MIPS INCENTIVE - PENALTY YEAR-END DEADLINE APPROACHING

If you have not begun working on MIPS for your practice, you still have time to avoid penalties for 2017 reporting.   You can avoid a penalty by following the guidance as shown through the AMA link below.  Submitting a measure through claims in this manner must be done by December 31^st, 2017.

Disclaimer

CMS is continuing to update and change measures and information regarding the MACRA / MIPS program.  Information is subject to change and is meant as general guidance only.  All questions related to specific situations of providers and practices should be addressed directly to CMS at QPP@cms.hhs.gov or 1-866-288-8292.

 

Avoiding Penalty

The AMA has provided an instructional video on meeting minimum requirements for avoiding a penalty for the 2017 MIPS program.  Details of how this method impacts your practice or the ability to also submit for a 90 period and achieve an incentive should be discussed directly with CMS.

https://www.ama-assn.org/qpp-reporting?utm_source=Selligent&utm_medium=email&utm_term=%25m%25d%25y&utm_content=PE_Small_Prac_Established_Product_062617&utm_campaign=Small+Practice+Product+Emails&utm_uid=2840707&utm_effort=

 

 

WHAT'S NEW - TCMS VERSION 4.9.2

TCMS Version 4.9.2 is now available to all clients

Patient export now includes additional insurance information.

A “CO45” ERN Auto Writeoff named “Contractual” will not write off the CO45 amount from a secondary carrier.

A new user right allows the user to utilize the Export Transaction Information feature.

Move Account Number on ERN report and make field bigger so it does not line wrap

Two new options restricting the preview/import of Insurance Due services by either “Master Physician” or by “Service Date” are now available in the Collections Module.

A new Insurance Type Custom Field, if selected, will print the Mammogram Certificate number in Box# 32 of the CMS-1500 form.

The ERN Kick List now offers selections to display services that were posted and/or un-posted.

The ERN Kick List now offers a selection to display all reason and remark codes.

The ERN Kick List now offers a write off feature that will write off the user’s choice of either the balances of the charges shown on the list (the list can be reduced denominationally by column) or the amount connected to the reason codes shown on the list.

The Corrected Claims Tab of a service now offers an Emergency Indicator check box.

For Pediatric Practices only- Electronic Statements now offers an exception report after generating an electronic statements file. The report shows that have no guarantor attached, excluding that patient’s qualifying services from the file so that the user can correct.

No Fault and Workers’ Compensation forms will now utilize CPT conversion codes.

- Various other bug fixes

WHAT'S NEW - TCMS VERSION 4.9.1.1

TCMS version 4.9.1.1 is now available to all clients

A new Practice Default 'Do not allow changing default Master Physician in ESB' - If checked, will stop user from changing the tied to physician when saving an ESB entry.

When an ERN can’t post a payment but it does find the service, it will put a denial-related ledger entry along with a button to the corresponding EOB.

NF and WC profiles will now show injury date on the Make Appointment screen – this will assist users in selecting the appropriate case for an appointment and avoid billing the wrong insurance carrier.

The Patient Demographics screen now provides emergency contact and relationship fields, and you can now search by emergency contact number.

There is a new label available in the Print Labels menu called "Lab B" which includes: 1) account number, 2) patient last name, 3) patient first name, 4) patient age, and 5) current date.

A new column containing the “Last Service Written” date is now included when exporting the Patient List by Referring Physician.

A new option on the Procedure Code Setup screen, named “Bulk Copy Fees” will now provide the ability to copy full fee schedules from one year to another, and also includes an option to do so in all practices.

The height of a Document’s image while printing is now scaled down to 97% of its actual size to ensure that the bottom of the page does not cut off.

When selected, a new Practice Default named “Update all future appointments when patient insurance profile changes” will update scheduled future appointments when the insurance carrier or the case number are changed.

When both Practice Default selections named "Print Location Name on Per-Se statements instead of Practice Name" and "Print Location Address on Per-Se statements instead of Practice Address" are left unchecked, then Patient Statements will not split by location when a patient has services in more than one location.

The NDC number in Procedure Code Setup can now contain a default “quantity” amount that will default when the service is written.

The Claims Export feature now contains columns named “First Visit” and “Injury Dates”

The Claims Export feature now contains a column named “Applied From Credit Balance”

The Payment Analysis Report can now be generated to include multiple practices

The “Patient List by Patients Seen in a Service Date Span” now contains an option to “Show only patients not seen since” - by selecting this option, only the patients seen in the date span selected, but not seen after, will appear in the report.

A new option in the PQRS Export feature named “Insurance” will limit the export to Medicare services.

In the Documents feature, when there is only one document available in a category and it is made inactive, the document and the category will now disappear.

The Schedule Export now contains a new column called “Policy Number”

The ERN Auto Write-off feature can now process negative amounts received from the carrier (which will increase the service’s balance due amount).

The Referral Source report now has a new column named “Insurance” – when selected, the Insurance carrier name will be added in a new column in the export. By selecting the feature and adding the column, a service may be duplicated if it contains more than one carrier.

Taxonomy codes will now print on UB04 claim forms when available.

- Various other bug fixes

RANSOMWARE - NETWORK SAFETY MEASURES

You may have already heard of the recent global cyber-attacks affecting over 200,000 organizations in over 150 countries known as ransomware. The “WannaCry” ransomware uses flaws in Microsoft software to spread quickly through networks and locking away files. There is no anti-virus that can fix ransomware.

Exercising caution can help to prevent an attack to your network.

So, what can you do?

Eliminate any computers running operating systems other than Windows, 7, 8 or 10.

Be sure to set Windows updates to automatic.  In this specific instance, we have found it better to also manually check for a Windows update.  Select “Settings, Windows Updates, Check for updates” and install.

Have anti-virus software installed on each PC.  We suggest and use ESET antivirus and www.Malwarebytes.org for ransomware and trojans.  You can go to Malwarebytes.org and download their free version.  Their lifetime subscription is better and we do have both available. 

Do not open unsolicited emails with attachments; especially from unknown or questionable sources, even if they address you by name.

Always type the website out yourself and resist clicking on any links that take you to seemingly authentic but fraudulent websites, or that warn you to change a password. Stay alert and be suspiciously cautious.

If you do become infected, you will need to disconnect the infected PC from your network and re-install Windows as soon as possible.

 

HORIZON BCBS OF NJ - NO LONGER PARTICIPATING PAYER WITH EMDEON/CHANGE HEALTHCARE

Effective March 1, 2017, Horizon BCBS of New Jersey (Payor ID# 22099) is no longer a participating carrier with Change Healthcare (formerly Emdeon). 

As a result, clients who are not enrolled with Change Healthcare's Provider Complete program will generate fees for claims submission, ERA retrievals and/or patient eligibility inquiries.

The following applies only to clients NOT CURRENTLY ENROLLED with Change Healthcare's PROVIDER COMPLETE program:

 

To continue sending electronic submissions to a non-participating carrier, you will not need to do anything; just continue submitting files as usual and you will be charged for them.

To discontinue electronic submissions to a non-participating carrier, you will need to:

a) Remove the Payor ID# from the carrier's "Payer ID#" field in the Insurance Carrier's Setup screen, and

b) Remove the checkmark from the "Send Electronically to" field, also in the carrier's setup screen.

 

To continue receiving Electronic Remittance Advices (ERA's) from a non-participating carrier, you will not need to do anything; you will continue to receive them and you will be charged for them.

To discontinue receiving ERA's from a non-participating carrier, you will need to contact our Support Services office directly, or simply create an e-Track, for our Enrollment and Eligibility Department, and let us know... be sure to include (1) the carrier's name, (2) the payor ID# and (3) the practice's Tax ID#.  We will remove the service and forward a Confirmation of Completeness to you when finalized.  

 

To continue accessing patient eligibility information from a non-participating carrier, you will not need to do anything; just continue eligibility inquiries as usual and you will be charged for them.

To discontinue accessing patient eligibility information from a non-participating carrier, you will need to remove the Payor ID# from the carrier's "Eligibility Payer ID#" field in the Insurance Carrier's Setup screen.

WHAT'S NEW - TCMS VERSION 4.9.1.0

TCMS version 4.9.1.0 is now available to all clients

Bulk Claim Write-off option, “Write-off based on number of statements printed,” now displays a reminder, “Claims that have been printed on a statement within the last 30 days will not be included"

Insurance Payment Posting screen now offers an option to post payments received from a payer-issued credit card.

Digitally locking the last document in Workflow’s Document View will switch to the List View and no longer generate an error for an empty queue.

A new System Default, “Force effective start date for insurance profiles” will, when selected, obligate entry of an effective start date on patient demographics when adding or editing insurance profiles.

A standard HIPAA Privacy & Security disclaimer is now added to all emailed statements, emailed chart, and bulk email.

Electronic statement ledger message, “Patient Statement Printed through Perse” is now a more generic message, "Electronic patient statement created"

The Payment Analysis Export now displays the Due from Insurance name.

The Payment Analysis Export now offers an option to include inactive locations.

The Claim Information export now offers an option to include inactive locations.

In compliance with the Worker’s Compensation Board of NY, the Workers’ Compensation report now offers the latest version of the MD1 form.

 The Schedule Information Export now includes the matching appointment for the services actually written, based on service written in the ESB Queue.

The Schedule Information Export now includes a new column called “CPTSWRITTEN” which identifies the CPT code of a service generated from the ESB Queue as “ESB=(CPT code number)”. If no service is found as written through the ESB Queue, the system will identify a service’s CPT code written for the patient on that appointment date.

The C4 Authorization Form now offers a new Location dropdown field, allowing the user to override the otherwise defaulted practice address/phone for the Master Physician’s information.

The Patients Seen with No Service Written report was not recognizing some services generated from the ESB Queue in bulk when the service contained a date/time stamp.  This problem is now fixed.

The Electronic Statements Export now includes the Master Physician’s name.

When creating an electronic claims file, the option to include all locations will also include eligible services from inactive locations.

A new Insurance Type Custom Field called “Bypass DTP Admission date segment in loop 2300” will, when selected, skip Admission Date and Discharge Date data awhile creating a file.

The Practice Default, “'Update all future appointments when patient insurance profile changes,” will now also update existing appointments to a new/changed No Fault profile.

A new Insurance Type Custom Field called “Print CLIA in Box 23 of Form HCFA-1500” will, when selected, print the CLIA number in Box 23 instead of a prior Authorization; however, Medicare Insurance Type will still override and force CLIA in Box 23.

Printing the Medicaid Form can now accommodate diagnosis codes of up to 7 characters.

The Aging Report can now be limited to “Show Patient Totals Only” when the Date Range option is enabled.

In the patient search screen, sorting by any column will now automatically also sort alphabetically by patient name as a secondary sort.

Medications sent to New Crop containing invalid characters, such as “#” are now stripped to only contain numeric values.

Worker’s Compensation claims will now print the Worker’s Compensation Case Number in Box 11 on the HCFA form (CMS 1500).

The Daily Totals report will now exclude debited non-allowed amounts from the non-allowed column. (When a payment is debited, the attached non-allowed amount is also debited).

NYS Medicaid form’s Box 24L will now display the “Received Other” amount of the claim (not the “Total Received”) when NYS Medicaid is the tertiary payer.

The actual date and time of the creation of a claim is now stored and displayed when hovering over the transaction date, identifying when a claim is written even if batch dating is used.

Various other bug fixes