Final claims sent where the OASIS assessments have not been received and accepted by CMS prior to billing will be denied. You may not be able to rebill and collect payment. A sent date does not indicate that the assessment was accepted by CMS. Acceptance information comes from the OASIS Validation Report. Agencies have starting reporting these types of denials and some were not aware, even though we have posted on Allegheny Messages.

Main Office Software version 6152 dated 05/30/2017 contains a new checkbox under Insurances/Insurance Company tab and the PPS tab that when checked will require a CMS Assessment ID (which comes from the validation report) or marking that the assessment was received, before a final claim can be created. This CMS Assessment ID or indicating the OASIS was received by CMS can be entered in Create OASIS XML screen using the “Accepted” button or in the view screen for the assessment under patients, or in the Edit PPS Billing Info screen.
Agencies using the “Accepted” button in the Create OASIS xml screen can now filter the screen by the software CMS Sent date to pull a list of all the assessments contained in the received Validation report to efficiently post the CMS Assessment ID or mark the assessment as accepted.

The entry fields have been in the software since early this year.

New Home Health and Hospice Agency regulations and requirements for Emergency Disaster planning will be implemented November 16, 2017. Agencies updating and/or establishing Emergency Disaster Plan policies and procedures will now have additional software enhancements for identifying high risk patient characteristics that may be needed during an emergency when identifying patients and the type of assistance required during a disaster or emergency will be required.
Agencies utilizing the Clinical Point of Care software and completing Comprehensive assessments will have Emergency/disaster alerts automatically populate based upon responses entered into the documentation screens of the assessments. The Emergency risks will populate in the new Risk/Alerts tab in the Case Management section of the Comprehensive assessments. Additional fields are also available to indicate if a patient lives in a disaster prone area, evacuation transportation available and any other concerns. Clinicians can then assign an Emergency Risk level based upon clinical judgement upon review of identified risks. To maintain consistent data between comprehensive assessments and the Alerts/Precautions and ADL/IADl assistance fields found in each patient medical information screen, a new button “Updates from assessments” will check items based upon the data entry in the comprehensive assessment.
Medical Information screens in the Main office software have been enhanced. The Emergency button will now include fields for the patient’s Emergency plan. The Therapies button/ Home Management tab contain the ADL/IADL assistance fields.
Agencies now have the ability to generate an Emergency Report for each patient. Agencies that would like clinicians to be able to print an Emergency Report for all active patients from the Clinical Point of care software in the event that the Main office software is not accessible due to utility disruption (electric, internet, etc.) can initiate and override by specific Employee in the Clinical Workstation Setting area in the MISC tab in the Employee database. Agencies will need to mark the new check box “Display ‘Print All’ check box (emergency Info) in Clinical notebooks. The Print All check box can be found on the Main Patient listing screen in the Point of Care Software next to the Emergency Info button.
Main Office Emergency reports and updated Emergency Information are available in the Control Board/ PT Status/ Risk Triage Alerts Emergency tab. Patients may be filtered by Location, Priority/Triage rating and by type of assistance based upon the location of an emergency or disaster. Emergency Reports are available for viewing and printing from this Control Board screen. Emergency Reports will contain patient demographics, Emergency Contacts, Emergency Risks, Medications, Alerts/Precautions, Assistance needed for ADL/IADL and a list of employees scheduled to see the patient in the next 7 days.

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.

A new PECOS file is available for download

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/

Agencies currently on Main Office Software Version 6139 and receiving an error message upon printing Supervisory Visit Documentation will need to update to the most current Main Office Software Version 6140 dated 05/04/2017.

Main Office Software Version 6138 dated 05/02/2017 and Clinical Point of Care Software Version 2565 dated 05/02/2017 contain updates for identifying and tracking patients with an Infection Risk and Risk of Hospitalization.  In the Clinical Point of Care software, there is a new tab in the Care Management button in OASIS Start of Care,  Resumption of Care and Recertification and a new system “Risk” assessment button in Hospice CA for Infection risk.  Certain data entry fields within the comprehensive documents will flag the patient at risk for either infection or hospitalization.  The new tab will summarizes all the items that have been completed that are flags for a risk for infection or hospitalization. The clinician will review all flags and assign a risk level  of high, medium, low or none.   The Main Office software will have a new tab in Control Board/Pt Status called Risk/Triage/Alerts  that will allow agencies to filter for patients at different risk levels.  For those agencies providing non-skilled services and not utilizing the comprehensive documents patients at risk can be filtered and listed based on select items that can be found in the Patient Demographics/ Precautions, Alerts and Triage, the Home Management tab in Therapies and Personal Traits found in the Miscellaneous info screen. Additional enhancements will be coming soon to further assist agencies in their Infection tracking and Emergency preparedness programs and identifying and initiating interventions for those patient at risk for hospitalization or emergency department use.

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