Volume No.  17    Issue No.  31  Date 07/11/2000

E-mail Updates
pms5 support

Most of our clients are already subscribing to an electronic Internet mail service.  This is a tremendous advantage. Our vendors - Informix, IBM, all use Internet e-mail for support communications.  Remember all the HCFA and Regional FI publications are now on the Internet. We need to do the same with our clients.  As your home health care support vendor we ask that you sign up for an Internet service as soon as possible.  America on Line (AOL), CompuServe, MSN and others offer basic month rates, which include unlimited flash sessions for e-mail.  If you need help to understand how to setup your e-mail, contact our offices. There are a few remaining clients that have not given us their current email addresses, please email us with that information so that we can add you to the subscription.

 

Support Dept.: Will Receive your ticket on line and reply.

Windows Version Information

Comprehensive Health Systems released in the summer of 1998 two years ago, the Informix Dynamic Server and Dynamic 4gl winpms5, which has an exciting thin client version. Currently over 75% of our client base is now using this product, and the rest are in the transition of receiving the product or having it installed. This has a full GUI with sound, videos and other friendly tools, and is fully mouse driven. The winpms5 runs on the AIX server along with the windows98 client or NT machines. For those with Informix maintenance the transition can be done with exchange rate charges. Remember that the upgrade for PPS requires dynamic 4GL.

 

The Monthly Update Club

We encourage all pms5 clients to join our monthly update club. Currently there are a number of clients in this group.  This club sends each member a monthly release notes bulletin. The client then has an option to request those enhancements and preview them.  To be eligible your agency must have an Internet e-mail address, and must be running winpms5 release 6.5 or greater on an IBM RISC 6000 computer with AIX operating system 4.3.1 or above, and Informix SE Engine 7.24.UC8 or greater. We also support Dynamic Server Workgroup edition 7.3X or greater, along with Dynamic 4gl Runtime 3.10 or greater.  Please contact Alex or Jessica at CHS if you wish to join us. They can be reached at alex@pms5.com or jessica@pms5.com or directly at our web site www.pms5.com.

Accounting Corner

To better service your quarterly maintenance we ask that your agency please pay promptly before the 1st date of the next quarter. Our accountant has been asking that we follow the contracts that indicate charging interest rates on unpaid balances. We also request that everyone get a valid Internet e-mail address for communications. Please remember that we MOVED November 26, 1998 and our new accounting offices are located at: 10220 SW 110 Street Miami, FL 33176-3404.

PMS5 FIELD SOLUTIONS: UFO, OASIS and ORYX News

Reminder to please visit the FTP site to keep up with the latest copy of the UFO software of the unit for each of the nurses that you purchased a license.  Also remember we offer full solutions using Scanning, Point-of-Care, Telephony or Haven Interfaces. Contact us before going outside for services. We also have developed nice interfaces with Oryx providers that are very smooth into the pms5 database engine. Also remember to check our website for valuable information.

Support Tracking Forms Reminders

Please remember to use your support tracking forms when opening new tickets.  You may fax or e-mail them to the office.  Be sure to obtain a tickets number. Review the support wheel and sample form for more information.  It is highly recommended that you obtain an Internet e-mail address for quicker more efficient service.  NAHC and others all encourage the use of e-mail and they all respond very quickly as well as the Fiscal Intermediaries who also use the Internet e-mail.

Backup Procedures

We continue to advocate the most effective backup procedure as that of the mirror.  A backup mirror drive is an extremely powerful solution to any failure.  We also suggest tape backup for the data nightly, of the programs weekly and of the full system at least once a month. For those with Mega size tape drives, a full nightly backup is encouraged, along with the disk mirror backups. Many of you have read/write CD drives, so be sure to purchase a box of blanks and do backups on the CD. Call Alex for instructions.

winpms5 Report Writer

Most of you already have received the winpms5 for windows95/98 or NT menus and report writer. Remember the advanced help screens offer both pms5 help as well as help with the report writer. We now offer a full set of classes for the use of this exciting tool. E-mail to alex@pms5.com for more information. It has a more advanced wizard for building reports. You can use the Haven Interface connection module to connect to your pms5 database to ACCESS and create many of your own reports. The ODBC is a free ware download from www.intraware.com:81/informix and then locate the SDK  version 2.40.UC1 or greater for the AIX machine and the matching tool for your windows98 or NT client side.

