We have very recently been notified that as of July 1, 2013, Medicare Advantage Plan claims need to include an OASIS HIPPS code record. Medicare Advantage claims are usually billed electronically under the ANSI 5010 billing. What we plan to do is add a check box somewhere in Insurances that the user wants the OASIS HIPPS code included on the claims. If checked, when the claim is created the system will search OASIS records to obtain the appropriate HIPPS code. We plan to compare the first billable visit of the claim with the certification period of the OASIS in order to select the correct OASIS assessment. We plan to have these changes completed by the end of this week. We will give specifics when the changes are complete.
It is our understanding that the electronic edit checking will not take place until September but we are not sure all plans will wait till then.