Welcome to the Omega Technology Solutions newsletter!
Our group is very excited because we have the necessary tools to make your operations work more efficiently and smarter.
Please check out the articles below to learn more.
You can find an archive of our newsletters by going to:
www.omegatechnologysolutions.com/Newsletters.htm
On that same page, you can access our FAQ Blog. Send us questions, and we'll get you the answers. Please, check it out!
Speaking of questions, here's the question of the day:
Can you explain what the rabbit and hunting for eggs has to do with Easter? |
Quarterly Update Time
April 1st the CMS quarterly updates go into effect.
Hospitals should review their pharmacy chargemasters for these HCPCS drug changes to stay current and compliant. Consider the following HCPCS guidelines.
"C" codes are used to report drugs, biologics and devices that must be used by OPPS hospitals and can only be reported for facility (technical) services. These codes may include device categories, new technology procedures, drugs etc. that do not have other HCPCS codes assignment.
"J" codes include drugs that are administered by other than oral method, such as injection, infusion and inhalation.
The following chart represents a series of "C" codes that have been reassigned with "J" codes in the coming April 1st quarterly update.
C9237 See ~J1930 Injection, lanreotide acetate, 1 mg -
C9238 See ~J1953 Injection, levetiracetam, 10 mg
C9239 See ~J9330 Injection, temsirolimus, 1 mg
C9241 See ~J1267 Injection, doripenem, 10 mg
C9242 See ~J1453 Injection, fosaprepitant, 1 mg
C9243 See ~J9033 Injection, bendamustine hcl, 1 mg
C9244 See ~J2785 Injection, regadenoson, 0.4 mg
Hospitals should review their chargemasters for all the upcoming CPT/HCPCS code changes that will be effective April 1st, 2009.
If you need help, please contact us and we can introduce you to our WebCDM product which will handle the above issues and more. |
Find out more about ChargeMaster... |
OCExaminer Gives More Cash To Hospitals
FORT LAUDERDALE, FL., March 19, 2009 - With the economic crisis facing this nation, hospitals are looking for ways to improve their cash flow. There are many companies offering various services and ideas on how to improve revenue. Most, if not all concentrate their efforts on the front-end registration process, dealing with eligibility and making sure the patients have enough insurance coverage. All these procedures are important and are a good practice to follow them. However, there is one component of the revenue cycle flow that is lacking. That is proper setup and use of a scrubbing system. In order to have a clean claim, the billers need to know how to work the scrubber, understand the results and most of all rely on the information from the edits. There are companies that would spend hours of research and development, concentrating on how well the electronic file is built so the insurance company will accept it. However, even though it is an important step as part of claim submission, how perfect is the information within the file? What if you do not have electronic file submission established for all the carriers? Omega Technology Solutions has created a web-based scrubber going beyond what a scrubber can do. OTS has been working for five years building and testing the product called OCExaminer. This system allows for on-demand claims editing, identifies potential lost revenue, acts as a "Safety Net", has pre-built edits ensuring compliance and lets the hospital decide what they want to review. There are three components dealing with hospital claims: ü Compliance ü Lost Charges ü Payer-specific There are five modules built into OCExaminer: ü Outpatient Medicare ü Carve out ü Interventional Radiology ü Drug Administration ü User-defined The system accepts the information from the Patient Accounting system in a print image file which gets uploaded into the system via a secured connection. OCExaminer provides flexible solutions as: ü Available via the Internet ü Unlimited user access ü Control user access ü Define menu access ü Ability to: ü View reports ü Upload claims ü Manage edits and users ü Easy report generation ü Focuses on critical issues ü Make changes in your system Omega Technology Solutions has been in business since 1992 and has worked with many facilities throughout the United States recovering lost charges. Their LCR (Lost Charge Recovery) projects have been approved by HFMA Peer Review and are working towards CORE certification. For instant demo please access http://www.omegatechnologysolutions.com/OCE%20Web%20Presentation/player.html About OTS Omega Technology Solutions provides a range of software technology and services to the Hospital and Healthcare Industry to ensure both compliance and profitability. For over 12 years the firm has been providing a complete suite of Revenue Cycle Management offerings including Lost Charge Recovery, Managed Care Contract Recovery, Concurrent Review Services, APC Review, and Remote Coding. In addition OTS provides web based Charge Master Maintenance as well as Claims Editing and Examining Technology. http://www.omegatechnologysolutions.com Contact Omega Technology Solutions at 1-800-559-8009.
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Eligibility coming soon to Omega
Omega has always committed to provide the best and most effective tools to accelerate reimbursement to our clients. What better way to do this, than to implement a tool that will assist hospitals and physicians with the eligibility of insurance for their patients?
Omega is working on a web based application where the client will enter a minimum amount of information about the patient insurance information and within 5 seconds, an eligibility report will be returned from the insurance company.
We are very excited to present this service to our current and future clients, especially when it was created with you in mind.
Along with electronic billing, Omega Technology Solutions is in the process of instituting claim status inquiries. Be on the lookout for future releases of this newsletter with updated information. | |
Omega working toward CORE Certification
Omega continues to please their customers and wants to acquire certification from CAQH, |
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CAQH launched the Committee on Operating Rules for Information Exchange (CORE) in January 2005 with the vision of giving providers access to eligibility and benefits information before or at the time of service using the electronic system of their choice for any patient or health plan.
CORE is more than 100 industry stakeholders - health plans, providers, vendors, CMS and other government agencies, associations, regional entities, standard-setting organizations and other healthcare entities. CORE participants maintain eligibility and benefits data for more than 130 million commercially-insured lives plus Medicare and Medicaid beneficiaries. Working in collaboration they are building consensus on a set of operating rules that will:
- Enhance interoperability between providers and payers
- Streamline eligibility and benefits data transactions
- Reduce the amount of time and resources providers spend on administrative functions - time better spent with patients.
CORE will track and publish metrics regarding rule impact to help quantify participant return on investment.
Operating rules build on existing standards to make electronic transactions more predictable and consistent, regardless of the technology. Rights and responsibilities of all parties, security, transmission standards and formats, response time standards, liabilities, exception processing, error resolution and more must be clearly defined in order to facilitate successful interoperability. Beyond reducing cost and administrative hassles, operating rules foster trust among all participants.
To receive a CORE-certification Seal, organizations must sign a binding pledge to adopt, implement and comply with CORE rules. By signing the CORE Pledge, the organization commits to work with a CORE-authorized testing vendor to prove its product or IT system(s) are compliant with the CORE rules.
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Thanks for your time!
Sincerely,
Ann Fierro, RN, CPA, MBA
President and News Editor
Omega Technology Solutions |
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| Thanks to Everyone! |
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We want to thank everyone of you who took the time to answer the surveys sent out by HFMA. We are so proud to have earned this prestigious designation!
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Putting the Pieces Together | |
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