DSM is working this week to make the necessary changes to your system to send claims to Novitas beginning next Monday August 20. An update will be going out this evening with software changes to accommodate the difference in Novitas’ transmission system. Once the update is installed we will make configuration changes to your system with the new submitter id, user id, and password that were assigned to your facility by Novitas. All of this will be completed by the end of the day tomorrow. According to the Novitas bulletin at the link below you should stop sending claims to Pinnacle at 1:00 PM on August 16 (Box 1 on the second page). Starting at 2:00 pm on August 16 we will begin making the final changes to your system to send claims to Novitas and will have your system ready to begin sending claims by the end of that day. However, according to the link below, you should hold ALL Medicare Part A claims until after 5:00 pm Friday August 17 (Box 1 on the second page).
The Enforcement Deadline for the 5010 Transition will soon be here. We may continue to see a few issues linger as our MAC’s perform “scheduled fixes” potentially causing unintended edits to fire. To stay up to date on these potential issues over the next few months, you may review the System Status Log for current Part A system issues.
AR/LA/MS Providers: Be on the look out for correspondence from our new MAC. In addition to a new EFT Authorization Form, providers should receive letters assigning new passwords to existing submitter IDs. These letters include dated material and failing to act by the deadlines will result in payment interruptions. Please fax EDI correspondence to Ursula Mercer at 601-925-2223.
For details about the J-H Implementation, click on “FAQS“.
DSM recently acquired the necessary infrastructure and connections to accommodate direct Medicare transmissions via high bandwidth connection. In addition DSM has received 5010 Approval from both Palmetto and Cahaba for direct transmissions. Transmitting claims through this new infrastructure eliminates the typical 3-day wait to get claims to Medicare through one of the large clearinghouses improving the turn-around time from claim transmission to payment. This in effect makes DSM your clearinghouse and removes one level of complexity as DSM provides the claim build and posting software as well as the transmission infrastructure. Only a few customers can take advantage of this direct connection at the moment but soon all customers will have this option.
On May 16, 2012 Novitas will mail letters requesting that each group/billing provider complete a new CMS-588 EFT Authorization Agreement. The revised CMS-588 should be sent in to Novitas no later than 30 days prior to August 13, 2012. Provider action is required to avoid payment delays.
Click here to see the “JH Implementation Alert”.
In the midst of all the EDI updates, transitioning to our new Part A/B MAC is right around the corner. Novitas, formerly known as Highmark , will begin this transition with AR/LA/MS Part A in August. DSM is asking all the right questions and informational updates will be posted here. We will help you “weed” through the overwhelming “blast” of information and highlight points of interest for our providers. Stay tuned for these and other updates…
Click here for more information about the JH Implementation.
DSM has been busy this summer bringing up EMR interfaces and installing our new insurance programs in customer hospitals.
DSM now has four different EMR solutions in seven different hospitals up and running. All are interfaced to our billing system and were up and running by the July 3 deadline. We have numerous hospitals in our customer base that have contracts signed and will be making the move on bringing up EMR’s in the next six months. DSM is also in talks with several new hospitals for a tightly integrated solution with our preferred EMR partner, Razor Insights.
The insurance system has steadily been installed in customer hospitals and it also has numerous enhancments in it. A new front-end edit system allows for a much larger number of edits and automatic claim modifications to occur before the scrub is done. We have also worked with our scrubbing partner to add customer specific edits to occur in the scrubbing process. The dashboard now includes dollar amounts and number of claims in the bar and pie charts. The 5010 X12 formatting programs are ready and testing for the January implementation is under way. Of course, our new insurance system was designed for 5010 compliance from the ground up which made the 5010 formatting a piece of cake.
Mississippi Health Department Discharge Reporting
DSM has installed a new upgraded server for the Health Discharge Reporting System which will accommodate the lab result reporting system that the Health Dept is bring online as well as future systems like electronic surveillance. DSM has also collaborated to come up with improved reconciliation procedures for the discharge health reporting.
Several customers have recently upgraded their servers with the latest Power7 servers from IBM. The machines are speed demons and make our new web based applications like insurance and time and attendance really whistle. The difference is truly unbelievable. The new servers have many great features that we like. The LAN console for example allows our support personnel to do functions requiring the console remotely. This allows most of the migration to the new system to be done remotely. IBM PTFs and operating system changes can be done without a technician being on site. The machine has many capabilities to make them even more highly available, like RAID-6 which allows for two drives to be damaged and the system will continue running.
DSM is partnering with a third party group for new program development to refresh our entire product line. Work has already begun with the design and integration of registration screens with our EMR partner, Razor Insights.
We now have medical necessity available through our new insurance system as a web service, eliminating the need to have a subscription. This system is transaction oriented rather than fixed price, meaning you can pay as you go at the same rate as insurance claims and only for the medical necessity checks that are performed. This is a vast cost improvement over partner solutions with fixed annual fees.
DSM recently completed new certification requirements for IBM with both sales and technical certifications being completed for the new Power 7 systems. The new Power7 systems have been really moving at IBM, providing some of the highest sales volumes of these systems seen in recent years.
Many thanks to all those who called concerned about us here at the Clinton offices when today’s tornado hit. The photo on the left was taken by someone at Mississippi College and of course DSM offices are nearby, but our offices received no damage. DSM’s network admin, Tracy Reynolds spotted a tornado briefly, we are not sure if it was the same one. It was certainly a scare. DSM employees were glued to the windows expecting a tornado, we are certainly glad that this one went east of us. Our thoughts are with the people who were injured.
I was looking on the web for information on electronic health reporting and found this 2007 report prepared by the National Association of Health Data Organizations. The report preceded the law that mandated health data reporting in Mississippi and laid out options that Mississippi used in planning it’s health data reporting systems. I found it very interesting that under the heading of “Hospital Burden” the report quotes a study that cites “upfront costs” and some very high reporting costs, from “$10 per record to $132 per record”. As DSM is providing it’s solution to it’s customers for only $100 per month for all records in a month and there were no up front costs, I think we hit a home run. Not to mention all the monitoring and behind the scenes processing we do. It’s actually an elegant solution:
DSM personnel monitor the automated processes with the following screen:
Each individual transmission for a hospital can be pulled up with the following screen:
If a an error is encountered, which is very rare indeed, a DSM representative contacts the hospital which can access the error by using the option below:
And any errors will appear on the following screen, however, you may notice the message “No records have been selected.”
That’s because the system rarely has any errors. Not only do we receive an email if there are errors, we receive emails from the Health Dept. which have totals of records received and we reconcile those numbers. All of these activities occur without the intervention of your personnel.
The same infrastructure was applied very similarly in the BCBS daily census reporting, which also runs behind the scenes in a very quiet and unobtrusive way, allowing hospital personnel to concentrate on other tasks. The MSHDS solution we provided is just another way that DSM continues to provide quality results with affordable efficiency.
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