Title: Message

Under consideration is a signed electronic certification document (BBA requirement) appended externally to the ISA-IEA communications envelope of a data file.  Would this be a violation of X12 transmission standards?  For details, please see information below.  If you have questions concerning contents of this email, please contact me.  Thank you in advance for your assistance.

   

 

 

BACKGROUND

 

Current Data Submission Forms Attesting to Accuracy, Completeness, and Timeliness

Currently, with regards to encounter data Arizona requires encounter data certification forms to be on file prospectively prior to encounter submissions.

 

         An Encounter Submission Notification form signed by the CEO or Administrator, which states that MCO agrees to submit all encounter data, and correct any encounter submission errors within the limited time frame prescribed by AHCCCS Administration; and

         An Electronic Data Interchange Agreement form signed by the CEO or Administrator, which states that MCO “certifies that the encounter data so recorded and submitted as input data are in accordance with all procedures, rules, regulations and statutes now in effect.  If any of those procedures, rules, regulations or statutes are hereafter amended, contractor agrees to conform to those amendments of which contractor has been notified.”

 

These forms are held on file by the AHCCCS Encounter Unit for all current and subsequent MCO encounter submissions and revised, as needed.

 

Current Encounter Processing Environment

Encounters are submitted to an FTP server at MCO convenience, e.g., 2-3 times per week, weekly, bi-weekly, or monthly.  The FTP server generally receives encounter data about 24 out of 30 days a month.  This data is processed daily, i.e., syntax check on data to verify that numeric fields have numeric values and alpha fields have alpha values and, if syntax is clean, the file is sent through edit processing.  Encounter outcomes from this processing are either finalized (data passed all encounter edits and is “clean”) or pended (data failed at least one encounter edit).  MCOs must correct pended encounter data. 

 

Balanced Budget Act (BBA) Certification Attesting to Accuracy, Completeness and Truthfulness

The BBA certification requirements (Federal Register, Vol 67, No 115, Friday, June 14, 2002, Page 41112), under Subpart H requires:

 

         �438.602 that “as a condition for receiving payment under Medicaid managed care program an MCO must comply with the applicable certification ….of this subpart.”

         �438.604 that certified data must include, but not limited to, “enrollment information, encounter data, and other information required by the State and contained in contracts, proposals, and related documents.”

         �438.606 certification by source, content, and timing.

o        For source, data must be certified by MCO’s CEO, CFO, or designated individual.

o        For content, “certification must attest, based on best knowledge, information, and belief, as follows:

         To the accuracy, completeness and truthfulness of the data; and

         To the accuracy, completeness and truthfulness of the documents specified by the State.”

o        For timing, MCO “must submit the certification concurrently with the certified data.”

 

 

ISSUE

Arizona will modify its current forms to include BBA requirements.  In order to satisfy the concurrent certification with file submission, personally, I would rather develop an electronic certification document to be electronically signed and appended (externally to ISA-IEA communications envelope) to each MCO’s encounter data file transmitted to the FTP server.  The document would be removed from the outer envelope and stored electronically.  (Of course this assumes MCO’s CEO, CFO or designated individual has the technology to electronically sign the document appended to the envelope.)  Otherwise these documents will probably be faxed to Arizona prior to or at the time of file transmission.  And if documents are faxed, a manual audit trail to match all files with documents will need to be developed and a protocol to manually stop encounter processing until paper fax forms can be matched to data file will be needed.

 

[Commentary] If patients can have a signature on file for claim submission and payer reimbursement to provider, it seems odd that MCOs can not have a signature on file for data accuracy, completeness, and truthfulness.

 

Would an appended electronic certification document externally to ISA-IEA communications envelope violate X12N transmission standards?  If yes, manual protocols to compare certification documents with submitted data files must be implemented.

 

 

Brent Ratterree

AHCCCS (Arizona Medicaid)

Office of Managed Care

602.417.4571 v

602.417.4725 f

[EMAIL PROTECTED]

 

 

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