Hospital Data Submitter Portal Training Participant Reminders
Submit your questions via webinar chat feature. Get updates on go-live date, outcomes of testing phase, payer and LOS crosswalks, and validation requirements. Learn about the necessary documents for validation and how to pass validation for payer and location of service fields in both inpatient and outpatient data.
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Presentation Transcript
Hospital Data Submitter Portal Training Participant Reminders: Please mute your line. Please submit your questions via webinar Chat feature. We will address as many questions as possible at the end of today s webinar. For those questions we are unable to get to answers will be distributed to the group August 4, 1:00 2:00 pm EST
Agenda Welcome & Updates 5 minutes Portal Demo 30 minutes Testing Summary 5 minutes Review of Timeline 5 minutes Payer and LOS Crosswalks 5 minutes Closing and Questions 5 minutes Validation Updates 5 minutes 2
Go Live Tuesday, August 2nd Welcome and Welcome and Updates Updates 3
Outcomes of Final Phase of Testing 1. Over 150 files submitted Testing Testing Summary Summary 2. 75% passed structural validation 3. Issues that failed were in the following categories: Issues with payer or LOS crosswalks b) Zero filled date fields c) Low population rates and minor code list errors a) 4. Submitters can solve majority of issues with overrides. 5. A few hospitals had a large number of validation issues during testing. We have been working with them directly. 6. Summary of revisions we made to validations as result of final phase of testing. 4
Payer Crosswalks (required) Needed for the validation of Payer ID and Payer Name in both Inpatient and Outpatient files Crosswalks for Crosswalks for Validation Validation Location of Service Crosswalk (situational) Needed for the validation of Location of Service in Outpatient files 5
Payer Crosswalk Required to pass validation for Payer Fields in Inpatient and Outpatient data: IP3004 Payer Identification Number IP3006 Payer Name OP3004 Payer Identification Number OP3006 Payer Name 6
LOS Crosswalk Situationally required to pass validation on Location of Service (LOS) field in Outpatient data: OP4005 Location of Service: To be used by those facilities that wish to report physician office/clinic data on the same file as facility data. 7
Requirements Your files will fail the related validations if your crosswalks are not provided and loaded to the portal prior to submission. 8
Crosswalk Updates List updates due every 6 Months Next update due in February 2017 Updated crosswalk files will be a full replacement of previous versions. Validation thresholds for fields validated against crosswalks will be relaxed (from 100%) to accommodate interim additions without triggering validation failures after initial submission period. 9
1. Validation Removals or Adjustments since Phase 5 Testing 2. Validation Clarification Future Change Validation Validation Updates Updates 10
Validation Removals or Adjustments 1. OP2011 Admission/Start of Care Date Rules: Removed a. Rule ID 322, Admission/Start of Care Date Populated: Removed. b. Rule ID 323, Admission/Start of Care Date Before Statement Covers Period Thru: Removed. 2. IP7034A/IP7035A Valid Present On Admission Rule IDs 142 and 144, Indicator #1 and #2: A when not blank condition has been added to the rule logic to match similar Valid POA validations (both in the 70 ICD-9 record and the 73 ICD-10 record). 3. OP6108, OP6115, OP6122 Service Units: These fields previously only accepted whole number units. The fields have been adjusted to allow for decimal places 11
Validation Clarification & Future Change OP4004 Valid Type of Bill, Rule ID 353- A Databay validation had required Type of Bill to be populated on all claims; therefore, providers had to submit all outpatient data with Type of Bill populated, even though the submitted claims may have been professional (CMS-1500) rather than institutional (UB-04). In response to this faulty validation, some submitters created a workaround or fix to provide a Type of Bill when it did not exist, most often by translating the Place of Service code from a professional claim into the closest equivalent match from the Type of Bill code set. In order to correct this issue and improve the quality of the hospital outpatient data, the MHDO is requesting that providers: 1. Always report Type of Bill only for institutional claims; and 2. Leave Type of Bill blank for professional claims. The MHDO is already considering adding a Place of Service field to the next revision of the Chapter 241 OP layout and new validations for Type of Bill and Place of Service in a future release of the hospital data portal. 12
1. Submitting a File 2. Viewing Submission History 3. Viewing Validation Results and Resolving Issues 4. Requesting an exemption 5. Updating information (including contacts, data streams, vendors etc.) 6. Help Resources (Help Desk Contact, User Manual, FAQs) Portal Demo Portal Demo 13
Review of Review of Timeline Timeline 14
Data Submission Timeline Task Start Date End Date Hospitals submit Q3 2015 (if not previously submitted), Q4 2015 & Q1 2016 data. 8/2/2016 8/31/2016 Hospitals submit Q2 2016 9/1/2016 9/30/2016 Hospitals submit Q3 2016 10/1/2016 12/30/2016 Hospitals update contact info & crosswalks 2/1/2017 2/28/2017 Hospitals submit Q4 2016 1/1/2017 3/31/2017 15
Will the presentation be available afterwards? Yes. The presentation will be posted to the MHDO Website. We will email a link to all participants as soon as the presentation is available. Questions? Questions? 16
Portal Help Desk Portal Help Desk Email: mhdohelp@norc.org Toll-Free Phone Number: (866) 315-7125 Available:8:00 AM 5:00 PM EDT, Monday Friday Compliance Help Compliance Help Contact: Kimberly Wing, Compliance Officer, Maine Health Data Organization Email: kimberly.wing@maine.gov Phone Number: (207) 287-2296 MHDO Website MHDO Website Hospital Data Submitter Page Hospital Data Submitter Page https://mhdo.maine.gov/hosp_data _submitters.htm
