Where are KX modifiers applied in Optima?
Exceptions generated from the application of KX Modifiers, appears in the patient Record on the Part B Management tab on the Exceptions & Authorizations tab.
Where is the Save button on a patient record?
When changes are made to the Patient Record, there are two buttons at the bottom of the screen you can use to save the changes: The first is the Save button. The second is the Apply button.
What is a closeout in a system?
The Closeout is a list of validations set up during the initial setup of your system. Settings can be changed, as needed, so the items on your closeout can meet the needs of your organization.
What is a hotlist?
The Hotlist is a list of issues that require your attention. Errors that need to be resolved, missing signatures and functional limitations due are just a few examples of the items that appear on the hotlist. The items on the Hotlist are user-specific so generally, no two users will have the same items on their hotlists.
What is discrepancy in therapy?
A discrepancy occurs when the projected minutes and the actual minutes are not the same. This can happen for a number of reasons. Suppose the patient was not scheduled for treatment on a certain day, but on that day, the patient was in a great deal of pain, so the therapist administered a treatment. Nothing was projected, but treatment was received. Here’s another example. The patient was scheduled for 60 minutes of therapy, but, since the patient was sick with the flu that day, she opted to skip her regularly scheduled therapy appointment. In this case, minutes were projected by no actual minutes were billed.
What is clear schedule?
When you are working in Projections and you want to clear the schedule, the process is simple. The Clear Schedule isn’t actually as extreme as it sound, it gives you options to clear the information you want to clear while leaving the other information in place.
Why is my patient not covered for services on a specific day?
This is usually due to changes in payers or changes to the patient’s coverage. In this situation, you can set a Skip Day.
What is GG0130?
Section GG Functional Abilities and Goals includes admission and discharge self-care and mobility performance (GG0130 and GG0170) data elements. Qualified clinicians code each data element, which are activities, using a 6-level rating scale to reflect the patient’s/resident’s functional abilities based on the type and amount of assistance provided by a helper. If the patient/resident did not perform the activity and a helper did not perform the activity for the patient/resident during the assessment period, one of four “activity not attempted codes” is used. This document provides a brief overview of the coding instructions and key questions to consider when determining the type and level of assistance required for a patient/resident to complete an activity.
What is coding safety?
Coding: Safety and Quality of Performance - If helper assistance is required because patient's/resident’s performance is unsafe or of poor quality, score according to amount of assistance provided.
What is the QRP measure?
This requirement is met by documenting at least one discharge goal item on Section GG for at least one self care or mobility item. The discharge goal does not have to be created by therapy (in some cases, that would not be appropriate) and should be based on results of the initial Section GG assessment and collaboration with the care plan team.
How many alpha scores does Section GG have?
Section GG has three numeric score options that can be used to classify the reasons for an activity not being attempted, whereas the CARE Item Set has four alpha scores. Section GG includes a slightly different set of items than are used in the CARE Item Set.
What is the impact act?
A: The Impact Act mandated that the Centers for Medicare & Medicaid Services (CMS) establish a Quality Reporting System (QRP), wherein each skilled nursing facility (SNF) must submit data on quality measures. CMS created Section GG to capture the required quality measures for functional data reporting. Thus, the SNF is ultimately responsible for completing Section GG. However, due to the nature of the requirements, all core staff (including therapy) working with patients will be affected.
What should a vendor ensure?
A: Your vendor should ensure that the software enables you to implement Section GG requirements in the most efficient manner for your organization. This will vary depending on your unique needs, but at a minimum your vendor should:
What is CARE participation?
A: Participating in CARE will allow you to contribute data to a national repository, giving you the opportunity to compare your organization to other providers. Plus, since clinician certification is required, you can trust the validity of the data.
Who is responsible for completing Section GG?
Thus, the SNF is ultimately responsible for completing Section GG. However, due to the nature of the requirements, all core staff (including therapy) working with patients will be affected.
Is GG required by CMS?
A: No. Section GG is required by CMS but the CARE Item Set is not. Section GG does contain CARE items, which is why some therapy providers are choosing to require staff to complete the CARE Item Set as well.