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.
Major Improvements to the Internet-based PECOS System
Over the last year, we have listened to your feedback about Internet-based PECOS. We have made improvements to increase access to more information. PECOS is easier to use than ever with the following upgrades that are now available:
- The electronic signature emails to the Authorized Officials have been updated. The new emails will include the Provider/Supplier’s name as well as “1 of 2 emails” or “2 of 2 emails” in the subject line. Email 1 of 2 will contain the Web Tracking ID to be entered on the PECOS E-Signature page and email 2 of 2 will contain the PIN for the PECOS E-Signature page. The body of the email also contains additional information about the application, including:
- LBN or First Name/Last Name
- Provider/Supplier Specialty
- State
- Form Type
- Practice Location
- NPI
- SSN/EIN (Last 4 Digits Unmasked)
- Providers/Suppliers are now able to see all of their Medicare IDs in Internet-based PECOS, including Medicare IDs (Provider Transaction Access Numbers (PTANs)) associated with reassignment of benefits, practice locations, and Other Medicare IDs. Other Medicare IDs are Medicare ID(s) that are associated with the specific enrollment record for claims payment purposes, but are not yet directly linked to a Practice Location or a Reassignment of Benefits within PECOS.
When there are Medicare IDs listed in the enrollment, PECOS will display the “View Medicare ID Report” hyperlink on the “My Enrollments” page. The “View Medicare ID Report” is also available in the Topic View tab within a specific enrollment record.
- Providers will now have access to an Advance Diagnostic Imaging (ADI) Accreditation Report. This report is accessible from the “My Enrollments” page by selecting the “View” button for a specific enrollment. This report will display the modalities that the provider is accredited for, the effective and end dates and the Accrediting Organization. This report is also available if performing a Change of Information (COI) under the Physical Location and Special Payments section.
The ADI Accreditation Report displays up to 50 records on the screen. If more than 50 records exist, the provider will be prompted to download the report into an Excel spreadsheet by clicking the “Generate Report” button at the bottom of the screen.
- Individual providers that are currently enrolled in Medicare solely to order, but wish to enroll to be reimbursed by Medicare for services furnished can convert their existing CMS 855O enrollment application into a CMS 855I enrollment application. Please refer to the “Converting Existing CMS 855O enrollment to CMS 855I” on the CMS website.
- Providers and Suppliers completing a CMS 855B enrollment will now be able to designate their practice location type as a Critical Access Hospital (CAH) or a Skilled Nursing Facility (SNF).
- Federally Qualified Health Center (FQHC) applications will now be routed to the correct Medicare Administrative Contractor (MAC). A new question has been added asking if the provider is a Tribal Owned FQHC. Based on the provider’s selection the Internet-based PECOS application will be routed to the correct MAC.
To access internet-based PECOS, go to the PECOS website.
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.
National Provider Call: Preparing Physicians for ICD-10 Implementation — Register Now
Thursday, October 25; 1:30-3pm ET
HHS has announced the final rule that delays the ICD-10 compliance date from October 1, 2013 to October 1, 2014. Now is the time to prepare.
During this ICD-10 National Provider Call, Dr. Ginger Boyle, a practicing family physician who has developed a coding education program for Spartanburg Regional Healthcare System (SRHS) and its family practice residency program, will share her success and some practical advice about the SRHS transition to ICD-10. CMS subject matter experts will also present the latest information and updates from their areas, followed by a question and answer session.
Agenda:
- Transitioning to ICD-10: practical pointers for providers
- Overview of ICD-10 implementation requirements
- Plans for Local Coverage Determination (LCD) and National Coverage Determination (NCD) ICD-10 conversions
- National implementation issues and plans
- Question and answer session
Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare FFS providers
Registration Information: In order to receive call-in information, you must register for the call on the CMS Upcoming National Provider Calls registration website. Registration will close at 12pm on the day of the call or when available space has been filled; no exceptions will be made, so please register early.
Meeting with Your ICD-10 Project Team
To make sure your organization successfully makes the switch from ICD-9 to ICD-10 by the October 1, 2014, compliance deadline, it will be important to meet with your ICD-10 Project Team regularly to discuss transition activities, challenges, and needs.
Preparing for Your ICD-10 Check-in Meeting
As you hold in-person check-in meetings or conference calls, it is helpful to establish a day and time when the meeting will occur each month (e.g., 1 pm on the first Tuesday of the month), so that all team members know that ICD-10 is a priority for your practice. As the transition date approaches, you should switch to more frequent meetings, weekly or bi-weekly.
