Training. Contract Health Services Management Information System Data Movement

Transcription

1 Training Contract Health Services Management Information System Data Movement 1

2 Data Exports UFMS Federal Financial Obligations FI Tribal and Federal Obligations NPIRS- Tribal Statistical Data DCIS Department Contract Information System Federal Sites (effective 10/1/2008) 2

3 Data Imports FI Electronic Explanations of Benefits 3

4 4

5 Internal data transfers CHS to PCC Paid Purchase Order information sent to PCC for use by Clinicians Data Found on the PCC Health Summary RCIS to CHS 5

6 How is the Destination of Data Controlled? CHS Parameters File Payment Destination field within the Purchase Order 6

7 CHS Main Menu ***************************************** * Indian Health Service * * CONTRACT HEALTH MGMT SYSTEM * * Version 3.1, Jun 11, 2001 * ***************************************** NOT-A-REAL FACILITY DOC PAY PRT ACC PT VEN DIS DCR MGT DEN EMNU XXXX Document Generation... Pay/Edit Documents... Document Printing... Account Balances... Patient Data... Provider/Vendor Data Display Documents... Document Control Register Facility Management... CHS Denial/Deferred Services... Electronic Signature Authorization Menu... CHS Programmer Utilities Select Contract Health System Option: 7

8 CHS Facility Management Menu CONTRACT HEALTH MGMT SYSTM, 3.1 NOT-A-REAL FACILITY Facility Management PVD PR PAD PED ALU XPOR EOBR CHEF HHS HVP RES TUPD TVR Provider/Vendor Data Reports... Payment Adjustment Parameter Edit... Allowance Update Data Export... Facility EOBR menu... C H E F Management... Edit HHS Contract Action Type High Volume Provider Menu... Reset the error global ACHSERR Add/Edit CAN, CC, SCC... Test Version Switch Select Facility Management Option: PED 8

9 CHS Parameter Edit Menu CONTRACT HEALTH MGMT SYSTM, 3.1 NOT-A-REAL FACILITY Facility Management EOFF ESIT LAB MAIL NAME OBLI OVER PAR SIG Add or Edit Electronic Signature Officials Add or Edit Electronic Signature Parameters Edit CHS Label spacing Edit CHS Mailing Address Edit CHS Register Names Edit CHS Document Obligations Limits Edit CHS Document Overpayment Allowances Edit CHS Site Parameters Edit CHS Document Signatures Select Parameter Edit Option: PAR 9

10 CHS Facility Parameter Edit Edit the CHS facility options for NOT-A-REAL-FACILITY. 1 questions mark (? ) will get you help. 2 questions marks (?? ) usually gets you more help. For printed help, print out chapter 1 of the Tech Manual (D ^ACHSTM) FACILITY IS 638 TYPE: YES//?? Answer Y (YES) if your facility operates under PL-638 guidelines. Answer N (NO) if your facility is not a 638 facility, If you facility is 638, cross checking of the COST CENTER TABLE will be simplified, i.e., presence of COST CENTERS 568, 573, and 574 will not be specifically checked. This parameter, in conjunction with field 14.09, controls the export of 638 data to the area office. Choose From: Y YES N NO FACILITY IS 638 TYPE:// YES// 10

11 UFMS Start Date Automatically UFMS EXPORT START DATE:?? Filled in for IHS Facilities Examples of Valid Dates: JAN oor 20 JAN 57 or 1/20/57 or T (for TODAY), T+1 (for TOMORROW), T+2, T+7, etc. T-1 (for YESTERDAY), T-3W (for 3 WEEKS AGO), etc. If the year is omitted, the computer uses CURRENT YEAR. Two digit year assumes no more than 20 years in the near future, or 80 years in the past You may mot the precise day, as: JAN,

12 Process FI Data This parameter controls whether the Patient(3), Vendor(4) and Document(5) records are processed at the Area office for transmittal to the Fiscal Intermediary. (Should be yes for IHS facilities). PROCESS FI DATA: YES//?? Answer YES if you want to send Patient, Vendor, and Document records to the Fiscal Intermediary (FI). Answer NO if you do not want to send the data. Choose from: Y YES N NO 12

13 Process Area Office Data PROCESS AREA OFFICE DATA: YES//?? Answer YES if you want to send Patient, Vendor, and Document records to the Fiscal Intermediary (NCR). Answer NO if you do not want to send the data. Choose from: Y YES N NO 13

14 File Setup for IHS (Federal) Service Unit Using CHS/MIS and Sending CHS Data to the Area Office Using the CHS FI CHS to PCC Link is Off CHS Facility File Example Select CHS FACILITY NAME: NOT-A-REAL-FACILITY JFMS EXPORT START DATE: OCT 1, 2007// PROCESS FI DATA: YES// PROCESS AREA OFFICE DATA: YES?? 14