PPS and pms5 Products

In recognition of the challenges posed by the approach of PPS, CHS has already taken the steps necessary to provide compliance in its winpms5 premier software product. However there are additional objects involved with the support maintenance, so be sure you have updated Informix and exchanged the 4GL to D4GL, AIX and pms5 to the correct level that will properly function under PPS.

Oasis and PPS Training Workshop

We suggest you order the OASIS and PPS data set training workshop and begin using it at your agency. There is an Oasis workbook kit that we have sent out with the sample screens and the sample forms. If you have not received it yet, please contact Jessica or Alex to order it. alex@pms5.com or jessica@pms5.com. There will be another one on September 15, 2000, please don't miss this opportunity.

 

PPS Useful Tips

Grouper software modules are being developed by HCFA. Mr. Tom Williams of Home Care Automation report indicates that it will be made available to providers. These interface directly to winpms. The Oasis data that is input into Haven or into UFO or winpms is then sent to the Grouper software to determine the appropriate HHRG. Current Haven software for Oasis data submission will be updated by HCFA to integrate Grouper logic. All PPS claims will be run through Pricer software which will price all HHRG codes and will maintain national standard visit rates for Outlier and LUPA determinations.  According to HCFA, the PC version will be designed so that it can be loaded on a LAN rather than individual PC's.

As indicated in the AB-00-65 Memo as downloaded from HCFA’s web site, they said that new fields will not be added to the claim form (UB92/ECS) or remittance advise to accommodate home health PPS. There will, however, be several new billing codes utilized solely for PPS processing and only one ERA format supported in the future. HCFA had identified a new bill type frequency code and revenue and admission code. The amount of paperwork for the Initial Request for Anticipated Payment (RAP) has been reduced and accommodation has been made for LUPA situations. This should come as good news to agency executives considering point-of-care automation, which will help to address HCFA’s, implementation timeline. The RAP’s will be submitted to HCFA using bill type 322. Submission of a RAP will be required to open routine episodes in CWF. They can be submitted immediately following the initial service delivery. As noted, Oasis data will not need to be transmitted to your state agency prior to RAP submission to your RHHI. To insure Oasis and claim data are accurately matched, HCFA is creating and 18 character claims-Oasis matching key. This key will be produced from Grouper software and is to appear in the treatment authorization field on claims. [In pms5 you would put it in the PE-P3 Payer Control and Authorization Screen in the treatment authorization field for the matching episode that it applies to. Also for those with our winpms direct interface to HAVEN that field will be automatically transferred to the PE-P3 for you.] HCFA is identifying 9/2000 until 12/2000 as the one-time Plan of Care (POC) transition period. Both CWF and claims processing systems will edit to reject claims that overlap the September/October 2000 dates. Bills must be either PPS or non-PPS based on date of service, and all open billing periods must close on 09/30/2000.

It is especially important to make sure in the next several months before PPS to review all departments to make sure they are making the most effective use of the pms5 system.

