Pathways to Wellness: Leading Full and Productive Lives
Wellness—it’s essential to living a full and productive life. We may have different ideas about what wellness means, but it involves a set of skills and strategies that prevent the onset or shorten the duration of illness and promote recovery and wellbeing. It’s about keeping healthy as well as getting healthy.
Pathways to Wellness— this year’s theme of May is Mental Health Month—calls attention to strategies and approaches that help all Americans achieve wellness and good mental and overall health.
Wellness is more than an absence of disease. It involves complete general, mental and social well-being. And mental health is an essential component of overall health and well-being. The fact is our overall well-being is tied to the balance that exists between our emotional, physical, spiritual and mental health.
Whatever our situation, we are all at risk of stress given the demands of daily life and the challenges it brings—at home, at work and in life. Steps that build and maintain well-being and help us all achieve wellness involve a balanced diet, regular exercise, enough sleep, a sense of self-worth, development of coping skills that promote resiliency, emotional awareness, and connections to family, friends and the community.
These steps should be complemented by taking stock of one’s well-being through regular mental health checkups. Just as we check our blood pressure and get cancer screenings, it’s a good idea to take periodic reading of our emotional well-being. One recent study said everyone should get their mental health checked as often as they get a physical, and many doctors routinely screen for mental health, which typically include a series of questions about lifestyle, eating and drinking habits and mental wellness. But a checkup doesn’t necessarily require a special trip to the doctor. There are also online screening tools you can use. While conditions like depression are common—roughly 1 in 5 Americans have a mental health condition—they are extremely treatable.
Fully embracing the concept of wellness not only improves health in the mind, body and spirit, but also maximizes one’s potential to lead a full and productive life. Using strategies that promote resiliency and strengthen mental health and prevent mental health and substance use conditions lead to improved general health and a healthier society: greater academic achievement by our children, a more productive economy, and families that stay together.
This May is Mental Health Month, and Home Care Software is spreading the word about why pathways to wellness are so important.
Download the Fact Sheets, including:
- What is Wellness?
- Four Simple Steps
- Understanding the Social Determinants of Health
- Addressing the Social Determinants of Health
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
With the October 1, 2014, ICD-10 deadline approaching, you may be wondering how you will code a claim that you are submitting in October 2014 for a service that your practice provided in September 2014.
Even if you submit your claim on or after the ICD-10 deadline, if the date of service was before the October 1, 2014, deadline, you will use ICD-9 to code the diagnosis.
For dates of service on or after the October 1, 2014, deadline, you will use ICD-10. You may not be able to use ICD-9 and ICD-10 codes on the same claim based on your payers' instructions. This may mean splitting services that would typically be captured on one claim into two claims: one claim with ICD-9 diagnosis codes for services provided before October 1, 2014, and another claim with ICD-10 diagnosis codes for services provided on or after October 1, 2014.
Some trading partners may request that ICD-9 and ICD-10 codes be submitted on the same claim when dates of service span the compliance date. Trading partner agreements will determine the need for split claims.
Here's an example of a split claim:
A patient has an appointment on September 27, 2014, and is diagnosed with bronchitis. He returns for a follow-up appointment on October 3, 2014. In this case, a practice will submit a claim with an ICD-9 diagnosis code for the first visit and another claim with an ICD-10 diagnosis code for the follow-up visit.
Make sure that your systems, third-party vendors, billing services, and clearinghouses can handle both ICD-9 and ICD-10 codes depending on the dates of service in the months following October 1, 2014.
Please note that future ICD-10 Email Updates will explore how Medicare will handle dates of service for inpatient settings (e.g., a hospital inpatient stay that begins before the transition date and ends after the transition date will be coded on a single claim with ICD-10). Stay tuned for details.
Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources and the ICD-10 continuing medical education modules developed by CMS in partnership with Medscape to help you prepare for the October 1, 2014, deadline.
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
|
 April 2013 Quarterly System Release - Claim Hold
CMS Article PE201304-01
The Centers for Medicare & Medicaid Services (CMS) has identified technical issues with certain parts of the April 2013 quarterly systems release.