15 File Setup for IHS (Federal) Service Unit (cont) PCC Master Control File Example Select PCC MASTER CONTROL SITE: NOT-A-REAL FACILITY Select PACKAGE: CONTRACT HEALTH MGMT SYSTEM// PACKAGE: CONTRACT HEALTH MGMT SYSTEM// PASS DATA To PCC?: NO// 15

16 File Setup for Tribal Facilities Using CHS/MIS and Sending CHS Data to the Area Office Using the CHS FI CHS to PCC Link is Off CHS Facility File example: Select CHS FACILITY NAME: NOT-A-REAL FACILITY EXPORT STATISTICAL DATA: NO// PROCESS AREA OFFICE DATA: YES// PROCESS FI DATA: YES// 16

17 File Setup for Tribal Facilities (cont) PCC MASTER CONTROL FILE example: (In this scenario, the only source of CHS data for NPIRS is from the CHS FI) Select PCC MASTER CONTROL SITE: NOT-A-REAL FACILITY Select PACKAGE: CONTRACT HEALTH MGMT SYSTEM// PACKAGE: CONTRACT HEALTH MGMT SYSTEM// PASS DATA TO PCC?: NO// 17

18 When creating a purchase order the document destination entry can determine the disposition of a document: Select RCIS REFERRAL by Patient or by Referral Date or #: Are you sure you want to enter a P.O. w/o a Referral? ENTER FISCAL YEAR: ( ): 2008// Enter Estimated Date of Service: Select PROVIDER/VENDOR: DESCRIPTION OF SERVICE: Period Of Authorization From Date: To Date: Hospital Order Number: Enter last 4 digits of the CAN Number: Service Class Code: OBJECT CLASS CODE = 254D DOCUMENT DESTINATION://F Choose from: I IHS F FISCAL AGENT Optional Comments: Estimated Charges: IHS REFERRAL MEDICAL PRIORITY: Enter ADDITIONAL REFERRAL DATA NOW? 18

19 To Change the Default Payment Destination From I or F: GO TO the Facility MGT Menu Select the Option TUBD Add\Edit CAN, CC, SCC Within the Submenu Select SCC Add/Edit Service Class Codes CAN Add/Edit CAN Number CC Add/Edit Cost Center SCC Add/Edit Service Class Codes PCCC Print CANs/Cost Centers PSCC Print SCC, CC, and Register Enter the Service Class Code: Select CODE: 252D// Enter the desired default payment destination (F or I) DESCRIPTION: DENTAL// PAYMENT DESTINATION: FISCAL AGENT// IHS Select COST CENTER: 568// 19

20 PARAMETER SCENARIOS 20

21 IHS (Federal) Service Unit Export Using CHS/MIS and Sending CHS Data to the Area Office Using the CHS F1 CHS to PCC Link is Off CONTRACT HEALTH MGMT SYSTEM, 3.1 Edit CHS Site Parameters FACILITY IS 638 TYPE: No Process Area Office Data? Yes Process FI Data? Yes Payment Destination: FI or IHS PCC MASTER CONTROL FILE: Package: Contract Health System Pass CHS Data to PCC? Yes 21

22 Tribal Facility Exports Using CHS/MIS and Sending CHS Data to the Area Office Not using the CHS FI CHS to PCC Link is On CONTRACT HEALTH MGMT SYSTEM 3.1 Edit CHS Site Parameters FACILITY IS 638 TYPE: YES PROCESS FI DATA: NO PROCESS AREA OFFICE DATA: YES EXPORT STATISTICAL DATA: YES PCC MASTER CONTROL File: Package: Contract Health System Pass CHS Data to PCC? YES NEW PERSON File: Select NEW PERSON NAME: NAME: CONTRACT,PROVIDER// AFFILIATION: CONTRACT// PROVIDER CLASS: OTHER// CODE: 999// CONTRACT,PROVIDER 22

23 Paid Purchase Orders = Statistical Record Fac: IHS#: NOT-A-REAL FACILITY CHYLTUN, LOLA M PHS Indian Health Center RED LAKE, MN White Earth MN F Est. date-of-svc.: Jun 30, 2008 KATHY OLSON MAMMOGRAM ALBUQUERQUE, NM Hosp Ord #: A1 Open Market Auth. From Jun 30, 2008 to Jul 10, SCC: 25.2H DCR Acct. = OTHER CHS CAN/OBJ: J53NW72 / 25.6Q --- Estimated Charge: $ Hosp Order No: --- Initial Obligation Amount Canceled: 0.00 ( Items) Amount Of Supplements 0.00 ( ) CURRENT OBLIGATION BALANCE (IHS) (3rd PARTY) FINAL PAYMENT ON Jun 30, 2008: TOTAL PAYMENTS:

