Is anybody else having problems with DDE black screen.  Every time I log in it tells me I already have a session open on this terminal.  I have disconnected, logged out and rebooted my computer.  This has been going on for days.  If I am lucky I will get logged in once a day. 

We have discoved when a patient is transfer then resumed if the transfer is approved after the nurse does the ROC then everything the nurse puts in is wiped out and the status is changed to on hold.  Do other agencies really get transfers done that fast, before the ROC is done.  We are always a few days behind and if the transfer has to go back to the nurse for correct it might be four or five days.  

We have also found this same problem if a patient is discharged from one insurance then readmitted the next day under a new insurance.  If that discharge is approved after the nurse readmits it wipes out all of her care plans, etc. 

Just wondering how other agencies are making sure that one gets done before the other.

We discharge and readmit when going from anything to a PDGM payer but in the past we did not when going from one commercial insurance to another or from a PDGM payer to Medicaid etc.  Our old system was date driven and it worked so easily.  Nothing changed, we ran off the same care plan, etc.  However, Axxess tells me the best practice is to discharge and readmit when changing payers.  Axxess did give me the step by step on how to change payers in the middle of an episode but it wipes out the care plans, frequencies, etc. and we have to put all of that back in.  

Wanted to know if anybody was doing the change insurance and is it easier than discharging and readmitting?

Thank You

Does Axxess have the Medicare Secondary Questionnaire for the RN to complete anywhere in the system?  Our old system had it incorporated into the assessment/oasis.  I logged a ticket but was told that the questionnaire was not required.  All that is required is to check that Medicare is primary so eligibility covers that.  I wish that was true but I know it is not.  I even sent them links to Palmetto website to show it is required but Axxess reads it differently I guess.  I hate to print a paper questionnaire and start yet another paper based process.

I was wondering what everybody's experience is with changing HH CAHPS vendors.  We changed from Deyta/ Healthcare First to Axxess.  When using Deyta we did not say anything to the patients or include anything in the new patient folders about the survey.  Deyta sent from 20 to 30 surveys a month and we would get back between 5 to 12 per month.  We changed to Axxess and we get between 0 to 3 a month back.  At this rate we will never get our 40 per year.  We have added axxess' survey information to our new patient folders along with a copy of the envelope.  We have told all the nurses to make sure to talk to the patients about the survey when going through the new patient folder with the patients and/or family.  We have put on our Facebook page about changing and where new surveys will come from.  We had Axxess up the number of surveys they were sending to get us back in the 20 to 25 range.  But we are still not getting but one or two back.  I don't know what else to do.  We have not had Axxess start calling patients.  From speaking with other agencies they say it does not work and that it upsets patients.  Does anybody here care to comment on their experience with have Axxess call patients.  I am looking for ideas.  If something does not turn around in December we will have to look at going back to Deyta which I hate because we are under contract with Axxess and I don't want to pay for something we are not using but not getting surveys will put us out of business under VBP.  Somehow Deyta was getting it done without us doing anything.

I would love to speak with somebody that can get their month end to balance.  I can't get anything to balance in this system.  I can't even find a report that we can balance our daily deposits back to.  I can't get answer on the month end reports on if the revenue number are for all claims that should be billed in a specific month or is it just the ones that have been sent out.  Just a mess.  Please let me know if you can help.

Need help with several issues.

Readmission issues:
If we have a patient dc then readmit sometimes it works fine and sometime it screws up the blling.  Example of Patient A

This patient was admitted on 6/17 and the NOA generated and the first final generated without issue.The patient was discharged on 8/4/22 and the second billing period now states that an NOA is needed for some reason.  Then readmitted on 8/19/22 and the NOA did not generated (I created on and entered it manually) and now the final to this one is like it is part of the original admission and that no NOA is needed.

Another issue is the referral information upon readmission.  When we readmit a patient the system only allows us to go in and edit the information on the previous referral.  We document a lot of stuff in a referral and that is our legal document of who we spoke with and what they told us.  Yes we get stuff faxed to us or from the other providers portal that we can upload to documents but we all know the real important information comes from what they tell you.  Like that last phone call you get stating that the patient is leaving the hospital and a specific IV was given at such a time so that is when we are going to start calculating when we need to give the IV next.  Those notes from the hospital will not be dictated for days or weeks even.  The only thing I can think to do is go back to a paper based referral that we upload to documents but that is another duplicate process that causes us more work.

