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IRIS & IRIS Proxy PowerPoint PPT Presentation


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IRIS & IRIS Proxy. Children’s Hospitals Graduate Medical Education Payment Program. Agenda. IRIS IRIS Proxy Updates IRIS Common Errors IRIS EDV3 Edit Program Q & A Session. IRIS. I ntern and R esident I nformation S ystem. IRIS Recap. Who can use the IRIS?

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IRIS & IRIS Proxy

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IRIS & IRIS Proxy

Children’s Hospitals

Graduate Medical Education

Payment Program


Agenda

IRIS

IRIS Proxy Updates

IRIS Common Errors

IRIS EDV3 Edit Program

Q & A Session


IRIS

Intern and Resident Information System


IRIS Recap

Who can use the IRIS?

Full Filing Providers

DOS based program (CMS)

Does NOT compute the FTE count of interns/residents


IRIS Files

Master File (M3XXXXXX.dbf)

Contains pertinent information about the interns/residents

Assignment File (A3XXXXXX.dbf)

Contains the rotational assignment data for those interns/residents

Some text fields report Numbers. Microsoft Excel XP will try to identify this as an error.


IRIS V3 Updates

Residency Code Table in Alphabetic Sequence

Operating Instructions

New

Part II, Section 7.4

Part V

Revised

Part II, Section 7.2

Part II, Section 7.3

Part II, Section 7.5

Refer to Table of Residency Codes (page 7-17).


IRIS V3 Clarifications

Employer’s Name

Add additional name to the Employer Name Table

Add, Modify, or Delete

<5> Reference Files/Data Management

<2> IRIS Reference Data Management Menu


IRIS V3 Clarifications

Residency Years Completed

Range for Total Number of Program Years

Medical School Code

“99998” – Foreign Dental School

“99999” – Foreign Medical School

Dental School Codes

10000 & 20000 – Obsolete

Use New Codes 80002-80109


IRIS V3 Clarifications

Assignment Time Periods

Added Non-Hospital Reference

42 CFR 413.78(e)

Periods that Span July 1

Enter as 2 periods on IRIS

Example

Fiscal Year : 10/01/04 – 09/30/05

Rotation: 05/01/05 – 11/30/05

Report Assignments:

05/01/05 - 06/30/05

07/01/05 - 09/30/05


IRIS V3 Updates – Effective Dates

New Dental School Codes

For cost reporting periods BEGINNING on or after July 1, 2006AND

Interns & Residents (I&Rs) in dental specialties with dental school Graduation Dates after April 30, 2006

New Residency Type Codes

Highlighted in YELLOW


IRIS V3 Reminders

  • Assignment File

    • Percentages (GME/IME %, Part/Full time Percent

      • Use Whole Numbers

    • Social Security Numbers

      • Links the Assignment file to the Master file

    • CMS Assistance

      • http://www.cms.hhs.gov/IRIS

      • [email protected]


Certification of IRIS Diskette

Since the IRIS report is submitted with the MCR, the signature on the MCR is all that is needed (W/S S, Part I).

All rotation schedules or additional certification is not necessary for IRIS verification.


IRIS PROXY


IRIS Proxy Recap

Who can use the IRIS Proxy?

No/Low Utilization Providers who are not required by CMS to submit an IRIS with their Medicare Cost Report

Excel program

Computes the FTE resident count

Available at no charge to hospitals


IRIS Proxy

Calculates Total GME Unweighted and Weighted Resident FTE counts by:

Each Intern/Resident Rotation

Current Specialty

Summary Totals

Total Allopathic and Osteopathic Residents

Total Allopathic and Osteopathic in Initial Residency Period

Total Dental and Podiatric Residents

Total Dental and Podiatric Residents in Initial Residency Period

Option to create IRIS Master and Assignment data files


IRIS Proxy – Summary Totals

Summary Totals

Located in upper right corner of the worksheet

Summary Totals do NOT account for any duplicate assignment periods (overlaps).


