OASIS/HIS


The Patient file Certify > OASIS/HIS tab allows for data entry of OASIS (Outcome Assessment Information Set) assessments and HIS (Hospice Item Set) records for non-clinical users.  For Clinical agencies, it allows for viewing assessment information and corresponding Status and HIPPS information.  

Review the OASIS Unlock FAQ for detailed information on unlocking assessments for correction or the HIS Unlock FAQ for detailed information on unlocking HIS records for correction.

Go to Patient > Admit/Maintain, Certify tab. Select the applicable cert record on the top half of the window to enter or view records associated with that cert period on the OASIS/HIS tab below.

 
Assess-Date:  Displays the Effective Date entered when creating an assessment record (see below on Adding OASIS or HIS records). May or may not be the same as the M0090 date.

Assessment-Reason:  Displays the reason for assessment (RFA) and OASIS Item Set version.

Status:  Shows whether the assessment is Awaiting Validation (Validation edit check routine hasn't been run on assessment yet), Failed Validation (failed Validation edit checks), Locked Awaiting Export (passed Validation edit checks and Locked/Ready for Export but hasn't been posted to export file for transmission to iQIES), Exported (has been posted to an export file for transmission iQIES), or Inactivated (assessment was marked Exported and subsequently marked Inactivated by end-user).

HIPPS: For PDGM dates, this displays the Period 1 HIPPS posted from Clinical but will update if changes are found when the Billing Pre-Audit report is run for the period.  Only applicable for RFA1 SOC, RFA3 ROC, RFA4 Recert and RFA5 Other Follow-Up.  For PPS, displays the HIPPS code based on assessment answers. (only shown if OASIS M0110 and M2200 are not answered "N/A")

HIPPS-P2: For PDGM, displays the Period 2 HIPPS posted from Clinical but will update if changes are found when the Billing Pre-Audit report is run for the period (if Pre Audit run for Period 1 date, it will update HIPPS-P2 as Late but will only update Period 2 with correct Admission Source HIPPS information if Pre Audit is run with a date range that covers the Period 2 Start Date).  Only applicable for RFA1 SOC, RFA3 ROC, RFA4 Recert or RFA5 Other Follow-Up.  Not applicable for PPS certs. Column only displayed if Period-2 checkbox is checked in the window.

HHRG: This column is only displayed if the 'Period-2' box is unchecked on the window.  Displays the Medicare OASIS PPS HHRG for the grouped HIPPS based on assessment answers.  Only applicable for OASIS RFA 1 SOC, RFA3 ROC, RFA4 Recert and RFA5 Other Follow-Up.

HIPPS-C: This column is only displayed if the Medicaid checkbox is checked in the window.  Shows the NY Medicaid EPS HIPPS score for NY Medicaid EPS primary patients.

HHRG-C: This column is only displayed if the Medicaid checkbox is checked in the window.  Shows the NY Medicaid EPS HHRG score for NY Medicaid EPS primary patients.

To Add a an OASIS or HIS record:

Press the  button to add a new row. (Clinical users will add OASIS into Clinical and post it to Billing)


Effective Date: This date may or may not be equal to the M0090 Date. Date entered here will pre-fill the M0090 Date in the assessment, but the M0090 Date may be changed in the assessment if the dates are not the same.  For RFA1 enter the M0030 SOC date, for RFA3 enter the M0032 ROC date, for RFA4 - 5 enter the M0090 Assessment Completed date and for RFA6 - 9 Enter the M00906 Discharge/Transfer/Death date.

State Correction Count: This number will increment when an exported assessment is unlocked for editing and the option to increment the correction counter is selected. If that option was chosen incorrectly, the user can manually change it back to the appropriate value.

Select Version:  Defaults to the current version for Home Health OASIS. If entering assessments for prior versions or for Hospice HIS record, select the appropriate version.  If the wrong version is selected, a message will display indicating the correct version based on the Effective Date entered.

Employee:  Select the employee who completed the assessment

Submitting Agency Information: Select the Agency Name. The State/Medicare/Medicaid IDs will auto-fill once the Agency Name record is selected.  If entering assessments for non-Medicare/non-Medicaid patients that will not be exported to the state, select "DO NOT USE" Agency Name. This record should be created in File>File Maintenance>Entity>Oasis Agency

HIPPS Code Calculation: Uncheck the "Calculate HIPPS code from OASIS Assessment Detail only when needed to manually enter the HIPPS/M0906/Claim Key information for PPS claims if the full assessment record isn't needed to be on file in the billing application.

Essentials-Only users, click the Assess button to enter, complete or edit the Oasis assessment. (Clinical users will do this in Clinical instead of Billing).


To utilize the program's skip patterns, click the Next button at the bottom of the window or type 'N' on your keyboard after answering a question. This will skip you to the next required question based on your response. Or use the tab key or scroll bar to navigate through the questions.

Once a section is completed, a green check mark appears at the top of the tab.

Once all sections are completed, click Save.

Press Validate to see if any corrections are needed.

Double click on the validation error message to jump to the failed M00 question for corrections.

Once you receive the message the assessment is successfully validated, click OK.

Click on "X" in upper right corner to exit the assessment.

Click the button to "Lock" the assessment. This icon will appear once an assessment is successfully validated. An assessment must be locked before it can be Exported to iQIES.


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