To All Clients:
Menu Changes for HOPE

Multiple menu names with 'OASIS' in the title have been changed to use the more inclusive 'Assessment' or CMS.
Examples:  




Set-Up for  HOPE

New charge codes for HOPE-related visits have been created for all agencies. The Bill Rates and Revenue Code tabs of these HUV1, HUV2, SFVRN and SFVLPN codes must be completed by the agency. Please refer to the HOPE Set-Up and Export Guide for detailed information.
Example:




Discharged Patients Without Discharge Reason

 Discharged patients without Discharge Reasons will now import into Billing. New edits for missing Discharge Reasons have been added to the Billing Pre-Audit and Hospice LOC Reports. This change is to assist clients with correcting this condition in a timelier manner if the Clinical Integration Log is not being reviewed routinely.







Billing Pre-Audit:  Excluded Diagnosis Failure

 The Expired Diagnosis check now also checks for Excluded Diagnosis codes on non-PPS Billing Pre-Audits (this is a warning only for PPS). If selected, this option will produce a warning/failure for charges when the associated order contains diagnosis codes that are excluded from being billed together (per the Excludes1 Notes in the ICD-10 table provided by CMS).
This change is to help prevent denials from payers that enforce this edit. The Fail option can be un-checked to allow claims to post with this condition.


From the Billing Pre-Audit Exception Guide:

Diagnosis [xxxxx] conflicts with [xxxxx]

This indicates that two diagnosis codes in the patient's order are exclusive of each other and may not be billed together on a claim.
•    Unmark the Diagnosis Exported flag in the Clinical chart and correct the diagnosis code(s) in the order. Complete the Diagnosis Export to Billing. Confirm via the Clinical Integration Log that the reposted record shows as Success.
•    To bypass this failure, uncheck the Expired Diagnosis Fail box on the More Options tab of the report.


Please refer to Help > Release Info for a complete list of program changes included in this release and contact Support with any questions or concerns.



 

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