1 / 18

Systems Update

Systems Update. May 2012. HIPAA 5010. Project Status Key Considerations/Timeline for 7/1/2012 Next Steps. Project Status. Wrapping up all 5010 changes per the previously stated timeline Key Milestones for 7/1/2012 full compliance:

goro
Download Presentation

Systems Update

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Systems Update May 2012

  2. HIPAA 5010 • Project Status • Key Considerations/Timeline for 7/1/2012 • Next Steps

  3. Project Status • Wrapping up all 5010 changes per the previously stated timeline • Key Milestones for 7/1/2012 full compliance: • 11/1/2011 – Programming re-started and Freeze Period began • 1/2012 – Coding completes, start internal testing • 3/2012 – Begin UAT (external testing) • 6/2012 – Complete UAT • 7/1/2012 – Implementation in Production and Freeze Period ends

  4. Key Considerations/Timeline for 7/1/2012 • To accommodate necessary changes to the PMMIS databases the 2nd Encounter cycle for June will be cancelled and PMMIS will not be available during this conversion process beginning 6/30 up to a late as 7/4. • Last day that plans may submit 4010 and NCPDP non PAH format encounters for AHCCCS processing is 6/7/2012 (before 6:00pm) • If 4010 format encounters are received after 6/7/2012 they will be rejected upfront in validation

  5. Key Considerations/Timeline for 7/1/2012, cont. • Contractors must also complete all TI corrections to 4010 format encounters prior to 6/7/2012 • All Contractors are encouraged to complete their 5010 and NCPDP Encounter testing as soon as possible

  6. Next Steps • Post implementation support 30 to 60 days after 7/1 • Publish final Companion Documents for all Transactions

  7. ICD10 • Proposed CMS Implementation Date Change • Revised AHCCCS Project Timeline • AHCCCS Project Approach • CMS Site Visit • Next Steps

  8. Proposed CMS Implementation Date Change • “The Department of Health and Human Services (HHS) announced a proposed rule that would delay, from October 1, 2013 to October 1, 2014, the compliance date for the International Classification of Diseases, 10th Edition diagnosis and   procedure codes (ICD-10).” • Comments to proposed Rule due by May 17th • Should be published by September 2012 if approved

  9. Revised AHCCCS Project Timeline • Assuming a 10/1/2014 effective date AHCCCS has revised our project milestones as follows:

  10. Revised AHCCCS Project Timeline, cont. • Complete Final Review of System Impacts July 2012 • Complete Document/Operational Impacts July 2012 • Finalize Operational Documentation Changes October 2012 And Policy Remediation • Complete Requirements and Design – Reference November 2012 • Complete Requirements and Design – All other January 2013 System Areas • PMMIS Code Freeze Begins…. February 2013 • Freeze Begins..... • System Implementation – Reference March 2013 • Initial Reference Table Loads April 2013 • External Testing BeginsSeptember 2013 • System Implementation – All other System September 2013 • Areas • PMMIS Freeze Ends..... • External Testing EndsSeptember 2014 • ICD10 Effective Date October 2014

  11. AHCCCS Project Approach • Native processing including review and remediation of impacted policies and processes • Use of GEMS as a points for reference/validation only

  12. CMS Site Visit • The CMS team responsible for ICD10 will be onsite in Arizona to conduct a half day Management level overview of interested parties • Information as to the specific date/time/location and how to RSVP will be posted on the AHCCCS webpage

  13. Next Steps • Finalize System Impacts • Finalize Documentation, Policy and Process impacts • Begin review and remediation of above impacts • Conduct Internal Training • Complete the detailed project planning • Inventory published GEMS and other related ICD10 documentation • Establish parameters for and initiate Contractor milestone reporting

  14. Other Projects • Pharmacy Data – Professional and Facility Form Type • Focused Encounter Pends and Denials Review • Recent Implementations – NEMT Copays; 340B Pharmacy Payments

  15. Pharmacy Data – Professional and Facility Form Type • Captured as reported effective 7/1/2012 with the implementation of 5010 changes • Specific rule tables outlining reporting requirements are in progress and will be implemented along with related encounter and claims editing for 10/1/2012 • http://www.azahcccs.gov/commercial/pharmacyupdates.aspx

  16. Focused Encounter Pends and Denials Review • We have identified a number of opportunities to clarify and or revise current encounter edit logic and related processes • The revisions and clarifications will be prioritized for completion between October 2012 and March 2013 • Specific details as to the impacted edits and proposed changes will be communicated as they are finalized

  17. Recent Implementations – NEMT Copays; 340B Pharmacy Payments • Non-Emergency Transportation Copays (NEMT) - http://www.azahcccs.gov/commercial/providerbilling/copayments.aspx • 340B Pharmacy Payments – http://www.azahcccs.gov/commercial/pharmacyupdates.aspx

  18. Technical Consortium Meetings • Looking at scheduling for late July, early August watch webpage for more information on date/time/location and how to RSVP

More Related