Prior Authorization Update

Medicare has announced the inclusion of six (6) new Prosthetic codes in the Required Prior Authorization List. This means that these codes will be required to have a prior authorization from Medicare before being delivered in order to obtain Medicare payment.

If prior authorization is NOT obtained, Medicare will NOT pay the claim.

The new additional codes are L5856, L5857, L5858, L5973, L5980, and L5987.

Phase 1 of this rollout will include California, Michigan, Pennsylvania and Texas and will begin for dates of service on May 11, 2020. (Submissions to begin on April 27, 2020)

Phase 2 of this rollout will encompass the rest of the Nation and will begin for dates of service on October 8, 2020. (Submissions to begin on September 24, 2020)

Here is a link to get more info:

https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/DMEPOS/Prior-Authorization-Process-for-Certain-Durable-Medical-Equipment-Prosthetic-Orthotics-Supplies-Items

 

To enter Code Intelligence into OPIE:

1. Log into OPIE as an Administrative User

2. Click on Administrative Tools

3. Click the Office Settings tab

4. Click the Code Intelligence tab

5. In the Code field type L5856

6. In the Insurance field click the drop down and choose your Medicare payer

7. In the Rule Type field click the drop down and choose Documentation Required

8. Click the Create Rule button

9. Under Custom Message click the blue + box next to the drop down

10. Type the Custom Message to be used

Suggested message: Medicare Prior Authorization Required

11. Click the Add/Edit button at the bottom of the window

12. Click the Close button

13. Choose the custom message from the drop down

14. Click the Save & Close button

15. In the Code field use the drop down to select the next code

16.  The Insurance field should still be populated with your Medicare payer

17.  The Rule Type field should still be populated with Documentation Required

18.  Click the Create Rule button

19.  Click the drop down next to the Custom Message field and choose the message created in step 10 above

20.  Click the Save & Close button

21.  Repeat steps 15 through 20 for the next 4 codes (L5858, L5973, L5980 and L5987)

22.Click the Show All button

23.  You may sort your existing rules by any of the column headers to view them

NOTE: These steps may need to be repeated if you have more than one Medicare payer. If you have multiple Medicare payers, it may be less time consuming to use the import procedures outlined below.

To Import Code Intelligence into OPIE (template upload file to be found here)

1.  Modify template file

2.  Log into Code Intelligence

3.  Click the Import Rules button

4.  Navigate to the file saved in Step 1

5.  Click Open

6.  The Insurance Company Name Mappings window should appear. Use this window to ensure that you have correctly identified your Medicare payer (if you have more than one payer, you will repeat this step later for the next set of rules)

7.  Click the Apply button

8.  Click the Import button

9.  The Prepare for Import window will appear which will notify you of any problems with importing any of the rules

10. Click the With button

11. Code Rules should now be imported

Please feel free to contact OPIE Support if you have any questions or concerns or need assistance with this process.

Futura Migration FAQ’s

What is happening?

The Futura Hosted environment is moving to a bigger, better, and more secure environment using the Amazon Web Services platform. As part of this process, we’ll be working with each individual customer to manage the process of migration. Our goal is to make the transition as smooth as possible, and ensure your experience with the new infrastructure exceeds your expectations.

Why is this happening?

OPIE Software is committed to providing the optimal hosting platform to help your practice be successful. By moving to this new infrastructure, we will be able to provide a greater level of service.

Will I need a new username or password?

Yes. The new environment will require a new password for each user. We will be importing usernames into the new domain soon. For Practitioner Portal users, new portal credentials will be necessary for user added/disabled or passwords changed. We will let you know when this needs to be done. As part of the migration process, a Migration Specialist will work with you to verify all credentialed users are able to access their applications prior to the go-live date.

Will I have the same published apps?

Yes but you will sign into a different web portal to access your published apps. By default, all users will have access to Futura, DBManage, and a Hosted User Admin tool. During the migration process, your Migration Specialist will assist in understanding what additional application are needed for each user at your facility.