IRIS Proxy – Summary Totals Report

Update: Summary Totals Report

Totals Report identifies Unweighted and Weighted resident FTE summary by specialty.

After viewing Totals Report, click “CHGME” tab at the bottom of the screen to return to original listing.

Totals Report FTE Count =

Allopathic/Osteopathic FTEs + Dental/Podiatric FTEs


IRIS Proxy – Edits

IRIS Proxy Edits

The following input errors will result in the FTE being reduced to zero:

Listed as a international/foreign medical school graduate but NOIMG/FMG Complete Date is entered

A Graduation Date is NOT entered or date is NOTPRIOR to first rotational begin date

Rotational Assignment Dates begin or end OUTSIDE of the fiscal year


IRIS Proxy – Edit Check

Edit Check

Highly recommended that the IRIS data be validated by a separate IRIS/GME edit program

CMS IRIS FI Edit Program (IRISEDV3)

Same software used by Full Filing hospitals and all FIs

Third-Party Vendor GME Software

Data that does not pass CHGME FI edits may be returned to the hospital for rework.


IRIS/IRIS Proxy Updates

New/Revised Program Codes

Specialties

Subspecialties

Combined Programs


IRIS Proxy Updates

Medical School Codes

Revised 6 of 8 Podiatry Schools

Codes 30100 – 30600

New Dental School Codes

United States, Canada, Puerto Rico

Codes 80002 – 80109

Replaced Codes

Codes 30010 – 30090 for Podiatry Schools

Codes 10000 and 20000 for all Dental Schools

Refer to Table of Medical Schools (page 7-10).


IRIS Proxy Updates

Medical School Codes (continued)

30010 – Barry University School of Podiatric Medicine (Miami Shores, FL)

New Code - 30500

30020 – William M. Scholl College (Chicago, IL)

New Code – 30100

30040 – College of Podiatric Medicine (Des Moines, IA)

New Code - 30600

30050 – New York College of Podiatric Medicine (New York, NY)

New Code - 30200

30080 – Ohio College of Podiatric Medicine (Cleveland, OH)

New Code - 30300

30090 – Temple University School of Podiatric Medicine (Philadelphia, PA)

New Code - 30400


IRIS Proxy Updates

Current Version updated 2009

Addition of New Programs and Medical School Codes

Updated Formatting Errors


IRIS Common Errors


IRIS – Key Inputs

Intern/Resident Name

Do not use nicknames or abbreviations!

Employer Name

Institution currently paying the resident’s salary

Residency Type Code

Initial Specialty Program

Specialty initially chosen by resident during the first year of post graduate training program

Medical School Graduation Date

If the specific graduation date cannot be determined, but the graduation month is known, use the first day of the known month


Assignment Time Periods

Assignment Beginning and Ending Date

Resident’s start and end dates for EACH rotational assignment during which the intern/resident was assigned to and worked at the hospital complex or any of its hospital based providers.

Follow original source documentation

Rotation schedules, calendars, etc.


GME Time Percentages

GME Percentage

Percentage of time intern/resident worked in the hospital in comparison to the total time worked at all facilities (Resident’s Total GME must equal 100%) .

If in a non-hospital setting must have a written agreement.

Hospitals must coordinate GME data reported in IRIS

IME % does NOT apply to Children’s hospitals. Enter the same % as the GME % or enter zero(0).


Initial Specialty

Initial Residency Period

Prior to 10/01/04

Determined as of the time the resident enters the “initial” or first residency training program

Based on the period of board eligibility associated with the program in which a resident participates in the first year of training, without regard to specialty in which the resident ultimately seeks board certification


Initial Specialty - Simultaneous Match

69 FR 49170 (August 11, 2004)

FY 2005 DRG Rates for Hospital Inpatient PPS

CMS’ definition..

