Categories
Accounting

Healthcare Accounting in Miami

Gustavo A Viera CPA are expert Healthcare Accounting in Miami providing a wide variety of HealthCare Accounting financial Management Services

Healthcare Accounting in Miami Services for doctors, dentists, healthcare professionals and healthcare related businesses. Our services are designed to simplify the process for you by providing comprehensive accounting, tax and financial management services. Gustavo A Viera CPA has over 25 years of being Healthcare Accounting in Miami focusing on healthcare professionals and their businesses.

Our Healthcare Accounting in Miami have always been involved with Healthcare Accounting in Miami in some capacity. Our first job was in the Chartroom for a local hospital.  As Healthcare Accountants in Miami  we feel that we could provide value by speaking to physicians in their own language and having significant knowledge of Health Care Accounting. Over the past 25 years our Healthcare Accounting in Miami commitment to healthcare has grown stronger as the economic changes have forced the healthcare industry to look past their primary objective, that of providing care, to that of earning a living.

Our Healthcare Accounting in Miami expertise will aid the preparation of a tax return and especially AHCA Cost Report. Tax & Medicare laws are very complicated and filled with exceptions to every rule. Most clients do not know if the return is wrong or right, and it may not matter since defending an audit, even if you are 100% correct, can cost you thousands of dollars. In many cases, different Healthcare Accountants in Miami will see things differently and arrive at different conclusions based on the facts of your return. The most important thing is that YOU understand what is on your return. The IRS & AHCA have increased the fines and penalties for return errors and it is becoming increasingly more complicated to prepare a return or AHCA Cost Report.

We’ve had clients, who prepare their own AHCA Cost Report., come to him after the AHCA has suspended billing during a review.

Our Healthcare Accounting in Miami services are performed by healthcare accountants. With Gustavo A Viera CPA you can be assured that your Healthcare Accounting in Miami team has significant, relevant experience with healthcare providers like you. Your Healthcare Accounting in Miami team will consist of individuals who spend virtually all of their professional time serving the healthcare industry – not manufacturing, retail or other industries.

Viera provides audit and Healthcare Accounting in Miami services to healthcare entities ranging in size from small physician practices and ancillary providers to multi-state integrated healthcare organizations with assets in excess of $1 billion. This experience across the spectrum of healthcare allows our Healthcare Accountants to quickly identify the financial reporting areas of greatest risk to your organization and to more efficiently and effectively perform audit or accounting services. Further, our Healthcare Accounting teams are structured to allow our senior executives more time with our clients in order to provide the “hands on” experience and oversight.

The following is a partial listing of the types of Healthcare Accounting in Miami services Gustavo A Viera CPA offers our clients:

  • Audits, reviews, and compilations of financial statements
  • Audits in accordance with Government Auditing Standards and OMB Circular A-133
  • Internal control reviews and risk assessments
  • Impairment testing of intangible assets
  • Agreed-upon procedure reports and special reporting
  • Transaction accounting assistance, including allocation of purchase price
  • New accounting standard implementation
  • Forensic accounting and dispute resolution
  • Outsourcing of internal audit functions
  • Accounting policy and procedure manual development

As Healthcare Accounting in Miami focused on serving the healthcare industry (over 75% of our revenues are healthcare related), we have available the resources to supplement the extensive knowledge of our Health Care Accountants through the use of our dedicated reimbursement, clinical and healthcare tax departments. Our relationships with lending institutions, bond underwriters and rating agencies are such that Viera is a nationally recognized Healthcare Accountant  in connection with debt issues.

Our Healthcare Accounting services in Miami consults practices and healthcare related businesses at every stage of the business cycle across the spectrum of medical specialties and allied fields. We work with you to increase revenues, reduce costs and enhance client/patient satisfaction.

Categories
Medicare

Healthcare Accountants in Miami

Healthcare Accountants in Miami

Healthcare Accountants in Miami, Gustavo A. Viera CPA, stated that the Centers for Medicare and Medicaid Services announced on August 10, 2011 that it will begin sending revalidation requests by mail to nearly 1.5 million health professionals, more than half of whom are physicians. These notifications are already being sent and will continue until March 23, 2013.

CMS has implemented new screening criteria for all Medicare applications in an effort to weed out individuals and institutions that shouldn’t have billing privileges, according to VieraCPA Healthcare Accountants in Miami. There is, however, a great concern expressed by many physician organizations that legitimate physicians and other Healthcare Agency professionals could mistakenly get caught up in this enrollment sweep, according to VieraCPA Home Healthcare Accountants.

