Health and Human Services Announces the Public Health Emergency Will End On May 11, 2023

Effective May 11, 2023, the Public Health Emergency related to COVID-19 will end. The end of the Public Health Emergency also means the end of the Qualifying Hospital Stay waiver and the 100-day benefit period waiver. Provider-specific factsheets about Covid-19 Public Health Emergency (PHE) waivers and flexibilities can be found here.

COVID-19: Reporting CR Modifier & DR Condition Code After Public Health Emergency

The end of the COVID-19 public health emergency (PHE) is expected to occur on May 11, 2023. Since the CR modifier and DR condition code should only be reported during a PHE when a formal waiver is in place, plan to discontinue using them for claims with dates of service on or after May 12, 2023. For benefit period and qualifying stay waivers, submit condition code DR for inpatient claims with admission dates before May 12, 2023.

Medical Assistance Renewals          

Because of the pandemic, the federal government allowed Pennsylvania and other states to continue Medicaid coverage for most people even if they were no longer eligible. This policy ended on March 31, 2023, for Pennsylvania as well as other states. Beginning April 1, 2023, renewals are now required due to the end of the COVID-19 Pandemic flexibilities. Medicaid recipients risk losing their health coverage if renewals are not completed by the due date. Use this link to read more. Any provider with questions may contact Medical Billing Manager Lindsay Esterline.

Medicaid 180-Day Claims — Automated Electronic Submission Process

Effective April 13, 2023, the 180-day automated electronic submission process will allow Fee-for-Service (FFS) and Office of Long-Term Living (OLTL) providers to request an Attachment Control Number (ACN) and upload the supporting documents for claims adjudication. 

Instructions can be found via Provider Quick Tip #263, or please utilize the PROMISe Provider Education and Training page for more information on live provider training sessions scheduled for April 13, 2023, and April 20, 2023. The live training will be recorded and available to providers. Any provider with questions may contact Medical Billing Managers, Lindsay Esterline or Gina Alifano.

AmeriHealth Configuration Delays Impact January Payments

AmeriHealth announced configuration for some of their new rates effective January 1, 2023, had not been fully implemented, causing some claims to need to go through a claims analysis in order to reprocess any underpaid claims. No action is required by providers to initiate the claims analysis, but they are encouraged to monitor their accounts receivable closely after new payments are sent and contact their AmeriHealth account executive if they see anything unusual. 

CMS Transitions from Quality Improvement and Evaluation System (QIES) to Internet QIES (iQIES)

MDS submission through QIES was closed on April 13, 2023, and iQIES submissions started on April 17, 2023. Some providers encountered issues with the transition that could potentially impact billing. Any provider requiring assistance with access or help with technical issues may contact Stephanie Kessler.

PCC Corner — Resident Merge/Delete Functionality

Did you know that if you accidentally duplicate a resident in PointClickCare, you can do a Merge/Delete at the facility level?

• Duplicate residents often happen when an appropriate database search is not done when entering a new resident or when the resident has been added pre-admission and the QADT (Quick Admission, Discharge, Transfer) is not done from the NEW or Waiting List tab.
• The ability to Merge/Delete is based on the security rights assigned to individual users.
• Locate the duplicate residents. Typically, one will be Current and one will be New. Both could be current if the Census/Rates have been populated with the admission.
  

• Note the Medical Record numbers and determine which one will be retained.
• Go to Admin/Resident Merge/Delete.

• Search for the duplicated resident. Click the plus (+) links on the far side. This will move the two selected residents to selected residents. Click the green Merge link.

• The following screen will pop up and you will click on the resident that you want to retain (the duplicate will be merged into the one selected). The selected resident will turn green and you will see the green checkmark. Check the “I Accept” box and the green Merge link will be available to select.   

• Click on the Dashboard and you will see the status of the merge. The Dashboard will show all resident Merge/Delete functions that have occurred.

• The same steps can be followed if you want to delete erroneously entered residents. Residents can only be deleted if there is no clinical information populated. If you select a single resident, the green Delete link will be available to select.

• After Delete is selected, you will need to accept the Disclaimer and select the green Delete link again.
  
  Any provider with PCC questions may contact Paula Hynum.

Questions about these updates? Need support to meet requirements?

Contact Stefanie Knaub, RKL Senior Living Services Partner, at 717.590.8648.