• Inpatient Facility Stays - Only Inpatient Facility stays are considered Institutional for PDGM scoring.  Therefore:
• Outpatient Rehab facilities should be linked to the new 'Outpatient Rehab' facility type and not 'Inpatient Rehab' facility type in myUnity Essentials Clinical.
• Outpatient Surgery Centers are not scored as Institutional for PDGM and as such should not be assigned facility type of 'SNF' or 'Hospital.'  Instead a facility type of 'Other' can be used.
  

• Final Claim Submission - Prior to submitting Final PDGM claims, it is critical to  confirm the proper diagnosis codes are present on the claim. Medicare will regroup the PDGM HIPPS using diagnosis codes from the claim and pay accordingly.  Submission of incorrect diagnoses can result in improper payment from Medicare.

• PPS Activity Report - When running the report for Open Period Visits to track LUPA Thresholds, it will  now include periods not yet RAP billed.  Prior versions of the report only included periods that had been RAP billed.

• Late Timing - A 'Late' checkbox has been added to the Patient >Admit tab for scoring PDGM timing for patients that have been discharged and readmitted or transferred from another HHA within 60 days. myUnity Essentials Clinical has added this item to their Patient Profile and will be exporting it to Billing in a future release. A new Warning/Failure for this condition has been added to the Billing Pre-Audit Report.

• Online Help - The "?" Online Help button has been relocated to the bottom of the Billing windows for easy access to the online help file for that menu.  Some FAQ links can also be accessed from here.

• No-Visit RAP - The HAS PDGM Billing FAQ has been updated with instructions for billing patients still on service who have no billable visit in a 30-day period.

• PDGM Reporting - A new column has been added to the PPS/PDGM reports to indicate whether the period shown is a P1 (Period 1) or P2 (Period 2).

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