24 A WALK THROUGH THE EXPORT PROCESS 24

25 CHS EXPORT: Facility Export Process ********************************************************** * Indian Health Service * * CONTRACT HEALTH MGMT SYSTEM * * Version 3.1, Jun 11, 2001 * ********************************************************* FACILITY NAME DOC Document Generation... PAY Pay/Edit Documents... PRT Document Printing... ACC Account Balances... PT Patient Data VEN Provider/Vendor Data DIS Display Documents... DCR Document Control Register MGT Facility Management... DEN CHS Denial/Deferred Services... EMNU Electronic Signature Authorization Menu... XXXX CHS Programmer Utilities Select Contract Health System Option: MGT <To begin the export process, enter MGT at the CHS Main Menu> 25

26 CHS Export: Facility Export Process PVD Provider/Vendor Data PR Reports... PAD Payment Adjustment PED Parameter Edit... ALU Allowance Update XPOR Data Export... EOBR Facility EOBR menu... CHEF C H E F Management... HHS Edit HHS Contract Action Type HVP High Volume Provider Menu... RES Reset the error global ACHSERR TUPD Add/Edit CAN, CC, SCC... TVR Test Version Switch Select Facility Management Option: XPOR <Exnter XPOR at the CHS Facility Management Sub-Menu> 26

27 CHS EXPORT: Facility Export Process CDPE RETD XPT XVEN CHS data - prepare for export Re-Export CHS Transmission Data Mark Patient For Export Mark Vendor For Export Select Data Export Option: CDPE <enter CDPE at the CHS Data Export Sub-Menu> 27

28 CHS EXPORT: Facility Export Process This report will examine data in documents produced since your last export, and produce a report listing any documents with missing or invalid data, that is required by the Data center in Albuquerque. Checks include checking for valid ICD-9 codes, EIN vendor number, Provider Type, and valid Admit/Discharge dates. You should run a pre-export data check, which will produce an error report displaying any potential errors. Data should be corrected in order to be sent. Run pre-export data check first? YES// DEVICE: HOME// VIRTUAL Right Margin: 80// CHS TRIBAL STATISTICAL EXPORT ERROR REPORT From Transaction Date Oct 16, 2007 to Oct 25, DOCUMENT NUMBER TYPE OF ERROR TOTAL HOSPITAL DOCUMENTS WITH ERRORS = 0 TOTAL DENTAL DOCUMENTS WITH ERRORS = 0 TOTAL OUTPATIENT DOCUMENTS WITH ERRORS = 0 Press RETURN To Continue or Escape to Cancel...: 28

29 CHS EXPORT: Facility Export Process After the pre-export error check, the screen will display the number and type of records sent. ******************************************************************************* BEGINNING ADD/UPD DATE = Nov 30, 2007 ENDING ADD/UPD DATE = Dec 11, T Y P E O F R E C O R D NUMBER PATIENT RECORDS FOR AO/FI 2 4. VENDOR RECORDS FOR AO/FI 2 5. DOCUMENT RECORDS FOR AO/FI 3 6. PAYMENT RECORDS FOR AO 0 7. STATISTICAL RECORDS 0 8. UFMS RECORDS 7 TOTAL ALL TYPES 14 29

30 DOS File Being Created' CHS EXPORT: Facility Export Process Please Standby - Copying Data to DOS File C:\INETPUB\FTPROOT\PUB\ACHS Export file C:\INETPUB\FTPROOT\PUB\ACHS queued up to be sent to naodev1... <Next, the screen will display the name and server destination of the file being exported> Press RETURN...: 30

31 Facility File to Area Office for Consolidation Area Offices receives all files from CHS Facilities consolidates and sends on to final destinations: FI UFMS (via OIT Integration Engine) NPIRS 31

32 CHS EXPORT to UFMS and the WHAT? Integration Engine (HUB) CHS Federal Service Units export obligations daily to Area Offices then to the integration engine to get to UFMS WHY? Federal Information Security Act requires security certification and accreditation (C&A) OIT is the only location with C&A IMPORTANT! Check your files for errors HOW? Go To 32

33 CHS UFMS EXPORT: Web Area File Status REPORT Select your area to check file status 33

34 CHS UFMS EXPORT: Click On Date For File Status 34

35 Now What Could Possibly Go Wrong with Exports? If it is a tribal site sending statistical data only paid documents with complete visit information will be sent. Incomplete Data Entry on Paid Documents (NPIRS) i.e. Invalid Admission/Discharge Date Out-dated version of send to script E-sig required? Exports not showing up at the FI (transmission failures) Incorrect parameter set up Incorrect payment destination codes (F=Fiscal; I=IHS) 35

36 Questions? 36