Available with Main Office Software version 5903 dated 01/25/2016, the software now has the capability to generate state W2 files in CSV format for eTides.  Agencies will find the option to create the W2 file in the Payroll Module/Payroll Reports/W2 .  In the Report Parameters screen, select the option to, ‘Create State W2 Report.CSVReport/file eTides’.

Agencies should be aware that CGS has indicated all Home Health Claims submitted with episodes that cross the January 1, 2016 time point which may hold HCPCS codes G0154, G0299 and G0300 are being RTP’ed with an S status or suspended.  Manual review of claims is being conducted.  No further action will be required.  CGS will notify the provider of Claims determined to be in error through the usualy channels.

Palmetto GBA has indicated all claims submitted with episodes crossing the January 1, 2016 time point will be placed in RTP with reason code  32402 or 32403.  No agency action is required at this time.  Palmetto has indicated when the issue is resolved further instructions will be provided  through their Claims Payment Issues Log.

Agencies who invoiced services  in 2015 which  required the 2015 transitional cbsa codes beginning with 500…, will need Main Office Software version 5898 dated 01/20/16.  The software update will replace the 500… code with the correct code for 2016 invoicing.

A new PECOS file is now available for download.

Available with Main Office Software Version 5893 dated 01/08/2016, additional data entry fields are now available to accommodate effective dates for the new G/HCPCS codes for RN and LPN visits for other Insurance companies.  Many of these other insurance companies will have different effective dates for use of these new G/HCPCS codes .   Agencies will find a new date field in Insurance Set Up for each Insurance Company, on the Insurance Company tab labeled “Effective date of G Codes G0299 G0300″.  Agencies will need to enter the effective date for the new G codes.

Agencies must then update their Service Setup for the insurance company with the new G Code.  The new G Code can be entered into the HCPCS field.  The update to the Service Set Up can/should  be done now, prior to the effective date.

When invoicing, the software will look at the date of the visits being invoiced.  If the date of service is prior to the effective date, the software will replace the new G Codes with Go154.  When invoicing for dates of service on or after the effective date, he software will use the new G codes already attached to the visits by complying with the previously detailed set up instructions.

ADDITIONAL SERVICE SET UP TO CONSIDER:

Agencies currently using different service codes for RN and LPN visits for the Insurance Company can update the HCPCS field with the new G code.

Agencies that do not currently differentiate in services between RN and LPN visits for the insurance company will need to update their current Skilled Nursing Visit service to reflect the RN visit and enter the new RN G Code in the HCPCS field.  Agencies will then need to add a new service for the LPN Skilled Nursing Visit using the new G code for services by an LPN in the HCPCS field.  If the agency has already added a new Service Code for the LPN visit, the agency should add the Insurance Company into the Insurance Company Billing rate tab with the Insurance company specific billing rate, billing unit, revenue code and the updated HCPCS.  The Service or Revenue code needed for invoicing these services should be verified.  Agencies that have the Insurance Company already entered in the Insurance Company Rates tab will just need to update the existing record with the new G/HCPCS code.

Agencies should contact their commercial insurance or Medicare Advantage/ HMO plans to verify if any changes are required for those payers.

Available with main Office Software Version 5892 dated 01/07/2016, agencies now have an option to print both an employer copy and an employee copy of the 1095-C form using the new field labeled, ’1095-C Format’.

Agencies receiving an OASIS error related to the OASIS Version when submitting xml files to CMS will need to update to the most current Main Office software version, 5891 dated 01/07/2016.  The software populated the new 2016 OASIS version for assessments completed in late 2015.  The version update will correct this problem.

Available with the current Main Office Software Version 5888 dated 01/04/2016, statistical subgroups have been made available for assignment in Services Set Up.   The field for the statistical subgroup can be found to the right of the statistical group field on the Service Billing Rate tab.  The statistical group for each service is still required.   For example, a service code for an LPN visit  must have the statistical group RN applied and the subgroup LPN can now also be assigned.  Historical Statistical Report, Cost Report Visit Counts & Patients can be generated to include the statistical subgroups by selecting the new check box in the report parameters screen.

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