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Your Questions!
updated 2 months, 1 week ago
22 Members
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81
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I really had issues w/ Quiz question #1. I answered it as “who resides in their home and needs medical attention”, and got it wrong. I looked back at my notes and that is what it stated as well, very confused.
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Alice, thank you for your question. We’ve posted our Friday Q&A session in the course…check it out!
https://online.pmbinstitute.com/lessons/day-5-hh01-qas-with-petria/-Petria!
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Good Morning, I wanted to know how to view your test what grade you got. After i completed the test it did not show me if i passed or not. It took me to another screen after i completed. Thank you.
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Thank you for your question. We’ve posted our Friday Q&A session in the course…check it out!
-Petria!
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This reply was modified 9 months ago by Petria.
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This reply was modified 9 months ago by
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If there is a child that is on the chip insurance (government funded) can they receive the same Home Health services offered to the patients that we see for post acute? I know that with private insurance there are some services that are offered at home, just was curious
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Hi Petria! I have a question on this week’s quiz, question #6. Once everyone is done taking the quiz, can we discuss or you could reach out to me privately.
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Tiffany, thank you for your question. We’ve posted our Friday Q&A session in the course…check it out! In regards to your question on #6…that was our mistake, the answer was True! We’ve corrected it and made a note in our system for your quiz.
-Petria!
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Can we do more than one module per day?
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Cindy, thank you for your question. You can only do one(1) module per week, but you CAN do multiple days in one sitting. We’ve posted our Friday Q&A session in the course…check it out!
-Petria!
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This reply was modified 9 months ago by Petria.
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This reply was modified 9 months ago by
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I am wondering if the study guide is able to be printed? I don’t actually find a study guide except for the printed text that goes with the video. Is that the study guide? I am also not sure if this is the discussion board or if it is the forum.
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Cindy, thank you for your question. The study guides are available via the left navigation bar under ‘Study Guides’ as well as at the top of the description of every module. They are online embedded flip books that can be read online only. Let us know if you run into any problems accessing them.
-Petria!
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I also had an issue with question #6. Unless I read it wrong I think I had the correct answer.
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Cindy, thank you for your question. In regards to your question on #6…that was our mistake, the answer was True! We’ve corrected it and made a note in our system for your quiz.
-Petria!
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I need clarifications on some questions on the quiz but I am not able to print/view the questions anymore after I got my score
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Paula, thank you for your question. Once you finish each week’s quiz, you’ll be presented w/ the following screen:
https://online.pmbinstitute.com/wp-content/uploads/2020/05/Module01QuizResults.pngThis screen will only show up and be available ONCE (you CANNOT see this screen again). The screen shows:
-the number of questions answered correct
-the time it took for you to complete the quiz
-your grade as a percentage
-the ‘view questions’ button is what you can push to see/review your correct/incorrect answers
-the ‘click here to continue’ button is what you can push when you’re ready to move forward in the course. ONCE YOU CLICK THE BUTTON YOU WILL NOT BE ABLE TO SEE YOUR CORRECT/INCORRECT ANSWERS AGAIN.-Petria!
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Aloha, is there a way to view your test?
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Trish, thank you for your question. Once you finish each week’s quiz, you’ll be presented w/ the following screen:
https://online.pmbinstitute.com/wp-content/uploads/2020/05/Module01QuizResults.pngThis screen will only show up and be available ONCE (you CANNOT see this screen again). The screen shows:
-the number of questions answered correct
-the time it took for you to complete the quiz
-your grade as a percentage
-the ‘view questions’ button is what you can push to see/review your correct/incorrect answers
-the ‘click here to continue’ button is what you can push when you’re ready to move forward in the course. ONCE YOU CLICK THE BUTTON YOU WILL NOT BE ABLE TO SEE YOUR CORRECT/INCORRECT ANSWERS AGAIN.-Petria!
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i cant seem to move forward in anything after i did the
<h1>Terms of Use & Privacy Policy Disclaimer module </h1><h1>and i have tried to login into a different browser and it did not work. please i do not know what to do </h1>
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I had the same problem, I was using my tablet. But when I switched to a computer it allowed me to move forward
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Bukunmi,
Thank you for your question. You’ll want to read/review both policies, then scroll to the very button and click on the text in the box under the section titled ‘Quizzes’. This will take you to the agreement page, where you’ll check the box and then submit. Let us know if you continue to have difficulties.
