Review Choice Demonstration
We have modified Barnestorm to allow for Review Choice Demonstration, as some of our customers went through that already.
Documentation for
pre-
claim review will consist of existing documentation you're already doing (plan of care, OASIS, visit note, F2F, etc). Someone in your organization will upload that documentation to Palmetto directly
in pdf format. Barnestorm allows you to save any document in print preview to pdf format. To see the list of documentation that will be uploaded, go to this article and check the attachments at the bottom, or check CMS: http://kb.barnestorm.biz/KnowledgebaseArticle51468.aspx
You'll choose preclaim and then upload info to PGBA, which will assign a UTN# for that episode.
You will take the UTN # that CMS provides and put it into Barnestorm on the Edit PPS Episodes screen (you can see it on there now, under the middle left Treatment Authorization Code).
Report that includes UTNs:
Reports > Billing > 14.03 > option to print the UTN
eServices - Palmetto GBA
- 15.0 Review Choice Demonstration - starting at page 117 for general; page 126 shows how to receive the UTN after approval
- 1.11 eServices Minimum System Requirements
- 3.2 Troubleshooting access rights once logged in
PDGM
The PDGM starting this January will still use a 60-day 485 and the Oasis recertifications are still on a 60-day cycle, so it makes sense that the care plan would also continue to be on a 60-day cycle. Only the billing is divided into 30-day episodes, and it will always use the most recent Oasis with a HIPPS code that has a date on (for SOC) or before (for all other) the episode from date, and will use the most recent 25 ICD codes dated on or before the episode start date.
The HIPPS code and Treatment Authorization code will continue to be assigned using the CMS provided validation tool, using the same Validate process on the OASIS screen in Barnestorm. Barnestorm does not assign HIPPS codes, the CMS tool does that, so the system will reflect any updates CMS makes.
We're anticipating that the CMS OASIS validation tool will audit ICDs to ensure that any ICDs not allowed as primary will be caught in OASIS validation. The OASIS validation process will not change in Barnestorm, but the validation specifications used by CMS will change.
In terms of transmitting the info to CMS, some of the claims systems (like Ability) have an add-on for that part (Ability calls their Optimize Analytics).
Related Question: Scrubbers for Coding and OASIS
Barnestorm does not offer a scrubber, but we do offer an OASIS comparison that performs a very similar function, with color coding to very easily target differences from OASIS to OASIS over any given period of a patient's care. Our OASIS system does not allow mismatched answers or errors in the OASIS; these are caught and the clinician is required to correct these issues before the OASIS can be locked.
Companies that Barnestorm customers use to integrate coding and OASIS scrubbing with Barnestorm include:
Barnestorm is not affiliated with these companies, but we do work with them to allow access for OASIS and coding evaluations.