For purposes of direct GME, a national process by which applicants to approved medical residency programs are paired with programs on the basis of preferences expressed by both the applicants and the program directors


Initial Specialty – First Policy Change

Effective for portions of cost reporting periods beginning on or after 10/01/04

If hospital documents….

Resident matched in an advanced specialty program that requires clinical base year prior to resident’s first training year

Then….

IRP is determined based upon period of board eligibility associated with second year specialty program


Initial Specialty – Second Policy Change

70 FR 47449 (August 12, 2005)

Inpatient Hospital PPS for 2006

To claim specialty program as IRP..

Hospital must document that a resident matched PRIOR to beginning any residency training in an advanced residency training program beginning in the second residency year


Initial Specialty – Supporting Documentation

National Residency Matching Program (NRMP)

http://www.nrmp.org

San Francisco Matching Program

http://www.sfmatch.org

Urology Matching Program

http://www.auanet.org/residents/resmatch.cfm

American Osteopathic Association Residency Match Program

http://www.natmatch.com/aoairp


Residency Years Completed

Residency Year

The total number of years the intern/resident has completed in ALL types of approved residency programs

Based on the number of years completed as of FIRST DAY of reported rotational assignment

This includes CLINICAL BASE year or transitional year for “Matched Residents”

  • Do NOT Use:

    • Resident’s PGY Level or

    • Only Years Complete in Current Specialty


The key is ……

Document, Document, Document!!!


IRIS EDV3 Edit Program


IRISEDV3

What is the IRISEDV3?

A program used to run edit checks on the Intern and Resident Information System (IRIS) diskette

Available at no charge to hospitals

Provides all major edit checks that will be done by your CHGME FI

36


IRISEDV3 - Setup

Setup of the IRISEDV3

Obtain all necessary files:

Edv3inst.exe

Db5lib.exe

Readme.doc

Program should be on computer’s hard drive

This is a MUST:

Read the installation instructions (Readme.doc) BEFORE beginning installation!


IRISEDV3 - Setup

First Time Use

The FIRST time the program is opened, complete “Data Management” from Main Menu


IRISEDV3 - Setup

First Time Use (cont.)

Data Management

Setup Administrative Data

Rebuild Data Indexes

Be sure to save (“S”) set-up and exit (“X”)

During Step <2> Rebuilding Data Indexes – Screen may flicker. This is okay!


IRISEDV3 – Process Data

<1> Capture IRIS Data Submitted

Ensure diskette with IRIS files (M3XXXXXX.dbf and A3XXXXXX.dbf) is in the disk drive (usually “A”).

Verify provider number is correct.

<2> Import Captured Provider Data into Test Shells

Automatically completed by program


IRISEDV3 – Process Data

<3> Evaluate and Edit Imported Provider Data

Provides on-screen EDITS during processing

Assignment End Date is after FY End Date (12/31/2004)


IRISEDV3 – Process Data

<4> Print Report of Evaluation and Edit

It is optional to print reports

Default = <2> Print All Records


IRISEDV3 – Reports

Report Sections

Part I – New Records that Passed all IRIS Edits

Part II – Records that Failed One or More IRIS Edits

e.g. Assignment date outside fiscal year

Part III – Invalid Records

e.g. Assignment record with invalid or blank fiscal year begin date

Part III may also include any duplicate records in the Master File


IRISEDV3 – Reminders

IRISEDV3 cannot be used to change data. It is only capable of edit checks.

IRISEDV3 does not check for zero values or blanks in the Full Time/ Part Time Percentage (%) and GME Percentages (%) fields of the IRIS files.


IRISEDV3- Conclusion

IRISEDV3 will greatly improve your chances of submitting a good IRIS/IRIS Proxy, but it will not guarantee complete success.

The CHGME FI may determine that an IRIS/IRIS Proxy diskette is still incorrect even though it cleared IRISEDV3 edits.

Example

Full Time/Part Time Percentage (%) was entered as the portion of the year the intern/resident was at a hospital instead of the type of residency slot he/she filled.


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