We aren’t joking about checking your mail, says VieraCPA Healthcare Accountants in Miami. Once you receive the request, you will have sixty days to recertify your enrollment information. CMS is playing hardball: “Failure to submit the enrollment forms as requested may result in a deactivation of your Medicare billing privileges” according to according to VieraCPA Healthcare Accountants in Miami.

Note that this recertification is also required for clinics and group practices. And, as you might expect, Healthcare Accountants in Miami anticipate that the notifications for the physicians in a large group practice might arrive in a “piece meal” manner. Diligence is required on behalf of you and your staff to avoid having your Medicare billing privileges deactivated, says VieraCPA Healthcare Accountants in Miami.

New Federal poster Requirements

The notification goes into further discussions regarding Healthcare Accountants in Miami what it is illegal for an employer to do, as well as what it is illegal for a union that represents an employee to do.

Healthcare Accountants in Miami experts say the background to this situation is that this is actually a rule put forth by the National Labor Relations Board. It was not passed by the Congress nor was it signed by the President.

What does this do to Your Practice?

What this does is effectively inform your employees that they do have the right to organize. It is widely understood that the Service Employees International Union (SEIU) has specifically targeted the Southeast, where there are a number of right to work states, with the intent of organizing. The healthcare industry, being obviously a significant service industry, is one of the key targets, according to Healthcare Accountants in Miami experts VieraCPA.

This being said, understand that if an employer knowingly and willfully even fails to post the notice, the failure may be considered as evidence of unlawful motive in an unfair labor practice case. The recommendation is that you watch for any implementation delays (there are a number of legal challenges of this requirement) and, assuming no change comply by Monday, November 14th. As practices become larger and larger due to mergers and other consolidations, it may inevitable that at some point or another, unions may approach your employees, or your employees approach unions.

HIPAA Enforcement Intensifies

The implementation of the HITECH Act under the ARRA in early 2009, and the recent refining of the regulations related to the enforcement of HIPAA by the Office of Civil Rights (OCR), has increased the scrutiny that healthcare organizations may undergo. In July 2011, the Office of Civil Rights awarded $9.2 million dollars to KPMG to conduct HIPAA compliance audits under the guidance of the Department of Health and Human Services staff. Under this program, there will be 150 audits varying in size and scope.

Of note in the discussion surrounding this project is the fact that most of the significant violators of late have been major institutions.

For example, UCLA Medical Center, Massachusetts General Hospital, and Cignet Health of St. George County Maryland. Mainly because of the publicity focused around HIPAA violations in national news coverage, there appears to be an increased awareness on the part of the general public about it. From January 1, 2010 thru December 31, 2010 there were 9,158 HIPAA complaints reported to the Office of Civil Rights nationally. Of those, 54% were resolved after intake and review. Of the remaining 4,229 cases that required investigation, in 2,703 (64%) the OCR required corrective action.

It’s worth taking a look at how this process works. As to how important cooperation is, in the case of Cignet, mentioned previously, $3 million of their $4.3 million fine was related to the fact that they failed to cooperate with OCR’s investigation on a continuing daily basis. This was perceived by the OCR as a willful neglect on behalf of Cignet to comply with the Privacy Rule.

Additional guidance will be forthcoming from CMS regarding specific issues related to the enforcement of the Security Rule under the HITECH Act. Look for this information to be published by CMS in the fall of 2011.

The Office of Civil Rights is seriously taking into account the severity of any privacy or security breach. There is what is known as a “threshold risk of harm” analysis that requires four steps. These are as follows:

  •  What was the nature of the data elements breached?
  • What is the likelihood that the information is accessible and usable?
  • What is the likelihood that the breach may lead to harm?
  • What is the ability of the covered entity to mitigate the risk of harm?

Some of the many breaches that have occurred have related, for example, to the theft of laptops containing protected health information (PHI). In many of these cases, the nature of the elements breached was significant in that it related to PHI. However, the likelihood that the breach could lead to harm was minimal due to the security systems that had been implemented and enforced. Simply stated, it was likely the thieves wanted the laptop and had no interest whatsoever in the PHI that it contained.

In fact, in some cases, the laptops have been recovered at pawn shops, etc. by law enforcement agencies and the covered entity has determined that the information was never accessed.

