Beginning August 1, 2016 agencies requesting new and/or additional authorizations for services for Highmark commercial and Medicare Advantage members will need to upload the Patient (member) OASIS in XML format and a PDF of the patient’s Plan of Care.  To accommodate the need to generate an XML file of the required OASIS a new button to perform the task has been made available with Main Office Software Version 5998 dated 7/26/2016.  The button, “Create XML” will appear at the bottom of the patient activity screen when the OASIS Assessment is highlighted in the grid.  The new button can also be found at the top of the Assessments tab in the Control Board in PT Activities section.  Again when the desired OASIS Assessment is highlighted selecting the button will offer the Export File screen to allow users to indicate the location on their local computer where the file is to be saved.  The software will auto-populate the file name.  The software will create the XML file and place it in a zipped folder.  Agencies will need to submit the entire zipped folder when requesting the authorization or reporting Discharges and Transfers to Inpatient Facilities through Navinet.  Authorization XML files created in the Assessment tab of the Control Board will have an Auth XML Date auto populated for tracking purposes.

PDF files of a patient’s Plan of Care can be created through the print feature available historically within the software.

A new PECOS file is available for download.

Documents previously available only in the main office software are now available for completion in the clinical point of care software with Clinical Software Version number 2466 dated 7/13/16.

The Progress Summary often used as the 60 Day Summary, Discipline Discharge Instructions and Final Discharge Instructions can now be added for a patient.  The documents may be selected from the ‘Add a New Activity’ screen when the green plus/Add button is selected at the top of the Patient Activity Screen.

All documents will hold an electronic approval/signature of the completing clinician and a patient signature.

Enhancements have been made to the Skilled Nursing Visit Assessment with Clinical Point of Care Software version 2465 dated 7/11/16.

Additional documentation fields have been added in the Supportive section for clinicians to detail the patient’s continued need for skilled service based upon the patient’s overall medical condition and complexity.  The Narrative field in the narrative section has been updated with a reminder to include documentation of the patient response or changes in behavior related to teaching, therapies or services provided.    The next and Future visits field in the Narrative section of the clinical note has been updated to include documentation of  the plan for the next visit.  A documented Next and Future Visit with Plan will now display on the next skilled nursing visit added in the default screen that displays immediately after the billing information screen.  The Clinician next visiting the patient will now have the plan for their visit readily available for review as they begin their visit with the patient.

A warning box will now appear if the clinician tries to exit the Skilled Nursing Visit Assessment  and have left certain key documentation fields blank.  The Warning will indicate to the clinician that their documentation appears to be incomplete.  The Warning will detail the sections missing documentation.

The updates to, addition of documentation fields and warning for incomplete documentation have been added to align with the Medicare Benefit Policy Manual details of requirements for home health clinical notes found under 40.1.1 General Principles Governing Reasonable and Necessary Skilled Nursing Care, the Conditions of Participation and Best Practices.  Allegheny Software realizes agencies are faced with increasing numbers of requests for medical record review, probe and educates and pre-claim review by payer sources.  The documentation field and warning enhancements are meant to assist agencies in ensuring all necessary and required documentation is present to meet eligibility and documentation requirements.

© 2019 Allegheny Messages Suffusion WordPress theme by Sayontan Sinha