Will I still be able to access the Practitioner Portal?

Yes, the new URL is https://portal.futuraintl.com/.

After we have been migrated to the new platform, how can I reset my password to access my published apps?

Ask one of your Futura Admin users to reset your account through the Hosted User Admin tool or you can call Futura Support at 1-800-876-7740, Option 3.

What can I expect for coordinating my migration day?

A Migration Specialist will reach out to your facility at least one week prior to your scheduled cutover date. They will provide you with a list of credentialed users, and temporary passwords for accessing the new environment and they will also give you a checklist for things to test prior to your migration,and will be available to test with you.

Will our monthly support costs change?

There will be no upfront charges to migrate you from the current hosted environment to the AWS platform since the current platform is going to be sunset. The Futura SaaS pricing has not been increased in over six years despite growing operating costs and average industry price increases of 5-7% every year. As a result of the enhancements to performance, capacity and security, in addition to a different user model there will be an increase to the monthly fees.

 

What will change?

The only changes you will experience is the loss of the Citrix application. A new website will be used to access Futura which can be found at https://login.futuraintl.com. A full walk through of the new environment can be found at the bottom of this FAQ.

I am seeing a security warning, is this normal and should I click ‘Run’?

Yes, you will get the security warning below when new executable files are pushed out. The notice is simply stating that the file does not have a valid or existing digital signature of a known publisher and Windows wants the user (you) to make the choice to allow it to run or not. This will pop up in serval areas throughout the Futura software commonly at login and when processing claims. We recommend that you click ‘Run’ and uncheck ‘Always ask before opening this file’ to stop it from always popping back up. Please note: Unchecking this box will only stop the popup until the next time new executables are push out then you will have to repeat this step.

OPIE Hosted Migration FAQ’s

How will my practice be affected?

When your practice’s migration date is selected, your system will perform one last backup at 10PM on the scheduled evening before access to your system will be locked. The migration will be performed overnight to a completely new system: all your programs, user data, documents, OPIE programs and data, and select optional features will be migrated to the new system. Your existing remote desktop icons will still work the morning after migration, but the desktop experience will have been upgraded to a Windows 10-style interface (see below for an example of how this change will appear).

If any problems should occur during the migration process, we will restore access to the original system. All migrations will be completed before 7AM/EST to ensure access to your system is available before business hours. As a precautionary measure, we will be archiving the old systems for 30 days.

Do I need to do anything to prepare?

It is crucial that you start removing all personal files and other important software from your servers. Something to remember: files saved on the user’s desktop or My Documents on the OPIE Hosted server, will not be transferred. Website URL and passwords will not transfer (unless done in Google Chrome and account sync has been turned on). Files in shared folders on the C: or D: drive (other than OPIE database files) will not be transferred. Some optional features that customers have purchased may require additional setup prior to migration. For instance, practices who have purchased support for hosting additional licensed software may have to provide those licenses beforehand or wait until the morning after migration to have those programs installed and licensed by our Support team. If you are identified as a customer with those additional requirements, you will be contacted before your migration date is selected.

What if I have questions?

The security of your system is of the utmost importance to us, which is why we are working at length to ensure a smooth migration for you and your practice. If you have questions regarding this transition, or any concerns once the migration has taken place, please review the detailed Frequently Asked Questions.

If you have any other concerns, please don’t hesitate to reach out to the OPIE Support team by phone at 800-876-7740 option 3. Thank you for choosing OPIE Software to be your partner in practice management!

What time do I need to be out of OPIE on the day of migration?

To allow us to migrate your system and have it available for your use the next morning, all users in your system (regardless of physical location) will need to be out of OPIE by 5:00pm EST.

OPIE Fax FAQ’s

What is OPIE Fax?

OPIE Fax is a cloud based, digital fax service (no traditional fax machine necessary) that integrates with the OPIE Software platform. You can send a fax directly from the patient chart, or other OPIE applications simply by printing the document to the OPIE Fax printer. You can also send a fax directly from the OPIE Fax website.