Healthcare Accountants in Miami VieraCPA are always available to assist you with questions related to the enforcement of HIPAA. Over the past few years we have had a number of situations in which our clients have been involved in breaches of PHI. Many of these were simply violations of common sense, others were due to carelessness. Fortunately we can state that none of them were done in a vindictive or truly harmful manner. Nonetheless, you need to be vigilant, constantly train your staff and keep them updated on HIPAA requirements.

Also be aware that a number of government agencies are involved in HIPAA enforcement. Aside from the HHS Office of Civil Rights, the Federal Trade Commission Bureau of Consumer Protection, the Centers for Medicare and Medicaid Services, as well as the Attorney General in your state may become involved.

Categories
Medicare

Miami Home Healthcare Accountants Bad Debt Recovery

Miami Home Healthcare Accountants Bad Debt Recovery

Miami Home Healthcare Accountants Gustavo A Viera CPA we’re concerned as the economic recession continues and with the rise in unemployment, Home Healthcare Accountants must deal with accelerated growth in bad debts in addition to the myriad of other financial and operating challenges presented during the downturn. Home Health Agency Accountants understand that while all bad debts cannot be recovered, 70% of allowable Medicare bad debt claims, including Medicaid cross-over balances, can be salvaged through the filing of a Medicare Cost Report.

CMS Home Healthcare Accountants define allowable bad debt in Provider Reimbursement Manual, Part I, Section 308 as debt that meets the following criteria:

The bad debt must be related to covered services and derived from deductible and coinsurance amounts.

  • The provider must establish that reasonable collection efforts were made.
  • The debt was actually worthless at the time of write-off.
  • There is no likelihood of recovery of the debt in the future.

Recent CMS Home Healthcare Accountants rulings provide some clarification regarding these criteria.  If the services of the Home Healthcare Accountants or clearing house are used by a facility, those bad debt claims must be returned to the facility and collection efforts discontinued before the debt is deemed “worthless”.  The Home Healthcare Accountants rulings also suggest that Home Healthcare Accountants Firms or clearing houses must treat Medicare Cost Report claims in a similar manner.

To mitigate any potential adjustments or reductions in Home Healthcare Accountants Medicare reimbursement during the annual audit of the Medicare Cost Report, Home Health Agencies Accountants should take the time beforehand to carefully review and analyze their bad debt logs. If you have any questions or concerns about your bad debt listings and would like more information on VieraCPA Home Health Agency Accountants bad debt review services, please call us.

As the largest operating division of HHS, the Centers for Medicare and Medicaid Services (“CMS”) undergoes multiple scheduled program reviews by the OIG.  As such, the Work Plan outlines the following areas of CMS evaluation:

  • Hospital Capital Payments – The OIG will evaluate Medicare reimbursement to hospitals for capital expenditures (facilities and equipment) for appropriateness.
  • Hospital Wage Data – Hospitals will be evaluated on the accuracy of wage data reported to CMS.  Specifically, because the wage data reported is used to calculate wage indices for the Inpatient Prospective Payment System (“IPPS”), appropriate representation of this data remains critical.
  • Critical Access Hospitals – The OIG will analyze payments made to Critical Access Hospitals; and, hospitals will additionally be evaluated on their ability to meet the criteria which defines a critical access hospital.
  • Medicare Disproportionate Share Payments – OIG will (i) evaluate Medicare disproportionate share payments made to qualifying hospitals and (ii) analyze the total amount of uncompensated care at these hospitals.
  • Hospital Readmissions – The OIG plans to assess trends related to hospital readmissions.  Specifically, oversight in same-day readmissions will be critically reviewed.
  • Diagnostic Imaging – According to CMS, increased use of diagnostic imaging services has proliferated during recent years.  As such, evaluations on potential overuse and service costs will be conducted.
  • Unbundled Laboratory Tests – The OIG plans to assess clinical laboratories which have unbundled laboratory tests to increase Medicare payments.  Specifically, the extent of this inappropriate unbundling will be evaluated by analyzing claims data.
  • Physician Reassignment of Benefits – Pursuant to the Social Security Act, physicians are not allowed to reassign Medicare beneficiaries except in the case of a specific exception. As such, the OIG will analyze reviews of such reassignments.  In addition, an examination of physicians’ awareness of these reassignments will reveal the extent of these occurrences.
  • Physician Identifier Number – The OIG plans to review Medicaid claims associated with invalid or inactive Physician Identifier Numbers; primarily, numbers used on claims after a physician’s death.
  • Managed Care Organizations (“MCO”) – MCO’s will be evaluated based on Federal standards regarding fraud and abuse safeguards and marketing practices.
  • Provider-Based Status – OIG plans to compile cost reports for hospitals claiming provider-based status for both inpatient and outpatient facilities.  Based upon such reports, it will then identify hospitals improperly claiming provider-based status for facilities.
  • Physician Hospice Billing – Based upon the standard that physicians should receive payments for hospice services solely under the Medicare Part B Physician Fee Schedule, the OIG will conduct reviews to identify whether physicians are double-billed (under Medicare parts A and B) for such services.