For claims with dates of service or "Through Dates" on or after April 1, 2013, the issues affect
(1) all home health final claims
(2) outpatient critical access hospital (CAH) and rural health clinic (RHC) claims where dollars have been applied to the beneficiary deductible, and
(3) the remittance advice summary payment amount for Medicare Advantage inpatient prospective payment system (IPPS) claims with indirect medical education (IME).
Actual payments and the claim-level payment amounts on the remittance advice are correct for these Medicare Advantage IPPS IME claims. Final home health, outpatient CAH and RHC, and Medicare Advantage IPPS IME claims with dates of service or "Through Dates" prior to April 1, 2013, are unaffected.
In addition, for claims pending with or received by the Medicare claims administration contractors on or after April 1, 2013, the issues affect
(1) all claims for assistant-at-surgery services, and
(2) all ambulatory surgical center claims.
As a result of these issues, CMS has instructed its Medicare claims administration contractors to hold all of these specific claim types until April 14, 2013, when system fixes are expected to be implemented. These claims will be released into processing on April 15, 2013. The claim hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 for paper claims) after the date of receipt.
CMS regrets any inconvenience and is working to resolve these issues as quickly as possible.
|
Copyright © 2011 Home Care Software Solutions. All rights reserved.
CMS is hosting an Elder Maltreatment Symposium.
The purpose of this symposium is to solicit input from stakeholders to assist CMS in further development of Measure #181: Elder Maltreatment Screen and Follow-Up Plan, as part of the Physician Quality Reporting System.
Interested parties are invited to participate, either on-site at CMS headquarters in Baltimore or via Webinar. The meeting is open to the public; however attendance is limited for both on site and Webinar participation. Please register for this event early as registration will close when attendance capacity has been met.
The symposium will be held on March 8 from 9am until 1pm ET in the main auditorium of CMS, 7500 Security Boulevard, Baltimore, MD 21244–1850.
Meeting Registration and Request for Special Accommodations Deadline:
Registration is now open. Anyone interested in attending the meeting or participating by Webinar must register by completing the online registration. For security reasons, registration and requests for special accommodations must be completed no later than 5pm ET on Friday, February 22.
CMS will post an audio download and/or transcript of the symposium on the CMS website and the US Quality Measures website following the meeting.
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
The next Home Health, Hospice & Durable Medical Equipment (DME) Open Door Forum is scheduled for
Wednesday, February 20, 2013
2:00pm – 3:00pm, ET.
If you wish to participate, dial
1-800-837-1935
Conference ID: 78869441.
Please see the Downloads section below for the full announcement including agenda. Thank you for your continued interest in the CMS Open Door Forums.
Home Health, Hospice, and Durable Medical Equipment Open Door Forum (ODF) Overview:
The Home Health, Hospice & Durable Medical Equipment ODF addresses the concerns of three unique health care areas within the Medicare & Medicaid programs. Issues related to Home Health PPS, the newly proposed competitive bidding for DME, and the Medicare Hospice benefit are all topics the forum has covered. Many of the issues covered bridge concerns within all three settings, and the combination of the topics under one Forum has been useful to many participants. We continue to hold Special ODFs when individual policy issues require special attention. Timely announcements and clarifications regarding important rulemaking, agency program initiatives, and other related areas are also included in the forums.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
Warning Signs of a Heart Attack
The American Heart Association is a national voluntary health agency to help reduce disability and death from cardiovascular diseases and stroke. Read More
9 Big Ways Heart Disease Is Different for Women
Heart disease is the leading cause of death for both men and women in the United States. And while nearly the same number of women die from heart disease every year as men, many Americans still mistakenly perceive heart problems as a man's disease. In fact, only half of women surveyed by the American Heart Association correctly identified heart disease and heart attacks as the leading cause of death among women. Read More
Heart Health Month: 7 New Things That We Learned Have An Effect On Our Tickers
Heart Health Month: 7 New Things That We Learned Have An Effect On Our Tickers
February is more than just a month to celebrate love that comes from our hearts -- it's also the month to recognize the
healthof our hearts.