Is OPIE Fax HIPAA Compliant?

Yes. OPIE Fax provides industry standard, end-to-end encryption for both incoming and outgoing faxes.

How much does OPIE Fax cost?

OPIE Fax Activation Fee$250
OPIE Fax Per Page (Monthly Minimum of $25)$0.06
OPIE Fax Additional Line (Monthly Fee per additional line)$10.00
OPIE Fax Per User Fee (Monthly Fee per user)$5.00

For Example:

  • 400 pages, 1 ADDITIONAL line, 1 user = $25 Monthly Minimum + $10 + $5 = $40
  • 1000 pages, 1 ADDITIONAL line, 1 user = ($0.06 x 1000) + $10 + $5 = $75

 

How do I get started with OPIE Fax?

The OPIE Customer Success team will be conducting webinars to demo the OPIE Fax system and to provide instructions to move forward. For now, there are a few things that you can do to prepare:

  • Compile a list of fax numbers that you would like to use.
  • Identify your internal OPIE Fax Administrator(s). The OPIE team will need their email address(es).
  • Review your General Contacts, Referring Physicians, and Insurance Companies in OPIE Dex. If you would like, the OPIE team can import any contacts that have a fax number on file to your new OPIE Fax address book.

I’m not an OPIE Plus (Hosted) customer, can I use OPIE Fax?

OPIE Fax is only available on the OPIE Plus platform.

Who needs an OPIE Fax user account?

Only users who need to send outgoing faxes from the OPIE Fax website or access incoming faxes need user accounts. Users that only need to send outgoing faxes from the OPIE Software platform do NOT need a user account. However, if you need to specifically track the person that sent each outgoing fax, you will need to create accounts for all users sending outbound faxes.

Who creates OPIE Fax user accounts?

The OPIE team will send an invitation email to your designated OPIE Fax administrator(s). Once their account is setup, your internal OPIE Fax administrator can easily add additional users by logging into the OPIE Fax website and clicking Users > New user > Invite User. Please note that you will be billed $5 per user per month.

How do I receive incoming faxes?

When a fax comes into a given fax number, all users tied to that fax number will receive an email notification. You can use the link in that email to log into the OPIE Fax website and access the faxed document. If you have a secure, HIPAA compliant email address, you can also choose to have a PDF of the fax attached to the email notification.

How do I send outgoing faxes?

OPIE Fax works like a printer. From any of the OPIE applications, you can print a document, select the OPIE Fax printer, and send a fax. You will be prompted with a list of your OPIE Fax contacts along with various other settings, like whether to prepend one of your cover pages. You can also visit the OPIE Fax website to send a fax from anywhere via a web browser.

Can I use a traditional fax machine alongside OPIE Fax?

Yes, you can contact OPIE to purchase a FaxBridge to connect your fax machine to the OPIE Fax system.

Can I send international faxes?

No, currently international faxing is not enabled for OPIE Fax.

OPIE Help for Apple iPhone & Mac

Summary

When visiting OPIE Help on an Apple device (iPhone, iPad, Mac) using Safari browser, the help website does not display. Instead of OPIE Help, the website shows a login screen for Upland Right Answers.

Solution for iPhone

Apple Safari users will need to change a browser setting to access the content.

1.Go to Settings then click Safari menu

2. Scroll down to Privacy & Security section and Uncheck the box for “Prevent cross-site tracking.”

3. Visit opiehelp.com and log into your OPIE account.

Solution for Mac

Apple Safari users will need to change a browser setting to access the content.

1. In Safari app, go to Preferences menu, then click Privacy tab.

2. Uncheck the box for “Prevent cross-site tracking.”

3. Visit opiehelp.com and log into your OPIE account.

 

Alternatively

On apple device, it is safe to use Google Chrome or Mozilla Firefox browser instead of Safari. These do not require a change to your browser settings.