Physician Self-Referral for Durable Medical Equipment – OIG will conduct analyses to review the legality of physician referrals to durable medical equipment suppliers in which the physician holds ownership.

Given the aforementioned items, Home Health Agency Healthcare Accountants and physicians should assess both operational and financial relationship matters in order to ensure proper compliance moving forward into 2010.

Categories
Accounting

Health Care Accounting Cycle

Miami Health Care Accounting Cycle

‘The Health Care Accounting Process’ itself is quite a vast topic to discuss. There are numerous factors involved in it which finally complete the cycle. The Health Care accounting process is also known as the Health Care Accounting Cycle. It starts with recording a transaction and ends with the closing of books by your Health Care Accountants. There are several methods used to record, analyze and finally close the data as final data of the year. Double checking the transactions recorded analysis of the data and creating a balance sheet for the upcoming year is also a part of this process.

Health Care Accounting site 5 major steps which complete the Health Care accounting process. The following are the 5 steps:

Identifying the Event:

Identification of a transaction or any other similar event which needs to be recorded is the first step in the Health Care accounting process. The Health Care Accountants needs to recognize whether this event is of any value to the accounting books of the company or not.

Preparing Source Documents:

The second step is to prepare the source document of the transaction. The source document can be a promissory note, an invoice and so on. Without the creation of this document, it won’t be possible to record the transaction.

Analysis of the transactions:

Analyzing and classifying the transactions refers to quantifying the transaction in monetary terms. This means that the money paid or the credit created should be present for recording.

Recording Transactions:

This part includes recording the transactions into the journals. There are different journals such as the purchase journal, sales journal and so on. Each transaction needs to be recorded in its respective journal.

Analyzing Entries:

By transferring the entries to the ledgers and then finally into the balance sheets and income statement, a double check is made on the credibility of the transactions. In various cases, while transferring the transactions to the ledgers, faults are spotted in recording by the Health Care Accountants.

These are the five basic steps of the Health Care accounting process. Without these steps, it is impossible for an organization to check the profit and loss of the year.

Categories
Business Trends

Miami Health Care Accountants Optimistic about Business Growth

Health Care Accountants Optimistic about Business Growth

Miami Health Care Accountants are more optimistic about business growth predictions for 2012 in their respective states than the nation as a whole, according to a new survey of Health Care Accountants in Florida, Texas and California.

Those polled were most confident about the Health Care Accountants industry, and their own Health Care Accountants. Information technology tops the list of capital investments planned in the coming year. Survey respondents also anticipate some new hiring in the next 12 months. Health care costs continue to be a top concern of businesses along with government regulation and uncertainty in the tax laws.

Healthcare Accounting Service

The poll was conducted for Health Care Accountants industry and Institute of CPAs.

It polled nearly 13,000 Health Care Accountants in who are partners or sole owners of public Health Care Accountants or serve as CEOs, CFOs or presidents of companies in various industries. More than 2,100 Health Care Accountants completed the survey.

“The poll showed that Health Care Accountants in the three states feel confident about the prospects for growth in the Health Care Accountants industries they work in and serve, but still have concerns about factors beyond their control”,  said Health Care Accountants VieraCPA in a statement. This includes increasing health care costs and government regulation, and the lack of available credit to grow theirs or their clients’ businesses.”

Only 6 percent of the Health Care Accountants who responded predict robust growth in the United States, but the numbers climb as they evaluated the growth outlook for their own state (9 percent), Health Care Accounting Service industry (20 percent), and organization (26 percent).

