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Risk Adjustment User Group. July 2008. Welcome to the July User Group. Introduction Payment Process Operations Update Data Validation Technical Assistance Update Questions and Answers Closing. INTRODUCTION. INTRODUCTION. User Group Process. All attendees must pre-register

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Welcome to the july user group
Welcome to the JulyUser Group

  • Introduction

  • Payment Process

  • Operations Update

  • Data Validation

  • Technical Assistance Update

  • Questions and Answers

  • Closing



Introduction
INTRODUCTION

User Group Process

  • All attendees must pre-register

  • It is only necessary to register once

  • Retain unique PIN for all sessions

  • Session will last for one hour

  • Session slides will be available by the Tuesday before the session

  • Panel will answer questions during the Q&A portion of the session


Introduction1
INTRODUCTION

  • The 2008 monthly Risk Adjustment User Group Q & A and Notes documents are posted at the CSSC Operations website.

  • Please continue to review the website for updates to this information.

www.csscoperations.com/new/usergroup/usergroupinfo.html



Payment process part a only option
PAYMENT PROCESS(PART A-ONLY OPTION)

  • Effective for 2006 payments, organizations may elect to have CMS determine payments for all “Part A-only” enrollees using either new enrollee factors or full risk adjustment factors.

  • Plans may not elect to move some eligible “Part A-only” enrollees into full risk adjustment, while retaining others as new enrollees.

  • Once elected, this option will remain turned “on” until CMS is otherwise notified prior to August 31st of any successive year.

  • This option is applied during reconciliation for a payment year only (i.e., it will not be applied prospectively).

  • Plans interested in this option must contact [email protected] by August 31st.


Payment process part a only option table
PAYMENT PROCESS(PART A-ONLY OPTION TABLE)



Data validation
DATA VALIDATION

  • Calendar Year 2007

  • Calendar Year 2006

  • Calendar Year 2005



Operations
OPERATIONS

Connecting to the FERAS

  • To establish an IP connection with the FERAS, you must be connected to the Medicare Data Communications Network (MDCN), which is provided by AT&T Global Network Services. The MDCN is the secure network linking the Risk Adjustment data processing entities.

  • If you are not connected to the MDCN, please contact AT&T at 1-800-905-2069.


Operations1
OPERATIONS

  • All submitters with IP network access have been authorized to connect to the FERAS.

  • In order to submit claims to the FERAS via the MDCN, you must be enrolled with the CSSC Operations. If you are not enrolled, please contact the CSSC Operations Help Line at (877) 534-2772. Once enrolled with the CSSC, to submit and retrieve data electronically, you will receive a Submitter ID and a password.



Technical assistance updates
TECHNICAL ASSISTANCE UPDATES

2008 Monthly

Technical Assistance Sessions

  • Enrollment & Payment Session

    • July 30th

  • Due to Regional Technical Assistance Sessions, the August Monthly Technical Assistance Session is canceled

Register today at

www.tarsc.info


Regional technical assistance sessions
REGIONAL TECHNICAL ASSISTANCE SESSIONS

Limited Availability…Register Soon!

CHICAGO, IL

August 11 – August 14

LAS VEGAS, NV

registration is closed

NEW ORLEANS, LA

September 9 – September 10


Technical assistance updates1
TECHNICAL ASSISTANCE UPDATES

*For detailed information

and to

register online

log on to

www.tarsc.info

Technical Assistance

Registration Service Center




Resources
RESOURCES


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