• Congress Saves Therapy Caps
• REPS Leads Now Works with QuickCare
• CMS Publishes Updated ICD-9 Codes for LTC
• Important Information for Texas Clients
• New in Version 3.5
• Client Satisfaction Survey

Questions?
Call 1-800-259-7633

Congress Saves Therapy Cap Exceptions
By overriding the President's veto, Congress enacted the Medicare Improvements for Patients and Providers Act of 2008 on July 15, 2008. One provision of this legislation extends the effective date of the therapy caps exceptions process to December 31, 2009. Outpatient therapy service providers may now resume submitting claims with the KX modifier for therapy services furnished on or after July 1, 2008 that exceed the cap and meet the exceptions criteria.

Prior to this legislation, the exceptions were to expire on June 30, 2008 and providers were instructed not to submit the KX modifier on claims for services furnished on or after July 1, 2008. The extension of the therapy cap exceptions is retroactive to July 1, 2008. As a result, providers may have already submitted some claims without the KX modifier that would qualify for an exception. Such claims would be rejected for exceeding the cap.

CMS has advised that providers submitting such claims using the 837 institutional electronic claim format or the UB-04 paper claim format should resubmit these claims appending the KX modifier so they may now be processed and paid. Providers submitting such claims using the 837 professional electronic claim format or the CMS-1500 paper claim format should request to have their claims adjusted in order to have the contractor pay the claim. In all cases, if the beneficiary was notified of their liability and the beneficiary made payment for services that now qualify for exceptions, any such payments should be refunded to the beneficiary.

For complete information, please visit the CMS website at http://www.cms.hhs.gov/TherapyServices.

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REPS Leads Now Works with QuickCare!
MDI Achieve's REPS Leads is a powerful software solution for lead management, marketing, inquiry and referral source tracking. This easy-to-use program is already in use by some QuickCare clients and allows them to manage all of the vital information they need to fill their communities. With the release of new programming, a referral tracked through REPS, can now be admitted directly into QuickCare.

The purpose of this interface is to eliminate the need for duplicate entry of data into both systems. Track the referral in REPS Leads and when you're ready to admit them, the resident data can be exported to a simple CSV file and easily imported into QuickCare where it is saved to the facility database. This is a security controlled feature so you must be assigned permission prior to setup of the REPS interface. To begin using this feature, you will need to complete the setup available under Enterprise Menu Level, Maintenance, REPS Import Setup.

As always, please call our Client Support hotline at 800-259-7633 with any questions you may have.

For more information about REPS Leads, please visit our website at http://www.mdiachieve.com/solutions/marketing/repsleads.asp.

CMS Publishes Updated ICD-9 Codes for LTC
CMS has released their 2009 ICD-9 update list which will go into effect on October 1, 2008. MDI Achieve advises QuickCare clients to carefully review this list to see which ICD-9 codes might have an impact on your facility and get a head start on which residents might need to be re-diagnosed by a physician before this effective date.

For more information, including the 2009 update list, please visit the CMS website at http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/01_overview.asp.

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Important Information for Texas Clients:
Texas Medicaid Transitions from TILEs to RUGs
The Texas Department of Aging and Disability Services (DADS) has announced their plan to transition from the Texas Index for Level of Effort (TILE) to the federal Resource Utilization Group (RUG).

Beginning September 1, 2008, Nursing Facility provider TILEs will expire with the submission of an MDS Assessment. On August 31, 2008, DADS will end all TILEs covering dates beyond November 30, 2008, to ensure that only RUGs are in use by December 1, 2008.

For complete information, please monitor the following websites:

Texas Medicaid & Healthcare Partnership
http://www.tmhp.com or

DADS Provider Communications http://www.dads.state.tx.us/providers/communications/index.cfm.

MDI Achieve is currently working on the programming changes necessary to accommodate this transition, to be available in the next release. To assist with this transition, MDI Achieve will offer a special web training session for our Texas clients. Stay tuned for more information.

If you have any questions, please contact us at QCTraining@MDIAchieve.com.

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New in Version 3.5
The latest version of QuickCare, Version 3.5, has been released and includes the following new feature...

• Resident PDP Form - Provides fields to store the resident's selected Prescription Drug Plan, including the Resident PDP Number and PDP Group Number. The numbers will also print on the resident's face sheet. It also provides a history of previous plans for the resident.
  
  PDP Carrier and PDP Plan: The lists are filtered based on the state selected. If no carrier is set to active in PDP Management for the state, the selector is not available. The current plan appears at the top of the list.
  
  To use this feature, follow these simple instructions:
  1. Go to: Resident > Admission > Resident Prescription Drug Plan
  2. To add a plan for the selected resident, click Add.
  3. In the Resident PDP pane, select:
     - Your State using the PDP State selector.
     - The carrier using the PDP Carrier selector.
     - The plan using the PDP Plan selector.
  4. Enter the Resident PDP Number.
  5. Enter the PDP Group Number.
  6. Enter the Start Date or click the calendar icon and the date.
  7. The End Date defaults to 12/31/9999 (no end date). Accept the default or enter the end date, if known.
  8. Click the Save button. This PDP Plan becomes the current plan and appears at the top of the list. The end date for the previous plan is automatically populated with the current date.

As always, please call our Client Support hotline at 800-259-7633 with any questions you may have.

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Last Chance to Take Our Client Satisfaction Survey and Enter To Win an iPod Nano
MDI Achieve's philosophy has always been to build long-term relationships with our clients. To that end, we want to ensure that we are consistently meeting your needs and exceeding your expectations with our service. Please take a few moments to complete a short Client Satisfaction Survey and let us know what you think. To take the survey, point your browser to http://www.surveymonkey.com/ s.aspx?sm=hzD1smUE0VnOOApmOpldDQ_3d_3d.

Each respondent will be entered into a drawing for an iPod Nano. Only one entry per person. You must provide contact information in order to be entered into the drawing. Survey ends July 31st.

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