The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
MyCare Ohio Update
The latest news on MyCare Ohio:
Claims processing: The five plans have all indicated that claims are being processed timely, although there are still issues around patient liability. UHC is still in the process of fixing the "S23" issue. CareSource has indicated that they are willing to meet with providers individually to discuss claims processing. Most of the questions they have received is around Medicare claims processing. Aetna has loaded all the providers and they should start seeing remits that include an offset from the cash advance.
Patient Liability:: Molina is aware of the PL not paying. They have a systems error in loading the 834 data (includes the PL data from the state). They are aware of the problem and hope to have a fix in place within in the next three weeks. Providers do not need to do anything at this time, but be prepared for the amounts to be taken off of future payments once the correction is in place. Buckeye is aware of the decimal place issue. According to Buckeye, Emdeon is making the error when their system process the claim. Buckeye is looking into the possible solution of leaving out the decimal point when submitting the claim. (For example, $650 would be 65000.) The collaborative continues to work on a spreadsheet that would allow a provider to submit multiple claims reconsiderations at once for a change in the PL.
Transportation: Providers are reminded that they must schedule transportation through Logisticare for Aetna members and MTM for UHC members. Aetna has indicated that you may work with your transportation provider directly; however, all runs will have to be confirmed in advance by Logisiticare.
EFT: UHC and CareSource have indicated that providers will need separate EFT applications for their MyCare product.
Payment rates: All of the plans have the new July 1 rates in place. UHC is still assessing which claims paid incorrectly and will do a reconciliation once they have identified any system problems. Molina is in the process of reviewing the claims and plans to have them reconciled by the third week of September. CareSource will have an automated process in place later this month to reconcile the claims. Aetna has loaded the July rates and most claims should be paying the correct amount. If that is not the case, please contact the Academy.
If you have any issues or concerns regarding MyCare Ohio, please contact The Academy.
FY2015 SNF bed tax increases slightly
The Ohio Department of Medicaid officially released the per day per bed franchise permit fee, or bed tax, for FY2015 (effective July 1, 2014) this week. The rate will be $12.10 for facilities with less than 200 beds and $9.85. This is an increase of $0.04 and $0.05 respectively over last fiscal year rates.
Ordering Residents' Rights booklets has never been easier!
If you are looking to order our little blue books, our online form makes it easier than ever! The form allows Academy Members to mail in a check or have us invoice the facility or parent company. And the ever popular credit card payment is always available. Other advantages of ordering online is confirmation that your order has been received and faster processing time so you get your booklets sooner. Order your Residents' Rights booklets online today!
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