-Petria!
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I have a question about one of the questions on the last test. In some states home health can remove stitches.
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This is true. In CO, I know you can.
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Hi Ladies, I don’t see a question about stitches? Was that on Module 1 or 2? Or please direct me to where you are looking. Thanks.
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Was on quiz one question 10
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How do the states get picked for each Jurisdiction?
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Did you get the answer to this?
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How can you print the study guides?
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I have tried everything and I cannot get it to print either. I also like to have paper in my hand to study so I can highlight and write on it. I don’t understand why we cannot have the option to print it if we want to?
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She posted elsewhere that there is no way to print them. I agree that on paper is much better
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Good Afternoon,
On the quiz were some questions that I did not see in the study guide, The questions pertaining to the claim payments and the LUPA.
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This reply was modified 9 months ago by Maria Angela Gundy.
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Hi Maria, the LUPA payments are based on which Clinical Grouping the patient falls into.
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This reply was modified 9 months ago by
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Had a few issues with Quiz 2. On the question related to the ” what information should a home health use before care is provided to the pt?” The only correct answer was OASIS, however wouldn’t doctors orders be required before even the SOC is done and wouldn’t patient information also be petinent in collection for OASIS?
Also there was a question related to the substantial change in care and adjustment in payment (mentioned 73/74, which honestly I don’t recall being covered at all), wasn’t the SCIC payment done away with?
And in relation to the LUPA payment, under PDGM would the numbers remain the same? I have seen some LUPA thresholds as high as 6 for some institutional SOC and as low as 1. Are we still to follow the previous definition of LUPA? ( I believe the question asked how many visits would constiture a LUPA)
Thank You,
Oma
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Hi Oma, that question was asked incorrectly. The answer should be a verbal order from the physician is what is needed before the HHagency goes out to see the patient.
LUPA visits now are based on Clinical Groupings under PDGM.
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My next question then would be, the question on the quiz related to the LUPA and the change in payment related to basically what would be a SCIC, assuming that the quizzes will be similar to what is on the final exam, how would we go about differentiating what needs to be answered. The Lupa question has the right answer of 4 on the quiz but since that is no longer the case, will that be changed? Same in related to the question about the SCIC payment. I initially answered that there would not be a change in payment since SCICs do not change the payment anymore, and got it wrong. Please correct me if I am wrong. I think some others were confused about the 73/74 question. (I don’t recall it being covered at all to be honest).
Oma
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Hi Oma, you are running all of your questions together and I’m having a problem understanding what you are trying to ask. It will be helpful if you form your questions as such: 1. What is this? 2. What is that? and so forth. This way I can be sure to answer correctly.
1. However, for now I will say as for a LUPA I answered it earlier for Maria. that LUPAs are paid according to the Clinical Grouping the patient falls under.
2. As for 73/74, I answered that earlier also. That must’ve been a glitch because I’m not sure what that is.
3. SCICs are gone, yes. However, clinicians have started calling Followup OASIS’ = SCICs to represent a change in the patient’s condition. Just know we mean Followup.
I hope I have answered your questions.
Also, please for now only ask questions via the Forum under the “Your Questions” group and not create multiple forums. I’m thinking about creating a Forum for each Module, however.
If you want to ask me something privately, you can always put it on your timeline and that will be for my eyes only.
Thank you
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oh to answer your question about what needs to be had before SOC, yes the answer should be the physician’s verbal order. I will make sure the quiz is corrected. Thanks.
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Hi Petria! I just have a question regarding the previous quiz. The correct answer for this question “In the federal register, a RAP is viewed as a claim, normally” is ‘False‘. Would you be able to explain further why it is False? I’m just a bit confused.
Thank you so much! 🙂
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Hi Kimberly.
I will try my best to explain.
According to the Federal Register, a RAP is not a claim. It is not called a claim when you are performing your billing and submitting it. Only the final claim is referred to as a claim during submission.