Another thing the system does not seem to handle well is when a patient switches insurance.  For example a patient is admitted on 9/1 under Medicare for a wound.  The wound heals on 9/14 but we are going to continue medication prefills which is a Kentucky Medicaid service.  We go in and change the insurance under Manage episodes.  But the system will pick up KY Medicaid for both the Medicare and the Medicaid services.  Our old system was date driven and we would put a date in along with the payer and the system would split the claims by date.  I have also found this issue when a patient switches between insurance like they were traditional KY Medicaid then they switched to Wellcare Medicaid.  Wellcare will show up on both claims.  I was told by Axxess that we needed to dc and readmit to get the payers to change.  That is a waste of time and money to send a nurse out to do a new oasis and all that admission paperwork.  I would not mind if it was a "fake dc" in the system and we did not have to do a whole new oasis.

On the billing and readmission when a patient is readmitted and the claim is not complete for the previous admission then the previous bill shows all the information from the new admission.  Such as it will have the patient as still admitted instead of dc, it will have the new diagnosis codes, admission date (or it does not know what to put in and it is blank then we have to look it up and put it in).

This is a mess.  It is like Axxess does not understand how home health works other than a basic overall knowledge.  I don't care the provider, patients change insurances all the time, patients get readmitted or changed to their other payer due to program coverage and I will never be able to bill next day.  We have orders to get back, billers go on vacation, we usually hold billing for a few days to make sure everybody has got their documentation in.  I know this happens to everybody or it does to all the agencies I talk to on a regular basis so I am in hopes that somebody out there has found a workaround.

We are new to Axxess.  Started transitioning patients over in May.  We are having lots of issues.  Real issue when a patient is readmitted.  We can't figure how to get back to our old stuff, like the patient referral.  All the system lets us do is change the information that we entered for the original referral.  If the patient address has changed or if there was specific notes about the original referral that stuff is gone.  Often billing will not be correct upon readmission.  For some reason it does not pick up the new admission and Axxess cannot seem to figure out way.  Another big issue is if we have a patient for only a short time like a week and the nurses discharges and ends all of their goals and interventions then none of that stuff shows up on the care plan with QA starts on it.  When a patient changes insurance from like Medicare to Medicaid or from one Medicaid MCO to another the system often just picks up whatever is the current insurance and generates a bill for that for the old dates of service.  It is like the system is not date driven at all.  RCM has all sorts of issues.  Our remittances are messed up.  Some will have all the information except the dates of service and the Medicare prints the amount that the episode should pay and does not show the sequestration amount.  We then have to calculate the sequestration and subtract that from the payment shown to get what was really paid.  Then with rounding we are off a few cents here and there.  I am going to multiple places each day to print a decent EOB.  This is my third clearinghouse and I have never seen anything like this.  Then RCM does not have any kind of an override to send the claims through even if RCM thinks the claim is wrong.  Like KY Medicaid always uses a 321 type of bill for home health (first claim, last claim and everything in between) and Humana Medicare always uses a 322.  I have been billing like this for years and never had a problem.  My previous clearinghouses either had an override and/or they have turned off the edit on certain payers for me.  When I log a ticket I am told that I need to fix the TOB and it will all be fine.  I have went around for days about this.  Then I am scared to death the CAHPS surveys are going to take us down.  They are only sending out 8 or 11 survey's per month.  Our old company would send out 20 to 30 per month.  I know there is a calculation but I had 8 surveys sent out for July and we had way more new admission that would have been eligible for  survey than that.  I think in three months of surveys we have received 2 surveys back.  That will never get us 40 per year.   With VBP measures coming from these surveys this could be a disaster.    

Just wondering if anybody else has these issues and if you have found a way to handle it.  Any help is appreciated. 

When doing an assessment on this tablet the screen flips sideways even when we turn the auto rotate off.  I thought it might be due to the tablet size so we tried it on a small iPad and it did not flip.  The nurses like it better when the assessment is vertical so they can see more of it.  Does anybody know how to keep the assessment from flipping?