To kick off the start of American Heart Month, we're taking a look back at what we've learned over the last year about keeping a healthy ticker. Read More
Everyday Heart Health Tips
If you're not convinced about the need to develop an exercise program for your life, you can at least try following some of these tips in your everyday routine. Take advantage of any opportunity for exercise. Try some today. Read More
Heart-healthy diet: 8 steps to prevent heart disease
Changing your eating habits can be tough. Start with these eight strategies to kick-start your way toward a heart-healthy diet. Read More
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
Heart disease is the leading cause of death for both men and women, but heart disease is preventable and controllable.
This month, CareSmart Blog will feature plans, tips, and resources to help you acheive a health heart.
Plan for Prevention - from the CDC
- Eat a healthy diet. Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables—adults should have at least 5 servings each day. Eating foods low in saturated fat, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt or sodium in your diet also can lower your blood pressure. For more information on healthy diet and nutrition, visit CDC's Nutrition and Physical Activity Program Web site and ChooseMyPlate.gov
.
- Maintain a healthy weight. Being overweight or obese can increase your risk for heart disease. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). Doctors sometimes also use waist and hip measurements to measure a person's body fat. If you know your weight and height, you can calculate your BMI at CDC's Assessing Your Weight Web site.
Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity exercise for at least 30 minutes on most days of the week. For more information, see CDC's Nutrition and Physical Activity Program Web site.- Monitor your blood pressure. High blood pressure often has no symptoms, so be sure to have it checked on a regular basis. You can check your blood pressure at home, at a pharmacy, or at a doctor's office. Find more information at CDC's High Blood Pressure Web site.
- Don't smoke. Cigarette smoking greatly increases your risk for heart disease. If you don't smoke, don't start. If you do smoke, quit as soon as possible. Your doctor can suggest ways to help you quit. For more information about tobacco use and quitting, see CDC's Smoking & Tobacco Use Web site and Smokefree.gov.
- Limit alcohol use. Avoid drinking too much alcohol, which can increase your blood pressure. Men should stick to no more than two drinks per day, and women to no more than one. For more information, visit CDC's Alcohol and Public Health Web site.
- Have your cholesterol checked. Your health care provider should test your cholesterol levels at least once every 5 years. Talk with your doctor about this simple blood test. You can find out more from CDC's High Cholesterol Web site.
- Manage your diabetes. If you have diabetes, monitor your blood sugar levels closely, and talk with your doctor about treatment options. Visit CDC's Diabetes Public Health Resource for more information.
- Take your medicine. If you're taking medication to treat high blood pressure, high cholesterol, or diabetes, follow your doctor's instructions carefully. Always ask questions if you don't understand something.
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
From our Partners at Fazzi Associates
Special Notice About How the Hospitalization Rate is Determined
There will be a significant change next quarter in the way the home health hospitalization rate is calculated for reporting on Home Health Compare (HHC). Effective with the January 2013 HHC data update, the hospitalization rate will be calculated using Medicare claims instead of using OASIS data.
Here are key changes regarding the claims-based measure.
- Claims-based measure uses Medicare claims data as the data source instead of OASIS.
- Claims-based measure is based on the Start of Care (SOC) date instead of the transfer/discharge date.
- Claims-based measure has a fixed timeframe of 60 days instead of the quality episode. Hospitalizations that occur in the 60 days following a SOC will be counted regardless of whether or not the patient was discharged from the home health agency.
- The claims measure numerator is the number of home health stays with a claim for hospitalization. Stays are essentially 60 day payment episodes.
- The claims measure denominator is the number of all home health stays.
- Claims-based measure applies to Medicare FFS patients only while the OASIS-based measure is applied to Medicare FFS, Medicare Advantage, and Medicaid patients.
- LUPAs are excluded from claims-based measure.
- Observation stays in the hospital that begin in the emergency room are not included in an agency’s hospitalization rate but will be included in the agency’s Emergency Department Use without hospitalization rate. The ED use measure is also claims-based.
Click here to download Claims-Based Utilization Measures Specifications from the CMS HH Quality Initiative/OASIS web site.