However, if that same RAP & final claim were to be reviewed and then, say they were to accuse you of fraud, at that time the RAP will be considered as a claim the same way the final is considered as a claim
The Medicare Claims Processing Manual says:
10.1.12 – Request for Anticipated Payment (RAP)
(Rev. 4489, Issued: 01-09-20, Effective: 01-01-20, Implementation: 07-01-19)
The HHA submits a RAP to their A/B MAC (HHH) to request the initial split percentage
payment for an HH PPS episode/period. The RAP may be submitted after receiving
verbal orders and delivering at least one service to the beneficiary. Though they are
submitted on standard institutional claim formats, the RAP is not considered a Medicare
home health claim and is not subject to many of the stipulations applied to claims in
regulations. (NOTE: RAPs may be considered claims for purposes of other Federal laws
and regulations.) In particular, RAPs are not subject to the payment floor, are not subject
to interest payment if delayed in processing, and do not have appeal rights. Appeal rights
for the episode are attached to claims submitted at the end of the episode.I hope this helps to explain it.
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Is there a reason we can’t rewind the video anymore? I sometimes need to rewind as the acronyms and their definitions sometimes pass to fast.
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Hi Oma, it has been set back to be able to rewind.
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Hi Petria, I somehow marked the survey complete without ever performing. The screen was blank and then the complete button appeared and well it’s been a day . Sorry about that it was totally unintentional. Judi
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Hi Petria! Is ‘Axxes’ an example of a clearinghouse? I got a bit confused on that module. Thanks in advance! 🙂
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Yes they do market themselves as having the capability of being called a “clearinghouse”. You need to just compare all companies, apples to apples.
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Hi Petria! I hope you’re having a nice day 🙂 I’d just like to ask if you know and can explain what the reason code U5391 means. Also, what should be done when that reason code comes up? We got this reason code on AXXESS. I’m new to billing and the home health care I work for is relatively new too, so there;s a lot we don’t know yet. Appreciate the help. Thanks so much! 🙂
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Hi Kimberly,
I would like for you to figure this out. It does not do you any good for me to just tell you the answer. By module 7 we do go over reason codes. However, you should look up the code either on DDE or go to your MAC and search for that reason code’s definition. Let me know what you find. Good luck! By the way, this is a very common reason code so you need to know how to navigate this one.
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This reply was modified 8 months ago by Petria.
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This reply was modified 8 months ago by
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In regards to the institutional vs. community explanation in Module 6, Day 2; On the final we report a 61 or 62 but what if the hospital or SNF hasn’t billed? You said to check but what if they have not billed? Do we hold the claim? I was under the understanding that Medicare would reprocess that claims once the inpatient facility submitted and their claim processed if a HHA should have been paid as institutional but was paid community because there were no inpatient claims on file. Have you found that having a 61 or 62 on the claim affects your payment if there are not inpt. claims on file? We have been working with our software to identify the billed vs. pd. HIPPS and are keeping track in a spreadsheet but curious as to what others are seeing.
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This reply was modified 7 months, 4 weeks ago by Tiffany.
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Hi Tiffany, you are to only put those codes on the final claim not the RAP. There is no need to hold the claim. It’s up your agency’s discretion how they wish to handle this. Either you can wait and let CMS correct your claim (if that ever happens) or you can do yourself with the 61 or 62. The agencies we bill for are adding the 61 or 62 when needed.
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Right, I know it is only on the final and we have been billing with 61 and 62, respectively, but I have had claims not pay institutional when there are those codes on the claim because there is not an inpatient claim on file. I was wondering if you were seeing the same thing. HIPPS shows institutional, Medicare downcodes to community, check HETS and there is no inpt. Claim on file But we know the patient was inpt. Code 61 or 62 did not matter on the claim because there was no inpt. Claim on file..
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No we are seeing these get paid. You are in our FB group. Ask this question in there and see if anyone else is experiencing this. It should pay you institutional. Why are you saying it is being downcoded? Where are you seeing the downcoded HIPPS code?
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On the remittance. I will post it there and see. Thanks!
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This reply was modified 7 months, 4 weeks ago by
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This reply was modified 7 months, 4 weeks ago by Tiffany.
