Ohio Medicaid Rate Changes
The Ohio Medicaid rate change letters for the July 1, 2015 rates are currently being distributed. We find that many PCC clients are confused by this rate updating process. In the PCC Help screens, there is a good troubleshooting video. You can find this by taking the following path in the Help screens: “Skilled Nursing, Administration, Troubleshooting Videos, How to Add a New Rate.” If you are not currently using Rate Templates, you should take advantage of this time saving feature, which is a very effective tool to automate the rate change process.
Medicare B Fee Schedule Update
Congress finally passed a permanent “doc fix” in April 2015. The bill included a continuance of the “zero percent” update through June 30, 2015 and a .5% update effective for services provided from July 1, 2015 through December 31, 2015. As a result, there are new Medicare B fee schedules in place for all Part B services after July 1. PCC will be updating these fee schedules, behind the scenes, via the PCC Managed Fee Schedule.
However, if you use the exact Medicare B fee schedule amount as your standard charge, (instead of a flat fee or a percentage markup), then you will need to update all your therapy charge code amounts with these new fee schedule rates with an effective date of July 1, 2015. Otherwise, if you bill at the old rate, you will likely be paid at the lower, older fee schedule amount. You must do this at the facility level, if you are a multi-facility organization. It is best done in Setup, using “Charge Code Amounts Setup”. Update the charge amount and change the effective date to July1, 2015 to go forward with the new rate, but also to properly retain the old rate.
Be sure to sign up to attend one of the PCC Q&A; sessions related to the ICD-9 to ICD-10 conversion. The dates for these are as follows. You can see these as links on the PCC Home Page to sign up.
Wed, July 22, 2015 12:00 PM-1:00 PM EDT
Wed, July 29, 2015 1:00 PM-2:00 PM EDT
In addition to this, if you are an Ohio Medicaid Trading Partner, you should make plans to send some test claims to ensure that any issues are resolved before October 1, 2015. The process is fairly simple, and carries big benefits. The Ohio Department of Medicaid has an ICD-10 webpage at:
http://medicaid.ohio.gov/PROVIDERS/Billing/ICD10.aspx. ICD-10 information such as Provider Q&A;, trading partner testing, free coding practice for providers, OhioMHAS coding resources, and other documents and resources have been posted there.
Please contact an HW&Co;. Revenue Cycle Consultant if you have further questions related to any of these items.