To make sure the check-in meetings are productive, consider the following tips for holding an effective meeting:
- Create an agenda. Developing and disseminating a brief agenda prior to the meeting will help keep the conversation on track and will allow team members to prepare their updates.
- Reserve time for questions. Remember to set aside time at the end of the meeting for questions from project team members.
- Take notes and draft action items. Following each meeting, distribute key takeaways and action items to the team to keep everyone informed about any important decisions made and individual responsibilities.
During meetings, team members should plan to discuss:
- Progress on ICD-10 transition activities. This will help to keep the team up to date on each individual's assigned tasks. It may also be helpful to use this time to set deadlines and goals for completing task activities.
- Upcoming education opportunities. Share information about local events or online trainings on ICD-10 that may benefit the team. Also, feel free to distribute ICD-10-related articles to keep the team informed about the latest ICD-10 news.
- Best practices. Have you done or did you hear about a novel way to address part of your transition to ICD-10? Take this time to share that information, and discuss how it can be applied in your group's implementation plan.
- Challenges encountered. Use this time to discuss any challenges the team has encountered, and brainstorm ways to successfully overcome these obstacles.
Keep Up to Date on ICD-10.
Please visit the ICD-10 website for the latest news and resources to help you prepare.
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Get more information at www.hcssolutions.com/datasmart or call 866-355-3164 today.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
From CMS Medicare FFS Provider e-News
The compliance deadline for ICD-10 is now October 1, 2014. With two years to complete ICD-10 implementation, providers and payers will need to communicate regularly to help ensure a smooth transition. To keep transition activities on track, providers and payers should:
Engage in an Open Dialogue:
Once you have established an ICD-10 Project Team or designated a representative to oversee transition activities, reach out to the organizations you coordinate with to inform them of your implementation plans. Regardless of your organization's size or resources, it is important to make sure you are regularly communicating with external partners about transition plans. If you have not already done so, make sure to:
- Communicate the current status of your organization's ICD-10 implementation efforts. As payers and providers may be at different stages of implementation, it is important to reach out to one another to share your organization's current focus.
- Share contact information for all key personnel at your organization involved in ICD-10 implementation activities. This will help ensure that information and updates are sent to the appropriate person(s) working on ICD-10 implementation, as well as reduce instances of miscommunication between organizations.
- Establish regular check-in meetings. Whether you choose to set up formal conference calls, in-person check-ins, or send updates via email, it is important to establish regular meetings to review transition progress and address challenges.
-
- Revise and Share Implementation Timelines :
Since the ICD-10 compliance deadline is now October 1, 2014, organizations will need to revisit their existing timelines or develop new ICD-10 implementation timelines. The timelines developed by CMS outline the steps you will need to take moving forward as well as the timing for each activity.
Following the revision of your organization's implementation timeline, share it with the providers or payers you are coordinating with on the ICD-10 transition. Providers and payers will need to work together on testing, so it will be important to make sure your timelines are in sync.
Please note: Current CMS timelines are based on the October 1, 2013, compliance deadline. CMS plans to update all materials to reflect the new October 1, 2014, compliance deadline. Continue to check the CMS website for updated materials.
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.
Per CMS Today:
Effective August 1, 2012, if you have not yet converted from the 4010A1 format of the electronic remittance advice, the Medicare Fee-For-Service (FFS) program will automatically convert your electronic remittance advice to the X12 Version 5010 format. If the computer software you use to open/translate the electronic remittance advice X12 Version 5010 format is not ready for this conversion, you may not be able to open and read the electronic remittance advice to review payments, adjustments, and denials, as well as post payments to patient accounts. If you use a vendor, clearinghouse, or billing service for receipt of your electronic remittance advice and your computer software is unable to open/translate the electronic remittance advice X12 Version 5010 format, please contact your vendor, clearinghouse, or billing service before contacting your Medicare contractor.
Providers should be advised that any billing staff or representatives that make inquiries related to Medicare payment on his/her behalf will need a copy of the remittance advice. Any issue with opening/translating the electronic remittance advice X12 Version 5010 format effective August 1, 2012 should be addressed with your vendor, clearinghouse, or billing service, if you use one of these entities for receipt of the electronic remittance advice before contacting your Medicare contractor.
If your software vendor, clearinghouse, or billing service does not have the ability to translate the X12 Version 5010, the EDI Smart Reader is for you.
This simple, user friendly program, allows you to quickly and easily translate the X12 Version 5010 Remittance Advice. The EDI Smart Reader is used by medical providers, home health and hospice providers, billing companies, risk management companies. Download today.