The Health Care Accountants surveyed did not report significant decreases in workforce or revenues since the financial crises took hold, and say they expect both areas to increase marginally in the next year. These Health Care Accountants business leaders expect marginal (53 percent) or substantial (7 percent) revenue growth in the next year, with marginal (32 percent) and substantial (2 percent) growth in employment. Less than 10 percent of respondents predict a reduction in employment.

Information technology topped the list of investment and spending priorities over the next year. Sixty percent of the surveyed Health Care Accountants said their organizations plan to invest marginally or significantly more in this area followed by 40 percent planning capital spending increases. Product development and marketing/advertising will remain relatively flat with more than 50 percent citing no change in either category.

Health Care Accountants and their clients listed the ability to obtain funding as a significant area of concern. Approximately 76 percent do not think small businesses have access to adequate credit to grow or sustain their operations. The financial crisis and forecasts for slow growth greatly reduce their or their clients’ ability to obtain loans, according to 70 percent of the Health Care Accountants polled. Health Care Accountants also cite health care costs as a concern, with 98 percent of those surveyed responding affirmatively when asked if the cost of health care benefits was a worry for businesses in their states.

Some are looking into this area for savings, with 94 percent agreeing that companies are reevaluating employee/benefit costs, while 63 percent are aware of companies dropping or reducing employee health insurance coverage. Labor costs, workers’ compensation, and public pension funding were also seen as problems, with public pension exposure taking the highest percentage among the three.

 

 

Categories
Accounting

Healthcare Accounting Services and Health Information Systems (IT)

Healthcare Accounting Services and Health Information Systems (IT)

Healthcare and all the political hype about Obama Care hаs become а fundamental pаrt оf оur day-to-day lives. But Healthcare Accounting Services has always been the engine keeping the healthcare sector on the right track. Thіs hаs bееn а result оf thе massive positive impact thаt niche CPA Firms and Healthcare Accounting Services hаve hаd іn healthcare.

Healthcare Accounting Services cаn bе improved thrоugh Health Information Systems (IT) іn various ways. It іs beneficial tо both patients аs wеll аs medical practitioners. Healthcare Accounting Services utililize healthcare software solutions that аrе cost-effective; provide centralized management оf patient records, billing, financial management аnd оthеr key aspects related tо Healthcare Accounting Services and  management. Thus, besides managing patient records, Healthcare Accounting Services/medical practitioners cаn benefit frоm software tо manage аnd organize thеіr business.

Administratively, іt hеlps іn preventing errors, whіch wеrе mоst probably а bіg headache іn thе traditional paperwork environment. Creating medical bills, recording patient profiles аnd generating piles аnd piles оf medical files wеrе vеry hectic аnd error-prone. However, an efficient Healthcare Accounting Services wіth healthcare software, оnе cаn expect smooth healthcare management, wіth minimal mistakes іf аny. It enhances thе level оf productivity thrоugh tіmе saving whіlе creating bills, invoices, balancing accounts, recording patient reports etc.

Healthcare software systems all-in-all bring аbоut an increase іn quality оf thе service delivered by Healthcare Accountants аnd bring аbоut efficiency gains within thе organization; promoting patient safety, upgrading security protocols, electronic health records, computerized provider order entry. Besides thіs, electronic billing аnd claims submission rapidly generate additional savings by decreasing thе costs оf creating bills аnd speeding reimbursement.

Many healthcare software solutions incorporate features such аs administrative billing аnd financial general ledger, cost accounting systems, patient registration, personnel аnd payroll, electronic materials management, clinical computerized provider order entry fоr drugs, lab tests, procedures, electronic health record, picture archiving аnd communication systems, filmless imaging, results reporting оf laboratory аnd оthеr tests, clinical decision support systems, prescription drug fulfillment, error-alert, transcriptions, electronic monitoring оf patients іn intensive care, units, іt infrastructure such аs desktop, laptop, аnd tablet computers, servers аnd networks, wireless networks, voice recognition systems fоr transcription, physician orders, аnd medical records, bar-coding technology fоr drugs, medical devices, аnd inventory control, information security systems, physicians, administrative billing, аnd financial accounting, scheduling, clinical online references (drug compendia аnd clinical guidelines), receiving lab results аnd оthеr clinical information, online, electronic prescribing, computerized provider order entry, clinical decision support systems, electronic health record, e-mail communication wіth patients infrastructure desktop аnd laptop computers handheld technology servers аnd network.

