Primaris will no longer handle Missouri Medicare case reviews beginning August 1
Thirty years ago, Ghostbusters made the question “Who you gonna call” go viral long before the days of social media.
1984 was the same year Quality Improvement Organizations (QIOs), like Missouri-based Primaris, began answering the call of Medicare patients. Primaris serves Missourians with Medicare by examining concerns about their care, or by reviewing cases where patients feel services ended too soon – for example, an early discharge from a hospital.
Beginning August 1, 2014, Missourian patients and providers will no longer call health care quality-improvement consulting company Primaris. All current and future beneficiary quality review case work and appeals will be conducted by KEPRO, located in Seven Hills, Ohio.
For more information, please visit Primaris at http://primaris.org/quality-today/ghostbusters-and-qio-program-turn-30-who-you-gonna-call-for-medicare-concerns.
Please note effective October 1, 2014 (FY 2015), CMS will no longer support Windows XP or Internet Explorer v8.0. This means after October 1, 2014, you will not be able to transmit MDS and/or retrieve CASPER reports until you upgrade your internal system. The recommended operating system is Windows 7 and the recommended browser is Internet Explorer v9.0. Visit the QIES Technical Support Office at https://www.qtso.com/ to view Minimum System Requirements for Home Health Agencies, Hospice Providers, Long Term Care Facilities, Inpatient Rehabilitation Facilities and Long Term Care Hospitals. NEW: FY2014 System Requirements [PDF 22KB].
This information is also available on the CMS MDS 3.0 System Welcome Page.
If you have any questions, please contact Joan Brundick, State RAI Coordinator at 573-751-6308 or email@example.com, or contact Danette Beeson, State Automation Coordinator at 573-522-8421 or firstname.lastname@example.org.
June 4, 2014
12:30 p.m. – 2:00 p.m. Central Time
To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.
HHS expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. Providers would have an extra year to prepare. During this MLN Connects™ National Provider Call, join us for a keynote presentation on more ICD-10 coding basics by Sue Bowman from the American Health Information Management Association (AHIMA), along with updates from CMS. A question and answer session will follow the presentation.
- CMS updates, including the partial code freeze and 2015 code updates
- Why ICD-9-CM is being replaced with ICD-10-CM
- Benefits of ICD-10-CM
- Similarities and differences from ICD-9-CM
- Coding: Process of assigning a diagnosis code, 7th character, placeholder “x,” excludes notes, unspecified codes, external cause of injury codes, type of encounter
- Documentation tips
- How to obtain answers to coding questions
- How to request modifications to ICD-10-CM
Target Audience: Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers. Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information web page to learn more.
Keep up with the latest news regarding ICD-10, visit http://cms.gov/Medicare/Coding/ICD10/Latest_News.html.
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 1, Issue 3. Topics include AANAC Conference Highlights; MDS Coding – Section Q; Websites of Interest; and features Dave Walker’s Questions from the Field. Please visit www.nursinghomehelp.org/qipmo.html.
A new release of the Program for Evaluating Payment Patterns Electronic Report (PEPPER) is now available for skilled nursing homes. PEPPERs will no longer be mailed to providers who previously received their PEPPERs by mail. They will now be able to access them through a secure website portal, http://pepperresources.org/PEPPER/SecurePEPPERAccess.aspx.
Those providers who have been receiving their PEPPERs through QualityNet will continue to do so. The Chief Executive Officer, President, or Administrator of the provider can obtain their PEPPER. Information on accessing and downloading the PEPPER is available in the Secure PEPPER Access Guide.
Training and Resources are available on the website: www.pepperresources.org/TrainingResources/SkilledNursingFacilities.aspx.
PEPPER Training Update (May 2014):
PEPPERresources.org is the official site for information, training and support. If you have questions about the PEPPER reports, you may submit questions on this website through the Help/Contact Us tab. Please do not contact your state QIO or state survey agency for assistance with PEPPER.
Are you a new MDS Coordinator? Are you unsure where to begin? Print and save the helpful tips below from the Section for Long-Term Care Regulation:
Support groups for Minimum Data Set (MDS) Coordinators meet monthly in each of Missouri’s seven regions. These meetings provide an opportunity to discuss issues relating to MDS, PPS, and the RAI Process. For more information, please visit the Quality Improvement Program for Missouri (QIPMO) at http://nursinghomehelp.org/supgr.html.