For 18+ years, Home Care Software has provided best in class solutions to home health and hospice agencies including software, outsource billing services, 277 readers and now Data Smart Online Backup. Home Care Software provides integrated home health software solutions with CareSmart AMS software.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
Lawmakers blast federal efforts to monitor and police Medicare fraud -- again
Lawmakers again hammered the Centers for Medicare & Medicaid Services' Medicare program integrity contractors Friday. The latest salvos were fueled by an agency admission that additional mistakes had been made. Read More
Medicaid audit contractors lag behind Medicare counterparts, federal officials admit
Federal officials acknowledged in a House hearing Thursday that Medicaid's recovery contractors have not been as successful as their Medicare counterparts in detecting fraud and recovering overpayments. Read More
Older People Often Get Final Care in EDs
June 7, 2012 — Half of the people who died during a longitudinal study of older adults visited the emergency department (ED) at least once during the last month of life, 77% were subsequently hospitalized, and 68% of those hospitalized died in the hospital, according to a study published in the June issue of Health Affairs.
In contrast, people who entered hospice care at least a month before dying rarely visited EDs. Read More
Affordable Care Act designates $52 million to help disabled, veterans avoid nursing homes
Additional government funding is being distributed for a program to keep seniors, disabled individuals and the veterans in their homes, and out of institutionalized long-term care facilities. Read More
What's to blame for health data breaches: Tech or culture?
Panelists participating in a discussion on technology and its potential for patient harm at the Second Annual International Summit on the Future of Health Privacyin Washington, D.C. yesterday pondered whether complex--and often conflicting--privacy policies were to blame. Read More
Healthcare jobs not slowing down
Home Health Services added 6,900 jobs in May, according to the U.S. Bureau of Labor Statistics. Healthcare continues to be one of the bright spots in national employment. Although the unemployment rate across industries remains at 8.2 percent, healthcare jobs continue an upward trend, while other industries remained unchanged, the U.S. Bureau of Labor Statistics (BLS) reported Friday. Read More
5.6 million health workers needed by 2020: study
A new study predicts that the U.S. economy will need 5.6 million more healthcare workers in the next eight years and most of the workers will need to have a postsecondary education or training.
Read More
Blogs
QI-Tip of the Month: Try It On Before You Buy It
Posted on May 31, 2012 by Champ CommunityM. Tags: CHAMP Resources, Effective Management, Health Literacy, QI/QA, Small Test of Change, Teach Back
The last time I went shopping with a friend, we were in Chicago, on the Miracle Mile. Anne had me try on things that I NEVER would have taken off the rack myself, and even talked me into buying some of them. You know what? I’ve worn all but one item to shreds. One became my new “uniform” at home. Read More
Extreme Couponing, Senior Living Style
Posted on June 05, 2012 in Featured-writers Newswire by Michelle Seitzer of SeniorsforLiving.com
TLC’s Extreme Couponing tells me this: American consumers are crazy about getting the best deals.
They should be, considering that costs are forever on the rise, causing us to cut back, trim fat, and tighten up on expenses wherever possible.
Funny how coupons don’t cover the most expensive things though, like the monthly rent at a senior living community or the hourly rate for the home care aide you hired to help Mom and Dad around the house. In fact, contrary to popular belief, even Medicare doesn’t cover these costs (at least not in full). Read More
Copyright © 2011 Home Care Software Solutions. All rights reserved.
Effective July 1, 2012 only ASC X12 Version 5010 (Version 5010) or NCPDP Telecom D.0 (NCPDP D.0) formats will be accepted by Medicare Fee-For-Service (FFS). Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected by this change. Now is the time to contact your software vendor, billing service or clearinghouse, when applicable, if you have not done so already to ensure you are ready. Transactions conducted by Medicare Administrative Contractor (MAC), fiscal intermediary (FI) or carrier telephone interactive voice response (IVR) systems, Direct Data Entry (DDE) and Internet Portals, for those contractors with Internet Portals, are not impacted.
Claims (837 I and P)
All claims received after normal close of business cutoff times on June 29, 2012 must be sent as ASC X12 version 5010 or NCPDP D.0. Any Medicare FFS claims received in version 4010 format after normal close of business on June 29 will be rejected back to the submitter. The specific message you receive if a claim is rejected will depend on your MAC. A detailed list of 4010 rejection error messages by MAC may be found on the Medicare Fee-For-Service 5010 and D.0 Technical Documentation page.
Claim Status (276/277)
The last Claim Status Inquiry will be accepted in version 4010 at the end of the business day on June 29, 2012. Following that date, all Claim Status activity will be in ASC X12 Version 5010.
Remittance Advice (835)
During the transition period Medicare FFS experienced issues with the Remittance Advice (835); therefore Medicare FFS will be allowing an additional 30 days to complete the 835 transition. Information will be forthcoming concerning the final cutoff and cycle timing for the Remittance Advice.