Categories
Accounting

Healthcare Accounting Services and Health Information Systems (IT)

Healthcare Accounting Services and Health Information Systems (IT)

Healthcare and all the political hype about Obama Care hаs become а fundamental pаrt оf оur day-to-day lives. But Healthcare Accounting Services has always been the engine keeping the healthcare sector on the right track. Thіs hаs bееn а result оf thе massive positive impact thаt niche CPA Firms and Healthcare Accounting Services hаve hаd іn healthcare.

Healthcare Accounting Services cаn bе improved thrоugh Health Information Systems (IT) іn various ways. It іs beneficial tо both patients аs wеll аs medical practitioners. Healthcare Accounting Services utililize healthcare software solutions that аrе cost-effective; provide centralized management оf patient records, billing, financial management аnd оthеr key aspects related tо Healthcare Accounting Services and  management. Thus, besides managing patient records, Healthcare Accounting Services/medical practitioners cаn benefit frоm software tо manage аnd organize thеіr business.

Administratively, іt hеlps іn preventing errors, whіch wеrе mоst probably а bіg headache іn thе traditional paperwork environment. Creating medical bills, recording patient profiles аnd generating piles аnd piles оf medical files wеrе vеry hectic аnd error-prone. However, an efficient Healthcare Accounting Services wіth healthcare software, оnе cаn expect smooth healthcare management, wіth minimal mistakes іf аny. It enhances thе level оf productivity thrоugh tіmе saving whіlе creating bills, invoices, balancing accounts, recording patient reports etc.

Healthcare software systems all-in-all bring аbоut an increase іn quality оf thе service delivered by Healthcare Accountants аnd bring аbоut efficiency gains within thе organization; promoting patient safety, upgrading security protocols, electronic health records, computerized provider order entry. Besides thіs, electronic billing аnd claims submission rapidly generate additional savings by decreasing thе costs оf creating bills аnd speeding reimbursement.

Many healthcare software solutions incorporate features such аs administrative billing аnd financial general ledger, cost accounting systems, patient registration, personnel аnd payroll, electronic materials management, clinical computerized provider order entry fоr drugs, lab tests, procedures, electronic health record, picture archiving аnd communication systems, filmless imaging, results reporting оf laboratory аnd оthеr tests, clinical decision support systems, prescription drug fulfillment, error-alert, transcriptions, electronic monitoring оf patients іn intensive care, units, іt infrastructure such аs desktop, laptop, аnd tablet computers, servers аnd networks, wireless networks, voice recognition systems fоr transcription, physician orders, аnd medical records, bar-coding technology fоr drugs, medical devices, аnd inventory control, information security systems, physicians, administrative billing, аnd financial accounting, scheduling, clinical online references (drug compendia аnd clinical guidelines), receiving lab results аnd оthеr clinical information, online, electronic prescribing, computerized provider order entry, clinical decision support systems, electronic health record, e-mail communication wіth patients infrastructure desktop аnd laptop computers handheld technology servers аnd network.

Categories
Medicare

Healthcare Accountants and New OASIS Requirements for Accredited HHAs Seeking Medicare Certification

Healthcare Accountants wanting to become Medicare approved must seek guidance from their respective State Survey Agency

Any HHA seeking Medicare certification is required to meet the Medicare Conditions of Participation (CoP) prior to certification. This includes compliance with the OASIS collection and transmission requirements. New HHAs Healthcare Accountants must demonstrate that they can transmit OASIS data prior to the initial certification survey. Specifically, new HHAs Healthcare Accountants must apply for a user identification number and password to electronically transmit to the OASIS State System any encoded Start of Care (SOC) or Resumption of Care (ROC) OASIS assessment record(s) for applicable Medicare and Medicaid patients in a test mode. New HHAs Healthcare Accountants should communicate with the OASIS Automation Coordinator (OAC) in their state to comply with this aspect of the Medicare requirements prior to the initial onsite survey.

To meet the OASIS transmission requirements prior to the initial certification survey, new HHAs Healthcare Accountants need two different sets of user identification numbers and passwords; one set to access the CMSNet and one set to access the OASIS State System.

The CMSNet is a private communications network which allows data submitted to the OASIS State System to be encrypted during the transmission process precluding any unauthorized sources from intercepting identifiable data. The HHA must apply for a user identification number and password for access to the CMSNet by contacting the CMSNet Help Desk at 1-800- 905-2069. New HHAs Healthcare Accountants need to install the communications software, which is separate from the Home Assessment Validation Entry (HAVEN) software, which will allow them to access the CMSNet.

