Q3 Lookback and Forecast for Q4
Our efforts in Q3 and continuing to Q4 are heavily focused on regulatory updates, most specifically for PDGM and OASIS D-1. We will fully support the new OASIS D-1 regulations starting 1/1/2019; forms will be updated based on final regulations and will be able to document 25 diagnoses.
We have continued to improve functionality for the mobile app. Mobile clients will experience a new data sync experience; the 30 most recent patients in their caseload are automatically imported to the mobile app upon the initial login. A new feature, the Patient Card, was also released, which allows easy reference to relevant clinical data such as allergies, meds and vital signs.
Clinicians using the mobile app can now view Shared forms, which will assist them if they are caring for a patient in partnership with other disciplines. Shared documents can now be viewed in the app for reference.
• Admission Source: The Location of Care field on the patient profile will be updated to document Admission Source and track all patient transfers, whether to hospital facilities, SNFs, home, etc. Agencies will be able to see a new field, “Facility Type,” which pulls information from their Facility library to show them the type of facility they have assigned to a given institution.
• Clinical Coding: This functionality checks the validity of the primary diagnosis for PDGM and flags co-morbidity diagnoses as high, low or none. When documenting Diagnosis through the Plan of Care Module pop-up, a new column for “Clinical Group” will be displayed. We will check Primary Diagnosis to make sure it is in one of the 12 clinical groups, and there will be a warning if it is not. We will also check Secondary diagnosis for co-morbidity, and there will be a helper tool to display none/low/high.
• Grouper Updates: CMS will release this update later in 2019. Our application will calculate the correct HHRG for billing with the new grouper.
• LUPA: LUPA tracking will be available through the HAS Billing Module, and Synergy billing modules. In HAS, the PPS Activity and PPS Revenue Reports will break episodes into 30-day periods starting 1/1/2020 and help agencies track LUPA thresholds.
Recent releases for myUnity® Essentials to the Billing Pre-Audit, Billing Audit, PPS Activity, PPS Margin and Claims are available in preparation for PDGM billing.
The PDGM Comparison tool was added to the PPS Margin Report to allow users to compare PPS EEP amounts to PDGM estimates. Release 220.127.116.11 included hospice wage index, rates and new/changed diagnosis codes effective 10/1/2019.
Version 18.104.22.168 will include additional PDGM-related program enhancements such as a new Diagnosis Export option to the PPS Activity Report. Version 22.214.171.124 will be the last release prior to 1/1/2020 and will include the finalized PDGM and PPS Rate Updates, Case Weights, PDGM Grouper, and OASIS-D1 changes.