Coordination of Benefits (837)
CMS has directed its MACs, FIs, and carriers to begin sending all claims to the Coordination of Benefits Contractor (COBC) in version 5010 as of June 29, 2012. This will ensure that all claims that the COBC will issue to COB payers as of its July 2, 2012 evening crossover claims cycle will be properly transmitted in the version 5010 format. Therefore, all COB payers will have to be in version 5010 COB production by June 29, 2012.
Medicare FFS will continue to coordinate additional outreach and education activities and messages throughout June. In addition, Medicare FFS will be participating in a series of Regional Webinars on Wednesday, June 20. Please watch for listserv messages on registering for these calls.
For more information on ASCX12Version 5010 and NCPDP D.0, please visit the Versions 5010 and D.0 website.
Looking for home health software that is HIPAA 5010 ready? We invite you to evaluate CareSmart AMS. Request a demo today!
Copyright © 2011 Home Care Software Solutions. All rights reserved.
Final Rule Released: Physician Enrollment and More
In May 2010, the Centers for Medicare and Medicaid Services (CMS) published an interim rule, with comment period, which required physician enrollment in Provider Enrollment, Chain, and Ownership System(PECOS) before referring and ordering home health and other services. This rule, although effective July 1, 2010, was not enforced because CMS had to solve issues with things, including the PECOS systems.
On April 24th, CMS published the final rule, Medicare and Medicaid Programs: Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements; and Changes in Provider Agreements, which appeared in the Federal Register on April 27th.
The final rule differs from the interim rule. First of all, language was amended to clarify the enrollment requirement to say enrollment in “Medicare-including PECOS or other Medicare enrollment systems.” According to CMS, work is underway to transition all physician enrollments to PECOS from other systems.
Some additional highlights of the final rule include:
- Requires that all providers of medical and other items/services who qualify for a National Provider Identifier (NPI) must include the NPI on all Medicare and Medicaid enrollment applications and claims submitted.
- Plans to activate edits for Medicare and Medicaid home health claims for physician’s legal names and NPI numbers.
- Residents who are state-licensed and enrolled in Medicare may order and certify homecare services.
- Physicians who comply with the official “opt out” requirements will be entered in PECOS
- Requires all physicians and other professionals who order and certify homecare be enrolled in Medicare.
- Enrollment in Medicare would be based on the date services begin and apply to both the RAP and claim. That said, Medicare won’t deny payment for any portion of the episode if the physician terminates enrollment.
- Providers cannot use HHABNs to notify patients when the reason for non-payment is failure of the physician to be enrolled in Medicare.
- Mandates document retention and provision requirements on providers/suppliers who order and certify items/services for Medicare beneficiaries.
- Clarifies that in-hospital services that are covered under the inpatient PPS will not be subject to this requirement; however, in-hospital diagnostic testing not paid under the PPS will be.
- CMS will provide notice to providers when the enrollment edits are activated.
Access the final rule here.
Copyright © 2011 Home Care Software Solutions. All rights reserved.
CMS to publicly report on consumer experiences with Medicare-certified home health agencies
Results from the CMS national survey that asks patients about their experiences with Medicare-certified home health agencies are now available on the agency’s Quality Care Finder website.
CMS Acting Administrator Marilyn Tavenner announced the new tool offering prospective patients, their families and caregivers the chance to compare home health agencies by looking at patient survey results. The Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey, which will be updated every four months with new survey data, will complement the clinical measures already available on the agency’s “Home Health Compare” website.
The HHCAHPS is a survey that collects feedback on topics that patients have identified as important to them in determining which home health agencies provide high-quality care. For example, the survey asks patients about the care they received from their home health agency, including such topics as overall care; provider communication skills; whether care was provided in a courteous and respectful way; and whether the agency discussed medicines, pain, and home safety.
A prospective patient or caregiver will be able to review and compare feedback from other patients about Medicare-certified home health agencies’ care of patients, communication between providers and patients, as well as the specific care issues identified on the survey. Ratings include an overall rating of home health care and a patient’s willingness to recommend the agency to someone else.
The survey results are designed to create incentives for home health agencies to improve quality of care, as well as to give patients additional information so they are aware of the types of care they will receive from a particular agency. Additionally, public reporting enhances accountability in health care by increasing transparency.
For more information on the survey, visit the Home Health Care CAHPS Survey webpage.
To access the survey data, visit the Quality Care Finder tool in Medicare.gov and click on Home Health Compare.
Full text of this excerpted CMS press release (issued April 19)
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