2014 Interactive Data Submission System (IDSS) Training

Transcription

1 2014 Interactive Data Submission System (IDSS) Training Michele Taylor Data Reporting Analyst

2 What is the IDSS? A fully web-based system used to collect non-survey HEDIS results for all product lines IDSS is used by: Health care organizations to submit HEDIS results NCQA-certified HEDIS compliance auditors NCQA-certified HEDIS software vendors 2

3 IDSS Timeline Full Data Collection timeline and materials December 2013-January 2014 XML Templates posted to NCQA s website RRU Data Collection Schema March 2014 Data Dictionaries, 1 st & 2 nd tier validations posted to NCQA s website April 14, 2014 IDSS available and open to receive submissions June 2014 Plan-lock must be applied to all submissions by June 9 th 11:59 p.m. (EST) Commercial, Medicaid and Medicare data and Attestation due on June 16 by 11:59 pm EST CAHPS Reports available 3

4 The XML templates Data Validations Data Dictionaries IDSS Materials RRU Data Collection Schema RRU Sample XML are available on NCQA s website: EDISDataSubmission/IDSSImportTemplateandMaterials.aspx 4

5 What s New in 2014? Updated the User and Organization Management Tools to include granting Auditor access at the submission level XML Import Schema was updated, added the Vendor ID to both the general and RRU XML files. Downloadable Reports The validation reports are now available to export. Added org and sub-id to CSV reports Org and sub-id time stamps were added to the RRU XML export 5

6 Policy Information NCQA requires that all plans plan-lock the data on June 9 by 11:59 p.m. (Eastern Standard Time) Attestations cannot be e-signed before the Plan Lock is applied. If the Plan Lock is removed, a new attestation is required After June 16, late submissions or resubmissions will be flagged in IDSS for exclusion from NCQA s public reports or products. NCQA will review requests to have a late submission or a resubmission included in a public reporting product and will assess a minimum processing fee of $5,000 6

7 IDSS Data Submission Process Health plan populates IDSS Validates and reviews submission data Applies the Plan Lock Auditor Reviews health plan data Applies the Auditor Lock Health plan submits e-signed attestation Marks submission Final Downloads final reports 7

8 Populating IDSS Import General submission file and RRU data XML file (if submitting) 8

9 Verifying Submission File After importing, verify the correct file was upload and received. 9

10 Validate and Review Data IDSS has two types of validations 1 st Tier Validation: checks the format and value of the data provided. Happens directly upon entering data in IDSS 2 nd Tier Validation: checks to ensure data was collected according to Volume 2. RRU format enables instant validation prior to even submitting to NCQA. 10

11 Applying the Plan Lock Occurs on the Audit Review Table (ART) Prior to submitting all data must be populated and finalized 11

12 Auditor Review Data Commercial and Medicaid Medicare Report Measure Rate Comment System Default Unchecked NR Measure Unselected After Plan Lock Applied Unchecked NR Measure Unselected Y Any rate Reportable Y NR 1. Plan chose not to report (Default) 2. Calculated rate was materially biased 3. Plan Not required to report* Y NB Required Benefit not Offered Y NA Denominator fewer than 30 Report Measure Rate Comment System Default Unchecked NR Measure Unselected After Plan Lock Applied Unchecked NR Measure Unselected Y Any rate Reportable Y NR 1. Calculated rate was materially biased (Default) 2. Plan chose not to report 3. Plan Not required to report Y NB Required Benefit not Offered Y NA Denominator fewer than 30 12

13 Auditor Logic continued RRU Comments (any product line) 13

14 Auditor Applies Auditor Lock After the Auditor completes the review, the Auditor Lock is applied to the entire submission on the ART 14

15 Submitting to NCQA Mark final from the submission list page after the Audit Lock is applied and no further changes are needed. Mark the submission as final submits both data sets. Submit Attestation that covers all data submitted in IDSS Download final reports 15

16 E-Signing the Attestation Only an authorized officer of the company has the rights to E-sign the Attestation The Organization Administrator is responsible for assigning the authorized officer the signer role and set the public reporting status in IDSS. The signer uses the login information from the Organization Administrator to access IDSS and sign the attestation. 16

17 Public Reporting A communication will be sent via the IDSS mailbox with the rules for public reporting Eligible submissions are used in the following NCQA products: Quality Compass (including RRU) For Quality Compass questions, please contact [email protected] State of Health Care Quality Report Health Plan Insurance Rankings For NCQA's Health Insurance Plan Rankings questions, please contact NCQA's Health Insurance Plan Rankings HELP DESK at [email protected] 17

18 Public Reporting Attestation Public Reporting selection results: Yes: No: 18

19 Additional Help or phone your NCQA HEDIS Account Manager The complete list is found at IS%20Account%20Managers_Last.pdf the IDSS mailbox at: 19

20 Questions 20

21 Demonstration 21