Software and Services for Home Health, Hospice and Healthcare Facilities

Blogs & Articles


Having Trouble with Claim Denials with Reason Code 37253

9/12/2017 HealthWare Clinical 1 Comments

This is because no matching OASIS was found and the claim receipt date is more than 40 days after the OASIS completion date. In most cases, these claims cannot be resubmitted for payment and the revenue is lost.

Denied

Medicare posted CR9585 on October 27, 2016 letting agencies know that a new edit was being put into place to enforce the OASIS as a condition of payment. The first phase of this was put into place back in 2015 when they made sure the payment group codes on the claim matched those submitted on the OASIS. The new edit that took effect on April 1, 2017 now enforces the reporting regulation that requires the OASIS to be transmitted within 30 days of completing the assessment of the beneficiary although the initial edit will allow for 40 days.

If your agency is struggling with this requirement HealthWare has the answer for you with our OASIS Validation Reporting Import feature. Not a fancy name, but it automates what you must otherwise do manually with your OASIS Validation Reports and helps to make sure that you can track OASIS that has not been submitted and validated and that you cannot submit a claim until it has been. Let HealthWare help you visiting our website at https://www.healthware.com/contactus or call us at 850-479-9035.

Review CR9585 at: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3629CP.pdf

OASIS-C2 2018 Guidance Manual Available and One Clinical Rule Q and A

9/8/2017 HealthWare Clinical 1 Comments

OASIS C2 2018 is almost upon us and CMS has released the guidance manual here http://dld.bz/gdX2W and a Q&A about the One Clinician Rule here http://dld.bz/gdX3r.

HealthWare offers a comprehensive suite of tools to help you with OASIS C2 2018 and the upcoming CoPs. Start with intuitive and easy to use point of care documentation including a fully integrated assessments. Combine this with a powerful point of care technology known as the Clinical Assistant to provide validation and recommendations to clinicians at the point of care. Add to that HealthWare OASIS Analysis Reporting for a detailed analysis of your OASIS in near real time, the PPS Revenue Calculator that lets you see the revenue and costs for an episode, Outcomes Analysis including QAPI, VBP and Star Ratings and Annotations for a completely digital QA process and you have an extremely powerful system to help you stay in compliance. For more information about HealthWare and how it can help your agency be ready for OASIS C2 1/1/2018, CoPs and more visit https://www.healthware.com/Products/Clinical_Compliance and then request a demonstration so we can show you how HealthWare can help.

Surface Tablet

Happy 35th Birthday Email

8/31/2017 HealthWare Other 0 Comments

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On August 30th, 1982 Dr. Shiva filed the first copyright for an email system. Email is a powerful tool that has grown to something like 60 billion emails per day. Most people use their mobile phones to access email these days and the average worker spends more than 10 hours a week dealing with email. While emails use in undeniable and it will maintain an important role in your agency it is also a source of spam and a very popular vector for malware attacks. You need to your email system to be powerful, available, secure and compliant.

HealthWare can help you create the perfect email system for your agency. As a Microsoft Partner and Tier One Cloud Solution Provider we can provide your agency with email through Microsoft Office 365. Microsoft Office 365 is an affordable and easy to implement solution to have secure and compliant email for your entire agency. Transport Layer Security to encrypt data between systems, automated spoofing and fraud detection and anti-malware protection. Microsoft Office 365 is also HIPAA compliant and for email offers Data Loss Prevention (DLP) to help protect your agency by detecting the presence of information subject to the Health Insurance Portability and Accountability Act (HIPAA) and helping to prevent it from being shared with people outside your agency. Spam is also an email plague that Office 365 can help with using its advanced spam protection which includes blocking IP addresses known to send spam, content filtering, email authentication and more.

Emergency Preparedness Mandate is Almost Here

8/30/2017 HealthWare Other 0 Comments

With Hurricane Harvey having just made landfall in Texas we are all reminded of how important it is to be prepared for an emergency. If you are a Home Health Care Agency it might also remind you that the Emergency Preparedness COP requirements must be implemented by November 15, 2017 which is right around the corner. This requirement includes a comprehensive risk assessment as well as specified training and testing. The requirements are focused on three key essentials necessary for maintaining access to healthcare during disasters or emergencies:

  • safeguarding human resources
  • maintaining business continuity
  • protecting physical resources

According to the guidelines to comply you must:

  • Risk assessment and emergency planning
  • Policies and procedures
  • Communication plan
  • Training and testing

HealthWare is prepared to assist you in meeting these requirements in a many ways: