On April 27th, CMS published a final rule confirming that physician enrollment in PECOS is soon to become a condition of payment.  Home Health Agencies may see claims edits introduced soon that would deny claims if PECOS enrollment is not confirmed.  Although the interim rule dealing with PECOS was made effective on July 1, 2010, CMS decided to delay enforcement of these edits due to issues with the PECOS systems.

Sansio has provided its customers with the ability to check PECOS status at several points within its HomeSolutions.NET agency management software since July, 2010, including intake/referral, order management, and claims.  Pictured below is a sample HomeSolutions Dashboard that can be referred to when managing the homecare admission or order management process.

Click here for the complete final rule in the Federal Register.

Job Title: Solution Center Specialist
Location: Duluth, MN
FLSA: Salary, Exempt

Sansio is currently accepting resumes for the Solution Center Specialist position from qualified individuals that are dedicated to providing excellent customer service.

Primary Duties:

• Think Customer First
• Provide functionality support to end users
• Respond to application inquiries via inbound telephone and electronic messaging
• Respond to inquiries within established time frames and service levels
• Track and monitor unresolved inquiries to ensure timely resolution

Qualifications:

• 4 year degree preferred
• Associates Degree plus relevant work history at a minimum
• Applicable knowledge of commonly-used concepts, practices and procedures within the field of technology
• Strong problem solving abilities required
• Advanced written and spoken communication skills
• SIETE – ability to be responsive, kind, courteous, respectful, professional, listen, and provide answers

Sansio is an equal opportunity employer.

Sansio currently has this career opportunity available. Qualified System Administrators who have what it takes to fit into our team oriented environment are invited to submit a resume.

Job Title: System Administrator
Location: Duluth, MN
FLSA: Salary, Exempt

Primary Duties:
• Design, install and configure network and computer systems
• Perform system maintenance
• Monitor network and infrastructure
• Participate in on call duties
• Participate in weekly scheduled maintenance
• Troubleshoot reported system errors
• Design and implement system and network security

Qualifications:
• Four year degree with two years work experience
• Associates Degree with five or more years of relevant work history
• Background with Cisco networking and VMWare preferred
• Familiarity with both RedHat Linux and Windows server OS preferred
• MS Active Directory management experience preferred
• Excellent communication skills at both a technical and professional level
• Strong problem solving abilities required
• SIETE – ability to be responsive, kind, courteous, respectful, professional, listen, and provide answers

Sansio is an equal opportunity employer

Sansio announces new product extension to support New York Medicaid LTHHCP Episodic Payment System.

Sansio, an established provider of healthcare information management (HIM) solutions, announces a new Extension to its HomeSolutions.NET home health agency management software to help New York Certified Home Health Agencies manage to new episodic billing requirements for Medicaid.  HomeSolutions RevNET for New York Medicaid incorporates skip logic, episode payment calculation, pre-billing validation, and revenue recognition for the LTHHCP program.

This automation will help providers continue to deliver critical services to homebound patients and avoid costly rehospitalizations while enabling patients to maintain their independence in the comfort of their own homes rather than more expensive facility-based settings.

Last year, the New York Department of Health decided to introduce a new episodic payment system (EPS) similar to Medicare PPS, but unique to the New York Long Term Home Health Program (LTHHP).  Previously, providers were reimbursed for their services on a fee-for-service basis for each hour or visit.

Sansio Vice President Kraig Erickson stated, “In order for New York CHHA’s to effectively manage to these new billing requirements, it became apparent that a full featured end-to-end solution was needed from both a compliance and efficiency standpoint.  We were able to work with our current New York customers and the New York Department of Health to develop RevNET for New York LTHHCP Medicaid in preparation for the implementation date, which is currently May 1, 2012 .”

About Sansio:

Sansio, based in Duluth, MN, is a leading provider of SaaS (Software as a Service) information management solutions that help healthcare providers improve clinical, operational, financial, and regulatory performance.  Sansio’s home care and Fire/EMS software empowers hundreds of organizations with tools that capture millions of patient encounters and effectively deliver billions of dollars in services annually with HomeSolutions.NET®, HealthEMS®, and ResiDexWEB.NET™.

