Achieving Medicaid Compliance Using PrecisonCare

REGULATION	PRECISIONCARE SOLUTION
593.6 (c) Community rehabilitation services shall be provided in accordance with a service plan developed within four weeks of admission to the program.	Upon admission, the due date for the Service Plan (28 days following admission) is automatically generated and displayed on the Admission note.
593.7 (1) A full monthly rate will be paid for services provided to an eligible resident in a residence for at least 21 days in a calendar month. 593.7 (2) A half month rate will be paid for services provided to an eligible resident in a residence for at least 11 days in a calendar month.	PrecisionCare’s billing report automatically calculates the number of days the resident was in the program during the calendar month and identifies the billing cycle and the corresponding cycle code.
593.7 (b) (4) For reimbursement purposes, a contact shall involve the performance of at least one of the services indicated in the resident’s current service plan.	PrecisionCare requires the author of a billable progress note to choose a restorative service. PrecisionCare will only allow staff to choose from current service plans and active objectives.
595.14 (a) (1) Case record entries shall be in no erasable ink or typewriter; 595.14 (a) (2) Case records shall be legible	PrecisionCare generates clear legible printed reports that comply with the uniform case record.
595.14 (a) (4) Case records shall be dated and signed by appropriate staff.	PrecisionCare dates all reports and prints the author’s/editor’s name below the signature line.
595.14 (b) The case record shall be available to all the staff of the program who are participating in the provision of services to the resident.	PrecisionCare allows staff to access a client’s PrecisionCare record from any computer on the network.
595.14 (b) (8) documentation of the type of service provided, the date it was provided, it’s duration and the name of the person rendering the service.	When writing billable progress notes, PrecisionCare requires the date the service is provided, and for the author to enter a minimum of 15 minutes duration for the contact. The Author of the note and their title is automatically printed on the note below the signature line.
595.14 (c) Statistical information shall be prepared and maintained as may be necessary for the effective operation of the program, and as may be required by the Office of Mental Health.	PrecisionCare generates numerous statistical reports based on a wide range of criteria.

BILLING CRITERIA	PRECISIONCARE SOLUTION
Duration of services must be a minimum of 15 minutes long and documented on the progress note.	PrecisionCare calls for the user to enter the duration of the service and will not allow the progress note to be saved if the duration is less then 15 minutes.
Only one billable service can be selected for any given day.	PrecisionCare will warn users if two billing notes are written on the same day and will prevent billing of two services on the same day.
Billable progress notes must contain the name title and signature of the author.	PrecisionCare requires users to select the goal objective that corresponds to the progress note. PrecisionCare will only allow users to select from valid, active goals and objectives.
Billable progress notes must be based on active, valid service plans and goals.	PrecisionCare generates clear legible printed reports that comply with the uniform case record.
Billable services must be provided while the resident is admitted to a program.	PrecisionCare alerts and prevents the user from billing for services dated prior to admission, after discharge or while the resident is hospitalized.
Billing is to be based on the services identified on the admission note during the first 28 days following admission.	PrecisionCare will only allow the user to bill for the restorative services identified on the admission note during the first 28 days following admission. PrecisionCare automatically calculates the service plan due date.
Date of contact , date note written and restorative service abbreviation must be written on the billable progress note.	PrecisionCare requires the user to provide the date the note was written, the date the service was provided and automatically displays the restorative service abbreviation from the objective selected.
Physician’s Authorizations must be up to date.	PrecisionCare tracks the expiration dates of Physician Authorizations.