2021 Regulatory and Ver 1.2.8.69 Changes Advisory

To All Clients:

myUnity Essentials Financial Release 1.2.8.69 includes the following enhancements:

Regulatory Data File Updates
New Medicare HH CBSA Wage Index effective 1/1/2021.
New PPS & PDGM Rates effective 01/01/2021.
New Diagnosis table effective 1/1/2021.

RAP Changes

Start of Care Period 1 RAPs are ready for billing on or after the Billing Period Start Date for admitted patients without a completed OASIS using default HIPPS of 1AA11 as long as the following are present:

Verbal Order or 485 with a Primary Diagnosis

Skilled Visit (can be in Pending/Unverified Status)

Recert Period 1 RAPs are ready for billing on or after the Billing Period Start Date for active patients without a completed OASIS using default HIPPS of 1AA11 with only the following present in Billing:

Verbal Order or 485 with a Primary Diagnosis

Period 2 RAPs are ready for billing up to 29 days prior to the Period Start Date (Days to RAP setting in System Settings must be set to -29). The default HIPPS of 1AA11 will be used if no valid P2 HIPPS is present in Billing.

Late RAPs for which an exception will be requested can have the KX modifier and Note added via a new HomecareNOA Bill Data Type in the Patient file Insurance > Bill Data tab.

Refer to the Essentials PDGM Billing 2021 FAQ for additional details.

Action Steps:

Medicare Advantage Payers Needing a PPS HIPPS
If your agency bills Medicare Advantage Payers that plan to continue using the PPS model instead of PDGM, extend their PDGM Effective Date in the Insurance File (File > File Maintenance > Entity). A date up to 1/1/2022 may be entered.

Days to Rap Setting

The functionality for the Days to RAP setting in the System Settings (File > File Maintenance) Reporting tab has changed. Enter -29 to allow the Period 2 RAP to post on Day 2 of the 60 Day Certification Period (29 days prior to the Period 2 Start Date). Note: Due to MACs not implementing 2021 edits until January 4, 2021 this date should not be altered until on or after that date.

MSP Billing
MSP RAPs must also be submitted within 5 calendar days after the start of each 30-day period of care or the agency incurs a 1/30th final payment reduction for each day submitted late. It's recommended to submit MSP RAPs for 2021 via DDE to ensure timely submission. Make sure your Medicare HH Biller is aware. Refer to the updated MSP FAQ for details.

Agencies Submitting Non-Qualtiy Data

New Homecare-NQ and Hospice-NQ rate types have been added to the Unit file Misc-Rate tab. This functionality replaces the Quality checkboxes previously stored in System Settings. These changes allow for calculation using non-quality rates for a specified period of time for a specified business unit. If your agency was non-quality for any period of time, enter the NQ rate type with the dates the NQ status was/is in effect. The Rate field can be left blank.

Holiday Closings
myUnity Essentials Financial Support will be closed on the following days:

Thursday - December 24, 2020 Friday - December 25, 2020
Friday - January 1, 2021
Happy Holidays!

To All MyUnity Essentials Scheduling Users:

Release 1.2.8.69 includes changes to recurrences functionality:

The first user in Scheduling after this update is loaded will be prompted to run a conversion that will cap any recurrences that were created with no end date.
With version 1.2.8.69 changes, recurring schedules can no longer be created without an end date. Instead, users must specify an end date or the number of recurrences to be created (maximum of 90 permitted).
The Stop DC button has been replaced with a Recurs button that will allow for the removal of schedules for discharged patients in addition to creating new recurrences (based on System Settings) for patients whose recurrences are ending but are still on service.

Reference the Scheduling Guide for detailed information.

Refer to Help>Release Info for a complete list of program changes included in this release.

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