Given the significant difference in the two data sources, the results from the claims-based measure will not be comparable to the OASIS-based measure results. However, an agency’s CASPER reports currently include the claims-based rate as well as the OASIS-based rate in individual reports. The OASIS-based result will continue to be reported on the CASPER Reporting System. Authorized Agency staff can access CASPER using their log-in credentials to the CMS OASIS System.
Visit Fazzi's Benchmarking Services Web Page to access the national averages and top 20% results of Home Health Compare measures, including the hospitalization rate, starting with June 2009.
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
Medscape Modules Available on ICD-10 [↑]
CMS, through Medscape Education, has released two ICD-10 video lectures and an expert article providing practical guidance for the ICD-10 transition. The video lectures are specifically for physicians, while the article covers more general topics for all health care providers. Continuing medical education (CME) credits are available to physicians who complete the modules, and anyone who completes them can receive a certificate of completion.
The modules are free. You can use the links below to access them. If you are not a member of Medscape, you will first be prompted to fill out a brief registration form.
The videos, ICD-10: A Guide for Small and Medium Practices and ICD-10: A Guide for Large Practices, feature Daniel J. Duvall, MD, MBA, medical officer with the Hospital and Ambulatory Policy Group at CMS, describe:
- Global differences between ICD-9 and ICD-10
- How ICD-10 will have different impacts on practices of different sizes
- Basic transition planning steps and resources
In the article Transition to ICD-10: Getting Started, Joseph Nichols, MD, of Health Data Consulting covers documentation improvements, the coder-clinician relationship, training, working with vendors and payers, search tools, and resources.
For questions or technical assistance with the CME modules, please contact Medscape at CME@medscape.net.
Keep Up to Date on ICD-10
Please visit the ICD-10 website for the latest news and resources to help you prepare!
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
CMS Medicare FFS Provider e-News
Develop Your ICD-10 Communication and Awareness Plan
Although the final rule on the proposed ICD-10 deadline change has not yet been published, it's important to continue planning for the transition to ICD-10. A critical step in planning is to build organizational awareness and to develop a communication plan.
A communication and awareness plan ensures that all your employees and other internal departments as well as external business partners understand their roles and responsibilities for ICD-10 implementation. Think of this communication plan as a formal roadmap for communicating about ICD-10 throughout the transition. A plan is particularly important in larger organizations where you work with many different people and departments that may affect your successful transition to ICD-10. But it can be just as important in a small practice that everyone knows what, why, and how the transition will happen.
Your communication plan should identify:
- Project purpose – Provide ICD-10 background information and clearly describe the current state of ICD-10 progress in your organization, identify goals for the communication and awareness plan, and explain the purpose and expected outcomes of the transition.
- Partners – Identify all parties involved in your ICD-10 transition. For internal staff, you will need to establish a process to communicate governance issues to leaders and assess staff training needs. Coordinate with external groups such as vendors, clearinghouses, and state agencies about implementation updates and changes required in your systems and business processes.
- Messages – Be clear and consistent about what you say, focusing on specific steps and actions that need to happen for the ICD-10 transition.
- Issues – Outline your organization's protocol for identifying potential implementation issues and provide a plan for correcting them.
- Roles and responsibilities – Assign and clearly define communication roles and responsibilities to everyone involved in the transition.
- Timelines – Identify project milestones, secondary tasks, and deadlines. Be certain all project teams know what they will need to do. Develop back-up plans for each milestone to help you handle potential problems.
- Communication methods – Think about how to best communicate within your organization. Emails, in-person meetings, and conference calls may all be effective, but some might work better for different staff and divisions.
While the size of your organization will determine how much planning and documentation will be necessary for the ICD-10 transition, it is always important to keep the lines of communication open. This will help to foster trust among staff members and show that your organization is taking steps to implement ICD-10.
Keep Up to Date on ICD-10:
Please visit the ICD-10 website for the latest news and resources to help you prepare.
Home Care Software Solutions, Inc. provides integrated home health software solutions with CareSmart AMS software.
Looking for software or billing solutions for your home health or hospice agency?
Check out CareSmart AMS, EDI Smart Reader, Data Smart Online Backup and CareSmart Billing.
Copyright © 2011 Home Care Software Solutions. All rights reserved.