Massachusetts All-Payer Claims Database Technical Assistance Group Agenda
Explore the agenda and updates from the Massachusetts All-Payer Claims Database Technical Assistance Group meeting, covering topics such as ICD-10 testing, post-partum coding, enrollment trends, risk adjustment, and more.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Massachusetts All-Payer Claims Database: Technical Assistance Group (TAG) October 13, 2015
Agenda Housekeeping ICD 10 Testing DPH Post Partum Coding Enrollment Trends Update Risk Adjustment Updates Wrap Up
Housekeeping Version 4 Variances/Files Pharmacy Claims Versioning Data Profile Reports
ICD-10 Testing ICD-10 Testing Ready October 2015 (2015_10) set up in TEST No requirement to test Any issues contact your liaison
DPH Post Partum Coding DPH Regulation 105 CMR 271.000 Post Partum Depression Screening/Reporting HCPCS S3005/Diagnostic Range V24/Modifiers U1/U2 Service Code may be set to pay at $.01 Further information contact DPH or your liaison
Enrollment Trends: October Update Ashley Storms | Senior Health System Policy Analyst October 13, 2015
Enrollment Trends: Cycle 2 Timeline Sept. 2015 Oct. 2015 Nov. 2015 Dec. 2015 Jan. 2016 Follow-up on remaining data issues Supplemental enrollment reporting (identified payers) Sept. 2015 file submission Data analysis Payer data verification Reporting
Enrollment Trends: Resources Questions may be directed to your CHIA liaison or to Ashley Storms at ashley.storms@state.ma.us at any time.
Risk Adjustment Small Group 51-100 Designation Member Month Tracker Sign Off Simulation Data Supplemental Diagnosis
Member Month Tracker Report After reviewing this Tracker with your team for completeness, please sign this page and return to CHIA within 30 days of receiving the report. If a discrepancy arises, you will be asked to identify and resolve issues to be fixed and work with CHIA on a timeframe for correction and possibly file resubmission. If you neither confirm that the data in the Tracker is accurate nor report any data discrepancy, the Connector and CHIA will assume that the Tracker report is accurate and that no discrepancies have been identified. Signature below must be from an officer of the company, preferably in the financial and actuarial area. Signed: Print Name: Carrier: Submission Year-Month:
Simulation Data Next Simulation: Q4 2015 July 1, 2014 June 30, 2015 Claims Paid Through September 2015 Data Due: October 30, 2015 All data must be in and passed edits by 10/30/2015
RA Supplemental Diagnoses (SD) Quarterly Submission March, June, Sept, Dec September 2015 due by October 30, 2015 Submission Guide is on our website Optional SD is an optional submission for RA only Notify Liaison
Next Meetings November 10, 2015 @ 2:00 pm December 8, 2015 @ 2:00 pm