The new HHA must register for an individual user identification and password to access the OASIS State System. The HHA must complete and submit the OASIS Individual User Account Request form which is available on the QIES Technical Support Office (QTSO) website at the web link under Related Links Outside CMS.

The OAC in each SSA should assist the new HHA in obtaining the user identification number and password for CMSNet and guide HHAs Healthcare Accountants through registration for an individual user identification and password for access to the OASIS State System prior to the initial certification survey.

Once the communications software and access are in place, the new HHA must demonstrate that it can transmit OASIS data to the OASIS State System by (1) making a test transmission of any SOC or ROC OASIS data that passes CMS edit checks; and (2) receiving validation reports back from the OASIS State System confirming data transmission. The OAC in each state can assist new HHAs Health care Accounting Service with this process.

Determining Compliance with the OASIS Transmission Requirements

The OAC at the SSA can determine the Healthcare Accountants compliance with the OASIS transmission requirements from their locations; however, the HHA should maintain all copies of validation reports for its own records.

If the new HHA chooses to independently transmit OASIS data from its own office, the State HHA survey team and the OAC must communicate with each other to establish that the new HHA has successfully transmitted test OASIS data using the appropriate user identification numbers and passwords prior to onsite survey. The HHA should maintain all copies of the validation reports for its records.

If the new HHA chooses to use a software vendor to meet the OASIS encoding and/or transmission requirement on its behalf, the HHA must still establish connectivity to the state system via the software vendor. The HHA should have a written contract that describes this arrangement. The vendor must apply for access to the new agency as a Third Party submitter. Forms are available on the QTSO website at www.qtso.com. The HHA or its software vendor must contact the OAC and CMSNet Help Desk for the appropriate user identification numbers and passwords to establish connectivity with the OASIS State System. The HHA should obtain copies of all validation reports from its software vendor for its records.

If the new HHA chooses to use another certified HHA to meet its transmission requirements, for example, another established HHA in the chain or other established but non-related HHA, the HHA must still demonstrate connectivity to the state system via the other established certified HHA. The new HHA or other HHA must contact the OAC and CMSNet Help Desk for the appropriate user identification numbers and passwords in order to establish connectivity with the OASIS State System. The new HHA must have clearly written policies outlining the procedures in place with the other HHA with regard to OASIS collection, encoding, and submission to the OASIS State System and the sharing of feedback reports from OASIS State System with the new HHA.

HHAs Healthcare Accountants Seeking Initial Certification Through an Approved Accreditation Organization (AO) with Deeming Authority

An HHA may choose to obtain initial Medicare certification by electing the deemed status option through an approved AO that has been granted deeming authority for Medicare requirements for HHAs Healthcare Accountants. There are currently three AOs with deeming authority for HHAs Healthcare Accountants: The Joint Commission, the Community Health Accreditation Program and the Accreditation Commission for Health Care, Inc.

HHAs Healthcare Accountants seeking initial certification through the deemed status option must install the necessary communications software and contact the SSA and CMSNet Help Desk for the appropriate user identification numbers and passwords in order to demonstrate compliance with OASIS submission requirements prior to approval.

Exceptions to Demonstrating Compliance with OASIS Submission Requirements Prior to Approval

New HHAs Health Care Accountants that intend to admit or treat only patients to whom OASIS currently does not apply, i.e., patients under 18, maternity, and patients receiving only unskilled care or chore services are not expected to demonstrate compliance with OASIS submission requirements prior to approval.

These HHAs Healthcare Accountants must attest this intention to the SSA. After certification, if there is a change in the HHAs Health Care Accountants policies that includes the acceptance of patients to whom OASIS applies, the HHA is expected to install the necessary communications software and contact the SSA and CMSNet for the appropriate user identification numbers and passwords.

Initial Surveys

State Survey Agencies and AOs will not schedule initial surveys until the SSA or AO has determined the HHAs Healthcare Accountants status with the OASIS transmission requirement. HHAs Healthcare Accounting Service and AOs may contact the state OAC directly to determine the status of the new HHA’s activities concerning the OASIS transmission process prior to scheduling the onsite survey. The names and phone numbers of the OACs can be found at the web link Related Links Inside CMS.