HW&Co. Revenue Cycle Updates

The Revenue Cycle process is constantly changing at warp speed, or so it seems.
We work hard to monitor all developments and news to keep you informed. 

Here are some of the most recent items you need to know.

Livanta Documentation Submission Update

Livanta, the Quality Improvement Organization (QIO) for Ohio regarding appeals made by residents and/or responsible parties for Medicare coverage has announced FY 2021 Final Rule CMS 1735-F requires all providers to transmit medical records and other documentation to the Beneficiary and Family Centered Care – Quality Improvement Organizations (BFCC-QIOs) electronically

  • Providers will be reimbursed $3 flat rate per case for the submission
  • Beginning October 1, Livanta will accept medical records via
    • Direct Secure Messaging
    • Livanta File Transfer Portal, e-LIFT portal

Most software vendors provide some type of direct secure messaging with their Electronic Medical Records (EMR). Please contact your vendor for more information and assistance as there may be some set up required.

Providers that do not have EMR are required to obtain a waiver from Livanta in order to continue faxing medical records. The waiver was made available on October 1, 2020 and can be found here. Providers must prove they do not have an Electronic Medical Records (EMR) system that can securely transmit electronic records and sign a memorandum of agreement with Livanta. This waiver gives providers additional time to acquire a direct secure messaging product and is only effective through December 31, 2020.

For more information and Frequently Asked Questions, please refer to www.livantaqio.com and https://LivantaQIO.com/en/Provider/Medical_Records

Medicare Advance Beneficiary Notice

CMS has extended the required deadline for use of the updated Advanced Beneficiary Notice (ABN) Form CMS-R-131

  • Revised ABN form will become mandatory on January 1, 2021
  • The Revised Form can be used now
  • This is provided for Part B services
  • Will be effective through June, 2023

The Form and instructions are available here.

Vaccine Billing for Seasonal Influenza and Pneumococcal Viruses

It’s that time of year again – your facility is probably getting ready to complete flu vaccine billing. As the vaccines are given, your clinical team should provide you with basic resident information including resident name, date given, the type of vaccine and manufacturer.

If you have questions on the Codes for Administration and Diagnosis, please refer to this MedLearnsMatters article.

Accessing Quarterly CASPER Report for VBP Information

Skilled Nursing Facility (SFN) Value-Based Purchasing (VBP) results are updated for Fiscal Year 2021 and available from your facility Certification and Survey Provider Enhanced Reporting (CASPER) Application.

For instructions on accessing the report for the VBP payment multiplier that will need to be updated in your software in order for your Patient Driven Payment Model (PDPM) rates to calculate properly click here.

If you re in need of more support, our Revenue Cycle department can assist with billing services and business office functions. Please reach out to one of our Healthcare Consultants with any questions you have.