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This reply was modified 7 months, 4 weeks ago by
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Hi Petria,
I have a question on this weeks quiz.. on question number it asked anout
The HHA can submit a Request for Anticipated Payment, or RAP, to Medicare when all of the four following conditions are met.
- After the OASIS assessment is complete, locked or export ready, or there is an agency-wide internal policy establishing the OASIS data is finalized for transmission to the national assessment system;
- Once a physician’s verbal orders for home care have been received and documented;
- A plan of care has been established and sent to the physician; and
- The first service visit under that plan has been delivered.
The answers on the quiz did not allow me to select them all, or it did not have an option for all of the above. I marked 1 of the correct answers and i still got it wrong.
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Yes we corrected that. You are correct it should be ALL. The quiz builder within the dashboard didn’t have a correct answer marked and unfortunately any answer you made would have been marked incorrect. Thanks.
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Petria,
Day 4 is not coming on just runs its course but nothing
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I am having the same issue, I tried to wait and give it another try but it just does not work
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On this weeks quiz, I have 2 questions,
on question number 15 and episode is considered early for the first __ days of care, the options were 180, 100, 90 and 120. Can you please clarify what was the correct answer, I thought it was 30 but that was not a choice.
and on 18 – Pac Post acute care consists of the following, IPF< IRF, LTCH and SNF, I marked all and it marked it incorrect, but it the study guide it says its correct.
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Yes 18 should be all and has been correct.
15 has been reworded to Under PDGM, an “early” claim can only be considered early for the first ______ days of Care, and yes it is 30.
Thanks!
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On question 11. Nursing G Code G0300 stands for Skilled License Nurse-direct patient care.
My answer is False because the question is incomplete.
G0299 Skilled License Nurse-direct patient care. (RN)
while G0300 Skilled License Nurse-direct patient care. (LPN)
On question 15. The answer should be 30 right?
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Hi Paula. Yes and Yes. The quiz was corrected.
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Good Afternoon,
is there no study guide for week 8,
Thank you
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When will study guide for week 8 be posted?
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Good Afternoon,
Is there going to be a study guide for this week? As well as are we going to get one for week 8?
Thank you
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will you offer billing program for tele-monitoring?
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Yes but not until Q1 of 2021
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I am having an issue with Palmetto denying my RAP for error code 255, any suggestions? I have reviewed my diagnosis coding but continue to have issues. I am using Palmetto GBA.
Thank you for any help you could give!
Heather
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Is there a way to go back and print the quizzes to have to study for the final?
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No it is not. We will different questions over the same subject matter of course on the final exam. The review is in module 10 week 2
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ok, thank you.
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Hello Petria, First of all let me thank you again for the information about the biller profile. It was very nice from you and I really appreciate it. I also would like to ask you if you could please double check the sound in this module’s videos. I don’t know it is happening just to me or if everybody is having the same issues with the sound. It is very difficult to understand and it isnt clear like in the previous modules. Thank you in advance for your help.
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Hi Petria! Hope you’re doing well.
Why can’t we access the Study Guides anymore?
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Did you get access yet? My apologies for just now seeing this. Did Rhonda take care of you?
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Just took Quiz number 1 for the 6 week course, I don’t remember there was a discussion about HHC Episode. Also, a couple of questions, if an individual has Medicare Part B and Medicaid would you be able to provide services? Would they need to be billed under Medicare and then under Medicaid?
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When can we bill Part A and when can we bill Part B?
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Hi. In what regard are you referring to?
As long as the patient has home health benefits under Part A or B, there is nothing you have to do. The Medicare Trust Fund will say “where” the funds for your services will be pulled from for payment.
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Ub-04. As, you were going through UB-04, you mentioned that we need to put the charge amount on the claim. Where can we get accurate charge amounts?
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Your charge amounts is something you come up with, with your CPA or accountant by looking at your numbers for your business. Your charge amount does need to be the same across the board for all payers.
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Thank you, doesn’t Medicare charge through pdgm?
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No. Medicare reimburses you through PDGM calculations. That’s different from your charge amount. You are asking about 2 different things here.
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@Petria Hello Petria, I am trying to take the quiz and it is giving me this error. You have already taken this quiz 2 time(s) and may not take it again.
What should I do?
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Yes, I had this same problem and can no longer move forward.
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