Update Related to XML File Creation For Highmark Authorization Requests Submitted Through Navinet

Updated instructions through Navinet indicate that the OASIS file to be submitted with an authorization request must not be in a zipped folder.  Navinet will accept only the xml file.  Agencies with Main Office Software Version 6002 dated 08/01/2016 will note the check box in the ‘Create XML’ screen will no longer be automatically marked.  The software will only create the XML file of the OASIS.  Agencies not yet utilizing software version 6002 or later will need to un-mark the ‘zip’ check box manually prior to creating the xml file.

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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.

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PECOS

A new PECOS file is available for download.

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Additional Documents Available for Completion in the Clinical Point of Care Software

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.

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Skilled Nursing Visit Assessment Software Enhancements

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.

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PECOS

A new PECOS file is now available for download.

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PECOS

A new PECOS file is now available for download.

Posted in All Messages, Billing, Physicians | Leave a comment

Training Videos For HHC 3000 Are Now Available

Training videos are now available through the Allegheny Software Publishers, Inc. web site, www.hhc3000.com.

Please call Allegheny Software Publishers, Inc. to set up your agency User name and Password for access.

Training videos now available are for the Control Board, Scheduling module, Adding new Patients and updating Medical Information screens, and for the Clinical Point of Care Software.

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Software Enhancements for Improved Efficiency in Assessment Diagnosis Coding and Obtaining Clinician Final Electronic Approval

Main Office software version 5969 dated 5/26/16 will have new screens available in the “PPS What If” button to improve efficiency for main office Coders reviewing clinician documentation, completing coding and sending the changes to the clinician for review, acceptance and final electronic approval.  Agency coding personnel can complete coding without opening or editing to the data entry screens of an assessment.  The “PPS What if”button and screens have been updated for “PPS Review/What if”.  The Control Board Cert Period screen will allow Coders to filter for the most recent OASIS assessments completed .  Once an assessment is selected and the orange “Load” button is initiated, the new PPS Review/What if button is available for selection.  A new document tab is now available at the top of the PPS Review screen providing a read only document format.  The Diagnosis tab will allow coders to complete the Diagnosis Codes for M1021, M1025, M1011 and M1017.  The  Clinical, Functional, Therapy and Margin tabs will continue to display the point yielding OASIS questions and estimated number of visits for historic ‘What if’ functionality.  The right side of the new screens allow for recalculation of HIPPS code and PPS dollar amounts and the Print Change sheet that have also been available historically.  New buttons will allow the Coder to post changes to the data entry fields.  Posting changes will remove the clinicians electronic approval.  A change sheet will be provided with a summary of the changes and any errors or warnings.  The software will now provide a secondary window for the coder to also update the 485 with the coding changes and send the changes back to the Clinician for review and approval.

For Server based Clinical Point of Care software users, the coder will mark the documents for re-approval, “Mark R/A”.  Clinicians will see the marked documents in their Re-approval screen.  Review of document changes and re-approval must be completed by editing the document from the re-approval screen.

For Managed Hosting Clinical Software users the Coder will send the clinician a Notification.  The software will create the Notification using the Change sheet information and include any errors or warnings.  Clinicians will need Clinical Software version 2442 dated 5/26/16 in the Managed Hosting Environment.  Clinicians will see the Notification detailing the changes and any errors or warnings in their My Notices screen.  When the Notice is selected the Clinician will now see a new button “Open Document” in the upper right corner of the screen.  By selecting the “Open Document “button the assessment will open, the clinician can review the changes and when exiting can apply the final electronic approval.

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PECOS

A new PECOS file is available for download

Posted in All Messages, Billing, Physicians | Leave a comment