About the New York Long Term Home Health Program:

The NY LTHHP is  a coordinated plan of medical, nursing, and rehabilitative care provided at home to persons with disabilities who are medically eligible for placement in a nursing home. This program offers patients an alternative to institutionalization. These individuals must have care costs which are less than the nursing home cost in the county.

The program, also known as the Lombardi program or the Nursing Home without Walls program, was established in 1978 as one of the nation’s first comprehensive community-based service programs for beneficiaries who require nursing home level of care.  It is one of the largest waiver programs for aged and disabled Medicaid beneficiaries in the nation.

LTHHCP providers are responsible for care management and for providing specified state plan services: nursing; personal care; home health aide services; physical, occupational, and speech therapies; and medical equipment and supplies as determined by patient need.  Providers are also required to meet the Medicare Conditions of Participation for home health.

They are also required to provide, as appropriate, the following waiver services: medical social services, audiology, respiratory therapy, and nutritional counseling. Additional waiver services may include a personal emergency response system, home maintenance, home improvement or adaptation, moving assistance, home-delivered and congregate meals, social day care, non-medical transportation, and respite care.

Health care took center stage in Washington, DC over the past few days as the National Association of Home Care and Hospice held its annual March on Washington while the Supreme Court held historic hearings on the Affordable Care Act.  Sansio executives joined industry leaders from every state to help share how homecare can play a central role in a more effective health care delivery model.

Several senators delivered passionate statements to NAHC attendees in the Russell Senate Office Building’s historic Caucus Room pledging their support of the expansion of home care to help answer some of the nation’s greatest challenges.  Appearances were made by Senators Cardin (MD), Carper (DE), Collins (ME), Klobuchar (MN), and Whitehouse (RI).

Senator Amy Klobuchar shares her personal homecare experiences.

Senator Collins affirms that homecare is saving Medicare
billions of dollars each year.

Click here to watch a summary of the event on YouTube.

Sansio joined the Minnesota Home Care Association leadership on congressional visits at the US Capitol.  The advocacy team shared how home care can be the answer to some of the nation’s greatest challenges, citing how home care makes good economic sense and provides great moral value.  The Minnesota delegation was able to provide information to all seven of Minnesota’s congressional House Representatives and both Senators.

The NAHC March on Washington also featured several educational sessions and an exhibition of products and services available to help homecare agencies more effectively manage their businesses.  Sansio exhibited its HomeSolutions.NET SaaS solution at the conference, providing attendees with a first look at its new Mobile point-of-care version which runs on a wide variety of browser-capable devices including iPads and tablets.

NAHC President Val Halamandaris tries out the new HomeSolutions Mobile on an iPad.

Additional Documentation Requests (ADRs) are on the rise and can be very costly to your homecare business.  On January 12, 2012 our friends at Ohio Council for Home Care and Hospice clarified that a number of their members received ADRs, and Palmetto recently stated “there will be more in the near future as new edits have been recently placed on some of the reviews”.

The purpose of this post is not to be a guide to fix ADRs but a source of information and resources shared from the many conversations going on across the nation regarding ADRs.

Consistent throughout the information being shared by home health consultants and professional associations, is to implement a proactive ADR management strategy. While it is certainly important to have a plan in place to respond to ADRs, avoiding them altogether by putting a proactive strategy in place will have more significant long-term benefit to your agency.  As they say, proactive is always better than reactive.

The 3 T’s of Proactive ADR Management

Talent

Success in home health is very dependent on human resources.  We are in a people business which requires excellent talent in both the field and the office.  Your staff needs the aptitude to learn and understand the importance of complete documentation and process as it relates to the health of your business and the continued ability to care for patients in their home.

Training

Focused training on activities that can minimize ADRs include the Intake/Referral process, OASIS Assessment and clinical documentation, QA, Order Management, Coding, and Pre-Billing Audits.

Technology

Several technologies can help agencies implement and manage to a more proactive environment.

Agency Management Software - A comprehensive home health agency management software system helps agencies adhere to regulatory requirements by putting checks and processes in place up front in key processes.  Key features to look for that can help minimize ADR impact includes:

Electronic Intake/Referral capabilities that requires certain data (such as Point of Origin) to be collected in the admission process.

