or later to accommodate Routine Home Care charges for Medicare Hospice days 1-60 (High Rate) and day 61 and after (low rate) to begin January 1, 2016.  Service set up will now have a new data entry field.  Agencies will need to use their current Routine Home Care service.  NO ADDITIONAL SERVICE CODE SHOULD BE CREATED OR ENTERED IN THE SOFTWARE.  Agencies who enter and update yearly the current Routine Home Care rates in the billing rate field in the Service Billing Rate tab will need to update the billing rate field with the Routine Home Care rate for days 1-60 (high rate).  An additional field has been added under a new section “Hospice Routine Charges Posting”.  The field is labeled “Hospice Routine Charges 61+days rate.  Agencies will need to enter the Routine Home Care rate for day 61 and after (low rate).

If your agency is using the system calculated Hospice rates and the check mark is in place to “Use system calculated Hospice rates based on national payment rates adjusted for wage index”, no updates to the service set up are needed.

The software will calculate and post the correct high and low rates to the routine charge when posting Routine Hospice charges through the Billing Utility- Hospice Routine Charges.  The software will use the Start Of Care date as entered in the patient demographics screen as day one when counting hospice days for each patient.

All agencies will need to indicate if a patient used Hospice days at another agency or in a different election period within the past 60 days of the current election.  The number of days used previously must be counted and a Date entered in the Patient/Insurance/Hospice tab in the Election/Certifications/CHAPS tab to indicate when the low rate, day 61 or after should be applied to generated Routine charges using the Billing Utility to Post hospice Routine Charges.

The software will use the additional fields to calculate the anticipated invoice total and will post this invoice total when Accounts Receivable is updated during invoice or electronic claim generation process in the software.

As a reminder per Medicare requirements, both high and low routine charges will be included in the total dollar amount on the same summary line for routine charges on paper invoices and electronic claims.  You will not see line items separating the two rates.

The 2016 Federal Tax Tables are now available with Main Office software version 5882 dated 12-17-15.

A new PECOS file is now available for download.

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