Software Changes for Submission Requirements for Authorization Requests Through Navinet for Highmark Commercial and Medicare Advantage Members

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.

This entry was posted in All Messages, Authorizations, Billing, HHC 3000 Office Software, OASIS. Bookmark the permalink.