Scheduling functionality that matches orders to schedules

Correct G-Code documentation at the Point of Care.

Order Management features that enable an agency to verify that an order is complete, signed, and dated prior to releasing an electronic trigger for that pre-billing check.

OASIS Inconsistency Checking that alerts agencies to changes between assessments prior to OASIS and claims submission.

Comprehensive Pre-billing Checks that hold claims from being created until necessary upstream processes are clean such as ensuring orders, schedules, and visit records are properly QA’d, validated, and complete.

OASIS Scrubbing - To compliment the process-driven agency management features, an additional layer of OASIS scrubbing can also be a significant element in your strategy.  There are several available tools such as Home Health Gold, PPS Plus, and Strategic Healthcare Programs (SHP) that integrate with agency management software to provide additional OASIS analysis.

Point of Care - Adopt Point of Care documentation technologies that facilitate timely, accurate, and complete documentation.  If your staff is not documenting at the point-of-care, then its not point-of-care.  All too often in home health, clinical documentation is not completed at the point of care due to the complexities in many technology-heavy approaches.  Thus, nurses end up documenting after the fact, which impacts downstream processes and also reduces accuracy, as the human brain continually loses information over time.

HomeSolutions.NET has been built to help agencies manage their business in a more proactive manner with several in-line processes and Flex Point of Care options.  When combined with OASIS scrubbing tools, exceptional talent, and focused training, the impact of ADRs can be minimized significantly.

ADR Resources – MAC’s

Palmetto

• Palmetto GBA Responding to Home Health Additional Development Request (ADR) Checklist
• Recent Palmetto update regarding notice now being sent in white instead of yellow envelopes
• Palmetto GBAs detailed list of what needs to be provided
• Palmetto GBA DDE manual with steps on accessing DDE (page 41 regarding ADRS)

Cahaba

• Quick Reference Tool

CGS

• Point of Origin: Avoid billing errors caused by overlapping episodes
• Quick Resource Tool

NHIC

• NHIC PDF with Information on ADRs and sound process for submission/reviewing

ADR Resources – Industry

We encourage providers to monitor the many ADR topics on their state and national homecare association listserves.  Here is a list of other known resources.  If you have more you’d like to share please contact us and we’ll continue to update this resource.

• Michael McGowan – Medicare Appeals Development -  http://www.madappeals.com/

• Carol Anderson – Article regarding having a pre-billing audit plan

• Haydel Consulting - Blog: http://haydelconsultingservices.com/2012/01/
• NAHC –  2011 Presentation  - Two Sides of the Coin – Why Was My Agency Denied

Computer Science Education Week (CSEdWeek), designated by the U.S. House of Representatives as the week of computing pioneer Grace Hopper’s birthday, recognizes the transformative role of computing and the need to bolster computer science at all educational levels.  During the week, Sansio staff members participated in a panel at the College of St. Scholastica.

The panel presentation was part of the college’s Pathways to Computing, a full day program allowing high school and college students an opportunity to explore careers in computer science and information technology.

Participating on the panel from Sansio were St. Scholastica graduates Kim Berrisford, Tom Berrisford, and Russ Kurhajetz, along with other Duluth-area CSS graduates working in technology including Reed Fulghum from 3Five Designs, Alyssa Engleson from aimClear, and Ben Friesen from Saturn Systems.  The panelists provided students with an overview of their technology businesses and personal insight into their positions and how they arrived at their career choices.

The engaging audience of students asked several questions that spurred conversation such as:

“How much of our day is spent working in teams?”

“How much difference in salary do you see if you have a degree?”

and “What skills did you learn that are vital to your role?”

Sansio representatives also provided these words of encouragement to students, “gain a base set of technical skills and show off your enthusiasm.  Technical skill may get you an interview at a Software as a Service (SaaS) company like Sansio, but attitude, aptitude, and passion will all be very influential in landing you a career.”

More information about CSEdWeek can be found online at: http://www.csedweek.org/

CMS has made available the 2012 Final Rule for Home Health Agencies, which takes effect January 1, 2012.  The Final Rule was displayed at the Federal Register (and revised 11/9/2011) to update Medicare’s Home Health Prospective Payment (HH PPS) rates for Calendar Year (CY) 2012.

