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Managed Care Claims

Managed Care Claims

View Adjustments (Quick Reports)


Managed Care claim’s adjustments of payment can be viewed by selecting on the View Adjustments (Quick Reports).



Patient Profile

Primary Emergency Contact


The Patient’s Primary Emergency Contact now saves successfully without an additional emergency contact.




New Certification Period


In the Episode/Assessment Information section of OASIS Demographics tab, the field previously labeled Episode Start Date has been replaced with read-only Certification PeriodThe Certification Period field displays the date range of the current or next episode (from Manage Episode).  The Certification Period can be updated from the Schedule Center under Manage Episode


Note: For OASIS-C2 Recertification and Resumption of Care, the Certification Period field will show the next episode date range within the five-days window.




Print Preview PDF


All previous OASIS-C (legacy) forms can still be previewed (print PDF) and print out by clicking on the printer icon.


OASIS-C2 SOC: Mobility

The OASIS Start of Care print preview PDF now displays GG0170C Mobility with the scale (score) values and descriptions of selected activity/goal for both SOC/ROC Performance and Patient Discharge Goals.



Medicare Beneficiary Identifier

(MBI): Populating on Documentations


Agency administrative staff can enable or disable the MBI feature functionality after entering an approved password to access the “Manage Company Information” tab located under the Admin menu.



Enabling the MBI Feature


Enabling the MBI feature in the Company Information tab allows agencies to begin using either the HICN or the MBI number during the transition period until January 2020, when the MBI will be the only allowed option. The “Enable” option is connected to a required effective date, which allows the system to activate and determine which number to use if both the HICN and MBI are indicated in the patient chart. The MBI number will be the default option, and if the MBI is unavailable the system will use the available HICN.


MBI Effective Date


The effective date can only be established on or after April 1,2018, which is when CMS announced their capabilities to accept the processing of either MBI or the HICN. All completed documents before the effective date will maintain their original number, and any documentation on or after the effective date will have the new MBI.



Once the feature is enabled, saving the information will trigger a confirmation to guide you to either “Update Now,” which will save the changes and the system will refresh instantly, OR “Update Later,” which will save the changes and the system will NOT refresh instantly.



Disabling the MBI Feature


Disabling the feature reverts the software functionality to its original structure of only using the HICN for all claims and OASIS submissions with no impact. The release of the feature will default to the “Disabled” option to provide administrators the authority to decide when they want to start the transition.


MBI in the Patient Chart


An MBI field has been added in the Payor tab of the different patient chart screens and will be labeled the same number as the old HICN (M0063), but only one number can be used per transaction. The MBI field will display in the “Patient Referral”, the patient “Edit Referral”, the “Add (Admit) Patient” and the “Edit Patient” screens. The system will automatically use the MBI Number. If it is not available, the system will use the HIC Number that already exists.


Once the MBI is documented in the patient chart, the system will automatically use the MBI by default for OASIS and billing transactions. The “NA” option has also been added to allow agencies to bypass the default if the patient does not have an MBI, even if the feature is enabled. The MBI field will not allow any special characters (e.g. dashes) and will follow the Medicare MBI format guidelines (a CMS link has been added as an additional resource). The system will automatically change lowercase letters to uppercase for consistency.



MBI Documentations


When enabled with an effective date, the MBI entered in Patient Form will populate or list in following documents/locations:

  • Patient Charts: list in the Insurance Name/ID field
  • OASIS-C2: M0063 Medicare Number (HIC) field
  • Patient Profile (PDF): list in the Payor section
  • Physician Order and Communication Note (PDF): populate in the HIC or Health Plan ID field for Traditional Medicare or Medicare HMO, respectively
  • Face-Face Encounter (PDF): populate in the HIC field


Note: If viewing a document that was scheduled before the MBI Effective Date, the legacy Medicare HI Number will be shown instead.






Print PDF: Braden Scale


Both numerical values and their corresponding descriptions of Braden Scale now display on the OASIS-C2 print preview (PDF).



Updated on 5/08/2018