PPS Transition Ideas

A good forecasting product will isolate specific problem areas where change should begin. Once you see exactly where you might lose money such as wound cares, you can activate triage principles where streamlining is most needed.  Forecaster analyses may identify a costly set of diagnosis, a branch with high utilization habits, or a particular referring physician as the source of cost overruns. Most forecast users find their workflow processes must be redefined. Mr. Tom Williams the Publisher of the magazine offered these helpful tips which also apply with your own pms5 software. Some ways of doing that involve these things: 1) Cross-train clinicians and administrators. Because PPS revenue will be determined by clinical decisions made during each OASIS assessment, many are concentrating early efforts on training. Clinicians will h have more need to understand company finances, while administrators will require a better understanding of what goes on at the point of care. Both must cooperate to deal with fluctuating revenues and get a better handle on complex patients, accounts and receivable systems. That is why timely scheduling and data is so key to PPS. Several vendors including CHS (winpms) have been preparing software that determines the Home Health Resource Group (HHRG) category and computes the locally-adjusted payment right at the point-of-care on a portable or handheld computer. (UFO). The OASIS nurse sees the dollar amount she has to work with before formulating a plan of care. There are also PPS training programs on CD or the Internet to help financial managers and clinicians learn new ways of using their applications after October 1. 2) Daily Billing accelerates cash flow. Cash flow under PPS will be different, but less critical, thanks to changes in the final rule. Still measures you take to accelerate cash flow will increase your survival odds. PPS introduces two billing systems, neither of which will fit into the rhythm of the old batch billing of all visits for a calendar month. Rather, every start of care visit and every episode conclusion will trigger billing. Some episodes will end on day 60, some earlier due to discharges or death. Rather than holding a bill until an arbitrary date such as the end of a month, you should plan to send an initial request for anticipated payment each time you receive a new patient or start a new episode with an existing patient, and then a detailed claim every time an episode ends. Luckily pms5 is very good at doing this, while we hear over vendors say their PPS version will need to be edited to allow for sending claims as often as necessary. 3) Accelerate cash Flow with streamlined workflow processes. Many providers plan to streamline and possibly eliminate paper flow in order to be ready to send the Request for Anticipated Payment (RAP) immediately after each start of care visit. These agency administrators realize the practice of transporting paper OASIS assessments to the office several days after a visit will no longer be acceptable. You must control what you can by shortening the time between initial visit and RAP submissions. The most efficient way is to give the Assessment Nurses a UFO tool to have at the point-of-care. However at the very least agencies should re-introduce policies that require daily delivery - whether hand carried, faxed, or courier services of the paperwork. Another idea that works great with pms5 is if the nurse is given a low budget PC to use at home, she can input her Oasis right into the screens and or email it via the Internet to the host. Also it is imperative that all field nurses at the very least notify the office daily of schedule changes and of what visits they actually made. This can be a simple 24-hour voice line that they can report to on a daily basis. 4) Keep tabs on patient outcomes. Administrators, clinical supervisors and financial managers will spend a lot of time running reports. Office staff should frequently query the pms5 software in order to monitor performance. The best protection against loses is your pms5 application's reporting capability with proper use. 5) Prepare for IPS-PPS transition. September through at least December are going to be intense, challenging months for everyone on your staff. The reasons are that every existing patient must have an October 1 SOC date and September Oasis assessment. Though the final rule lifts the 5-day window for October 1 starts, your nurses will still be very busy in September. If a significant number of these patients stay on service through subsequent PPS episodes, prepare for a crush of OASIS assessments Thanksgiving Weekend and then again around the Super Bowl too. Billing staff will be busy completing per-visit bills while beginning to submit first half PPS claims. Depending on your usual schedule for billing a previous month’s visit, they may be doing double duty for several weeks. You’ll want to produce the 485’s (POC) as quickly as possible so that you can start receiving those first RAP payments, but you will also want to bill for September without delay. You may want to notify your existing staff to not schedule their vacations during the transition period.

 

Some of the materials in this pms5 Sun Publication was compiled with the data gathered from the www.hcfa.gov web site and also from information in the Home Care Automation Report Newsletter, which is protected by copyright laws. Unauthorized electronic duplication or photocopying is not permitted of the HCAR magazine. They would be pleased to provide you with subscription information. If you found this information useful Mr. Tom Williams the publisher would like to offer a special deal for all pms5 clients. He will send a free copy of the current newsletter and then include an $80 discount for a 12 month subscription to all clients who indicate that they read about HCAR in the pms5 Sun Newsletter. His email is stonyhill@prodigy.net and you may phone him at 262-692-2270. Please be sure to mention that you are a CHS pms5 client. Each month they provide independent and timely information about how home health care executives use automation to boost productivity, cut costs and improve patient care.

 

To obtain the ODBC for pms5 contact CHS for download information on this free-ware tool.