Allegheny Messages

Reminder for Medicare Providers: All periods of care with “From” dates on or after 1/1/2021, RAPs must be submitted and accepted within 5 days.  **This would include 2nd 30-day billing periods.**

Medicare no longer makes payment on RAPs, though RAP submission is still required for periods of care. RAPs with ‘From” dates on or after 1/1/2021 will no longer be automatically canceled because there will be no payment to recoup.

Per the Medicare Claims Processing Manual, A timely-filed RAP is submitted to the A/B MAC (HHH) and accepted by the A/B MAC (HHH) within 5 calendar days after the “From” date of a HH period of care (30 day billing period). While a timely-filed RAP is submitted to and accepted by the Medicare contractor A/B MAC (HHH) within 5 calendar days after the “From” date, posting to the CWF may not occur within that same time frame. The date of posting to the CWF is not a reflection of whether the RAP is considered timely-filed. In instances where a RAP is not timely-filed, Medicare shall reduce the payment for a period of care, including outlier payment, by the number of days from the home health “From” date to the date the RAP is submitted to, and accepted by, the A/B MAC (HHH), divided by 30. No LUPA per-visit payments shall be made for visits that occurred on days that fall within the period of care prior to the submission of the RAP. This reduction shall be a provider liability, and the provider shall not bill the beneficiary for it.

If an HHA fails to file a timely-filed RAP, it may request an exception which, if approved, waives the consequences of late filing. The four circumstances that may qualify the HHA for an exception to the consequences of filing the RAP more than 5 calendar days after the HH period of care From date are as follows:

1. fires, floods, earthquakes, or other unusual events that inflict extensive damage to the HHA’s ability to operate;

2. an event that produces a data filing problem due to a CMS or A/B MAC (HHH) systems issue that is beyond the control of the HHA;

3. a newly Medicare-certified HHA that is notified of that certification after the Medicare certification date, or which is awaiting its user ID from its A/B MAC (HHH); or,

4. other circumstances determined by the A/B MAC (HHH) or CMS to be beyond the control of the HHA.

**A new report is available to users for tracking of Non-billed RAPS. Billing/PDGM Reports/PDGM Billing Status Report & run Including “Including Only RAPs Not Billed”.  This Report will display all RAPs not billed and the amount of days that have passed since the “from” date of the billing period.

2021 Home Health Regulatory Changes found in update 6789 dated 12/30/2020.

Starting 1/1/2021, agencies that bill Medicare will now be required to submit the RAP within 5 days from the Start of Care. The split-percentage payment will be lowered to 0 percent for all HHAs.

All HHAs will still be required to submit a RAP at the beginning of each 30-day period.

RAPs can be submitted when:

1. The appropriate physician’s written or verbal order has been received and documented as required. And
2. The initial visit has been made within the 60-day certification period.

In instances where the POC dictates multiple 30-day periods of care, the HHAs are now allowed to submit the RAPs for both the 1^st & 2^nd 30-day periods at the same time.

CMS has announced that there will be a non-timely submission payment reduction when a HHA does not submit the RAP within 5 calendar days from the SOC date for the 1^st 30-days period of care in a 60-day certification period and within 5 calendar days of the “from date” for the second 30-day period of care in the 60-day certification period. This reduction in payment will be equal to a 1/30th reduction to the wage and case-mix adjusted 30-day period payment amount for each day from the HH start of care date/admission date, or “from date” for subsequent 30-day periods, until the date the HHA submits the RAP.

CMs has announced that you can now bill the RAP with a generic HIPPS code to ensure you get it submitted and accepted within the 5 day window. The Main software will now have the ability to add a generic HIPPS code to the RAP & Final claim. Within PDGM Billing/OASIS Billing Info screen, there will be an override, “Bill generic HIPPS” within each 30-day period billing areas. This will enter a generic HIPPS code on the RAP claim. If this is selected, agencies CANNOT remove the checkmark unless they have cancelled their RAP and resubmitted a new RAP without a generic HIPPS code on it. The HIPPS code on the RAP & the Final MUST match.

Accounts Receivable will still be updated on RAP billing as it always has. If an agency chooses to bill with a generic HIPPS code, A/R will reflect that generic HIPPS code amount, but when the FINAL is billed, A/R will show an adjustment to the correct amount generated by the accurate HIPPS code calculated.

12/29/2020 Main Software Version Update 6788,  includes updated federal tax withholding and social security withholding rates.

There is a known issue when running the software via Chrome internet browser that is causing your screens/fonts to look blurry and distorted.  This appears to be an issue with the “zoom” settings within Chrome and/or your  computer’s “display” settings.

If this is happening to you, please check the following settings:

1. Click on Customize and Control Google Chrome (3 dots in upper right corner of the screen)
2. The “Zoom” setting needs to be at 100%
3. You may need to log out and back into the software for this to reset

After this, please make sure your computer’s display settings are set for 100%

1. To access your computer’s display settings right click on the desktop and go to the “Display Setting”
2. Check within the “Scale and Layout” section
3. Make sure this setting is at 100% (Recommended)
4. You may need to log out and back into the software for this to reset.  Some computers may require a reboot.

Your agency’s IT Department may be able to assist you with this if needed.

You may also try running the software on a different internet browser –ex.  Microsoft Edge or Firefox to see if this helps.

If you are still experiencing issues, please contact Support at Allegheny Software for assistance.

New Listing labeled “Most Recent Therapy Assessment” available within Main Software Version 6718.

This listing will pull the date of the last therapy assessment and the number of days it has been since it was completed, to assist agencies in determining when the 30 day therapy reassessment is due. The listing will pull this information for each therapy assigned to the patient.

A new feature has been added to the Patient and Employee Attachments.  Users have the ability to assign the attached documents to a “Folder” and view the documents within the Folder assigned.

Add the attachments to either the Patient or Employee as normal.

Once Attachment is added:

There are designated folders available within both the Patient and Employee Attachments.

This feature is not available when you are attaching an item to an individual “Activity”

Cloud Users:  If you are experiencing an issue with the software “freezing” within the Main Software with the main screen transposed over the Activities Grid, this is a known issue that Allegheny Software Programmers are working on.

A work around for this issue is to click on the “HHC 3000” icon in the lower right corner of the page (see image below).

This will “un-freeze” your screen and allow you to continue working without closing out the software.  This seems to be an issue within the Activities Grid when exiting a document and prior to the Approval screen appearing.

Please contact Allegheny Software for any questions.

Texas Health & Human Services released Emergency Rules related to COVID – 19 for LTCR Providers on July 1st, 2020. A Home & Community Support Services Agencies (HCSSA) must ensure its staff are screened at the beginning of each workday per emergency rule §558.408 (Emergency Rule for HCSSA Response to COVID-19) Staff are employees, contractors, and volunteers. Staff include attendants, home health aides, hospice aides, health care professionals, and providers of hospice core and non-core services. Staff who do not pass the screen in §558.408 must not remain in the agency for make home visits. An HCSSA must implement the documentation requirements described in this alert by July 22, 2020.

A HCSSA must also ensure a client and the client’s household members are screened before a home visit. They must document that each screening occurred. Based on the Screening, the HCSSA provides services to the client with the protections described in the emergency rule.

Allegheny Software Publishers have added an enhancement within the software to allow for documentation of the COVID-19 screening for both Patients & Employees.

User will select the COVID -19 screenings button on the main screen.
User will then enter the date the screening was performed by entering the ‘Screening Date’, then will also enter the ‘Type of Screening.’ Within the Type of Screening, the user will select either Employee COVID-19 or Patient COVID-19. Once the ‘Type of Screening’ is selected, the user will select the ‘Load’ button. The User will then select the ‘Load All Active’ to get all of their active patient/employees. If the user wants to add a single employee/patient, they would select the ‘+’ button and select the patient/employee from a drop-down. The patient/employee will then display within the grid on the left-hand side of the screen. When the patient/employee is highlighted within that grid, they can perform and document on the COVID-19 screening. The User would then change the status to the appropriate response and select the ‘Approve’ Button.

The User has the ability to print the individual screening out, the ability to print a log of all screenings for a certain patient/employee, or to print a daily log/all patients/employees at one time.

A ‘+’ button was added beside the Attachments Button. This allows the user to add an attachment without having to open up the Attachments folder.

For agencies in select states that are required by CMS to perform the Review Choice Demonstration, and participate in the Pre-claim Review Choice, Allegheny Software has added a 2nd spot for the Pre-Claim Review Choice Authorization number, as each 30-day period within home health will be eligible for review. Users will see these both within the Assessment/View/Changes button, and also within the ‘OASIS Billing Info’ Screen.

This is included in Software Version 6618.