2. Opera Care
OPERA is designed to focus on “Data Patterns”.
With more than 20,000 data analytics creating probabilistic
models, most of the notifications will prompt you to make decisions
regarding the patient care you are about to provide. Error
correction of OASIS inconsistencies is always left to you. OPERA will
update analytics and coding each week as CMS changes the data
mining techniques it employs.
OPERA cannot stop 100% of your ADR’s yet is a significant tool
helping you achieve the lowest levels of ADR’s possible.By analyzing
your data patterns before you submit them to CMS, you have the
ability to clarify the care you provide by enhancing certain areas of
documentation, or assuring you have the most accurate OASIS
possible to support the care to be provided before transmission to
CMS. OPERA will also track the differences between assessments
for you.
3. Opera Care
Data Patterns Regulatory Edits
We have worked to provide you with validation edits inside of
OPERA. When encountering a regulatory edit, you will see
every OASIS question that interacts with the errant item. By
revealing the multi-relational aspects of the OASIS, OPERA will
train your clinicians to understand the OASIS assessment
much better.
When you encounter 13-20 errors, simply fix the one OASIS
item that triggered the error string and all errors go away…
4. Opera Care
Data Patterns Recertification Edits
Recertification OASIS data strings are significantly abbreviated in
relationship to the SOC OASIS data string requiring special
analytics specific to the OASIS items inside of the Re-Cert
OASIS. The error messages will guide you through the next
steps to take.
Always make sure documentation confirms homebound stats
and medical Necessity in relationship to the Medicare benefit
policy guidelines.
5. Opera Care
Data Patterns ZPIC Edits
ZPIC edits are therapy and non-therapy based probabilistic
models. If you trigger one ZPIC edit, OPERA will validate the
trigger by locating a similar edit to assure 100% accuracy in
the initial error triggered. ZPIC edits should be analyzed and
discussed with all clinicians before continuing with care.
Clinical documentation, service utilization, and frequency will
be critical topics to consider in the provision of care for your
patient.
6. Opera Care
If you have received an ADR we need to analyze it to assure our
code is updated promptly as each RHHI deploys edits at
different times.
Please use the ADR upload portal in your account to upload PDF
files for analysis.
We look forward to seeing you in the “Consultants Corner” where
we will be actively coaching you on various methods that have
proven to reduce the frequency of ADR’s and to assist agencies
through probe edits. “You ask we answer….”
The consultants corner is the most affordable consulting
resource anywhere…
Thank You for becoming a member of the OPERA team………
