Special Notice About Medicaid Applications For Long-Term Services & Supports

We have recently been notified that effective January 5, 2015, three of the four Connecticut Long-Term Services and Supports (LTSS) Application Processing Centers will receive and process all new nursing home applications and the remaining Center will receive and process all new applications for Medicaid waivers for home and community based services. 

The Hartford office is the LTSS Application Processing Center designated to process only Medicaid waiver applications for home and community based services. The Bridgeport, New Haven and Waterbury offices are the LTSS Application Processing Centers that are designated to process applications for nursing facilities within the assigned towns and cities.

Application packets with the required documentation that is available at the time of submission should be mailed directly to the appropriate LTSS Application Processing Center. 

LTSS Applications should not be directed to the DSS ConneCT Scanning Center.

If you have any questions or concerns, please contact the DSS Benefits Center staff at 1-855-626-6632.

Tiptastic Tuesday: Practical Tips For Improving Patient Collections In 2015

The Affordable Care Act is now entering its second year. With continued implementation of its many provisions, both patients and providers are still getting use to the new law. 2015 will see a steady increase in the number of patients becoming insured-many for the first time. With higher out-of-pocket costs, more and more patients will become financially responsible for larger portions of their claims. Therefore, as a provider, it is integral to set financial policies in place, so that you are able to collect all monies for your services.

In an effort to assist providers with collections, we have put together a few strategies any organization can implement:

  • Establish a financial policy. Practices should establish a financial policy that is reviewed and distributed every year. This comprehensive policy should provide patients with a clear understanding of the practice’s expectations with regards to patient balances. Make sure each patient signs a copy which you should keep in his or her file. Please note, it is important to update your financial and insurance verification policies annually to reflect requirements of your individual practice.
  • Collection of patient demographic and insurance information should be obtained when the patient makes the appointment. Make sure to enter insurance information into the system prior to the visit for eligibility verification.  Advise each patient in advance to bring a copy of current insurance cards, applicable co-pays, and any deductibles owed. We also suggest that you advise your patients to verify benefits with their particular insurance company prior to the appointment. This way, the patient thoroughly understands his or her contractual obligations.
  • Eligibility verification process. For providers that use our software, Caretracker/Optum PM and Physician EMR, it performs an automatic eligibility check for the next five dates of service. Each patient’s eligibility history is automatically updated when their check is complete. Other systems may work differently and it is important to utilize this functionality to capture your patients’ current insurance information. If you do not have software that checks eligibility, we suggest that you designate a staff member to verify your patients’ insurance prior to visits.
  • Co-pay collection. Practices should collect applicable co-pays prior to visits.
  • Payment plan. With higher out-of-pocket costs and increasing premiums, there’s a good chance there will be a patient who is unable to pay for a service at the time of visit. For situations like these, it may be helpful to set up a payment plan with a promise to pay. Draft a form and make sure the patient signs it. Give the patient a copy and keep one in your accounts receivable section. This way, you will be alerted with a reminder to process a credit card, or collect cash or a check. Be sure to always follow up with a patient who has not paid on time.
  • Credit cards. Another great option for your organization is to have a credit card machine. Credit cards are a safe option to ensure payments are made on time.

President & CEO Of HMS Healthcare Management Solutions, Inc., Donna Galluzzo, Elected CBIA Board Chair

We are proud to announce that Donna Galluzzo, President and CEO of HMS Healthcare Management Solutions, Inc. has been elected chair of the Connecticut Business & Industry Association’s board of directors. Donna Galluzzo succeeds James P. Torgerson, President and CEO of UIL Holdings Corporation.

Referring to CBIA’s 200th anniversary in 2015, Galluzzo said, “I’m honored to serve as chair of the CBIA in its bicentennial year.”

“CBIA has forged its reputation based on trust, integrity, and working collaboratively toward thoughtful policy and business solutions to some of the state’s most pressing challenges.”

“It is my intent to build on this strong history and to help the association benefit from a smooth transition of executive leadership while elevating Connecticut to one of the top 20 states in the country for business by 2017.”

Congratulations, Donna!

Click here to read more from CBIA.

Holding Of 2015 Date-Of-Service Claims For Services Paid Under 2015 Medicare Physician Fee Schedule

The CY 2015 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register on November 13, 2014. Medicare Administrative Contractors will hold claims containing 2015 services paid under the MPFS for the first 14 calendar days of January 2015 in an effort to implement corrections to technical errors discovered after the publication of the MPFS rule. Please note, this hold will have a minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 days (29 days for paper claims) after the date of receipt. MPFS claims for services provided on or before Wednesday, December 31, 2014 are unaffected by the 2015 claims hold and will be processed and paid under the normal procedures and time frames.

Click here to see the Final Rule.

Click here to read more.

6.4 Million Have Already Enrolled To Obtain Healthcare Coverage For 2015

Between November 15 and December 18, HealthCare.gov enrolled 1.9 million new customers for health insurance. During the same time, 4.5 million existing policyholders re-enrolled or were automatically renewed into their existing policy or similar one beginning January 1, 2015. Health and Human Services Secretary Sylvia Burwell believes the numbers indicate “an encouraging start.”

For those who were re-enrolled, percentages around the mid-to high-30s logged into the system and either renewed their old plans or changed it to a different one. The rest were re-enrolled automatically. Anyone who was auto-renewed can change plans until February 15, 2015. Increased competition among plans, variations in premiums or benefits, and changes in financial circumstances have caused many people to switch plans.

Burwell remained tight-lipped about whether her department is making contingency plans in the event the Supreme Court rules that subsidies are not available in the 37 states where HealthCare.gov is operating the exchange.

Click here to read more.

Monday Morning Recap

The HMS Healthcare Management Solutions Monday Morning Recap reviews some of the top stories and healthcare highlights you may have missed last week.

EHR Incentive Program Blog Series Part VII: Attestation

In our last EHR Incentive Program blog series post, we’ll look at the final step: attestation.

Attestation is a legal statement that you have met all the thresholds and requirements of the Medicare and Medicaid EHR Incentive Programs. The process of attestation happens through an internet-based CMS system that allows you to enter certain required information, including 15 core objectives, 5 out of 10 menu objectives, 3 core (or 3 alternate core) clinical quality measures, and 3 out of 38 additional quality measures.

So, where do you go to attest? For the Medicare EHR Incentive Program, you will attest through the same system where you initially registered. Click here to go to the CMS EHR Registration and Attestation system. During the attestation process, you will enter data and answer questions on the core objectives, menu objectives, and clinical quality measures.  There is an attestation guide to help you through the process. Click here to download it.

After you attest, you will find out immediately if you have successfully achieved the core and menu objectives of the program. If you are not successful, you can edit any information that was incorrectly entered and resubmit your attestation. You may also resubmit for a different 90 day reporting period with new information. If you are successful, CMS will perform internal checks to make sure you are eligible for payment. You will receive your EHR incentive payment approximately 4-8 weeks following attestation.

The attestation process for the Medicaid EHR Incentive Program is similar. First year participants are required to demonstrate the ability to adopt, implement, or upgrade certified EHR systems. This can be done by submitting the CMS EHR Certification Number obtained from the Certified Health IT Product List (CHPL) for your certified EHR through your state Medicaid agency site. Second year participants are also required to attest through you state internet-based portal, but you will only attest to meeting meaningful use requirements (as well as having met all other eligibility criteria).  For more information on your state’s internet-based portal, click here. States are required to issue Medicaid incentives payments within 45 days of completing all eligibility verification checks.

This post concludes our EHR Incentive Program Blog Series! Click here to see EHR Incentive Program FAQs from CMS.