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Risk Adjustment User Group

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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Risk Adjustment User Group

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  1. Risk Adjustment User Group July 2008

  2. Welcome to the JulyUser Group • Introduction • Payment Process • Operations Update • Data Validation • Technical Assistance Update • Questions and Answers • Closing

  3. INTRODUCTION

  4. 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

  5. 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

  6. PAYMENT PROCESS

  7. 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 henry.thomas@cms.hhs.gov by August 31st.

  8. PAYMENT PROCESS(PART A-ONLY OPTION TABLE)

  9. DATA VALIDATION

  10. DATA VALIDATION • Calendar Year 2007 • Calendar Year 2006 • Calendar Year 2005

  11. OPERATIONS UPDATES

  12. 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.

  13. 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.

  14. TECHNICAL ASSISTANCE UPDATES

  15. 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

  16. 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

  17. TECHNICAL ASSISTANCE UPDATES *For detailed information and to register online log on to www.tarsc.info Technical Assistance Registration Service Center

  18. QUESTIONS & ANSWERS

  19. CLOSING

  20. RESOURCES • Sean Creighton (Director, Division Risk Adjustment Operations) sean.creighton@cms.hhs.gov • Henry Thomas (Training, Project Officer) henry.thomas@cms.hhs.gov • Lateefah Hughes (Data Validation, Team Lead) lateefah.hughes@cms.hhs.gov • Louis Johnson (FERAS,GTL) louis.johnson@cms.hhs.gov • Chanda McNeal (Payment Issues) raf_payment_questions@cms.hhs.gov • LTC www.tarsc.info • CSSC www.csscoperations.com

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