A summary of the changes introduced include:

• Payments to home health agencies (HHAs) are estimated to decrease by approximately 2.31 percent, or $430 million in CY 2012, the net effect of a 1.4 percent payment update ($280 million increase), the wage index update ($10 million increase), and a 3.79 percent case-mix coding adjustment ($720 million decrease).

• The final rule imposes a negative 1.32 percent case-mix coding adjustment to the national standardized 60-day episode payment rates for CY 2013.

• The final rule finalizes structural changes to the HH PPS by removing two hypertension codes from the case-mix system, lowering payments for high therapy episodes and recalibrating the HH PPS case-mix weights to ensure that these changes result in the same aggregate payments.

• Finally this rule adds flexibility to allow physicians who attend to a home health patient in an acute or post-acute facility to inform the certifying physician of their encounters with the patient in order to satisfy the face-to-face encounter requirement.

Related:  The online version of the 2012 Home Health PPS Final Rule is available on the Federal Register webiste.  See this link for the online version. 

Sansio hosted a HealthEMS User Conference on Thursday, September 29, 2011 for Minnesota area Fire/EMS customers.  The event was held at the new state of the art Woodbury Public Safety Building training center in Woodbury, MN.  Attendees received valuable information to help maximize their investment in HealthEMS and related partner services. 

The attentive crowd heard presentations from Sansio staff that ranged from strategic items including corporate updates and product roadmaps, to practical tips on optimizing the HealthEMS experience in the areas of dashboards, reporting, and operational management.   The conference was specifically geared for administrators, operations and clinical QA/QI staff, and Medical Directors.

In addition to reviewing new HealthEMS feature enhancements, Sansio staff presented the vision for development of the browser- based ePCR, previewing the new HealthEMS Mobile v5 running on tablets and iPads.

Attendees were also provided a preview of HealthEMS RevNET™, an optional HealthEMS Extension designed to provide secure, integrated, web-based revenue cycle management for processing claims, ERA, eligibility, and statements.  Sansio staff shared how HealthEMS RevNET will provide Fire/EMS customers benefits of having a single, completely integrated “CAD to Cash” solution.

Sansio thanks the City of Woodbury EMS Division for providing the venue for this conference.

Sansio is pleased to announce that Kaitlyn Steffen, a graduate of Park Rapids High School, was awarded the 2011 Sansio Scholarship for the UMD Labovitz School of Business and Economics (LSBE).  Ms. Steffen is a senior at UMD studying Human Resources Management and Finance. 

Sansio representatives Kevin Noreen, CFO and Dave Purdy, HR Manager presented the award during the LSBE Scholarship Reception at the UMD Kirby Ballroom on Thursday October 6, 2011.  “We were impressed with the spirit and passion for excellence that this young lady exhibits and she was very appreciative of the financial award,” stated Kevin Noreen. “The Sansio Scholarship for UMD is an investment in the development of future business leaders and we couldn’t be happier with this year’s winner.  We wish her the best of success.”

The Sansio Scholarship for UMD was established in 2007 to reward a deserving LSBE student for their excellence in and out of the classroom.  Sansio is a leading provider of SaaS (Software as a Service) information management solutions that help healthcare providers improve clinical, operational, financial, and regulatory performance.  Always “Thinking Customer First”, Sansio employees and partners follow its SIETE principles at the core of its business model; Be Responsive, Kind, Courteous, Respectful, Professional, always Listen, and provide Answers. This award is targeted for students that demonstrate those principles.

The UMD Labovitz School of Business and Economics (LSBE) was established in 1974 and serves approximately 1,850 students annually. The UMD LSBE is one of only four schools in Minnesota to be accredited by the Association to Advance Collegiate Schools of Business International (AACSB).  Nationally, only one-third of the 1,200 schools of business and management have earned and maintained AACSB accreditation. LSBE offers high-quality undergraduate and MBA programs and its students experience a rigorous curriculum inside the classroom and through hands-on internships and projects with area businesses outside the classroom.