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Briefing: MEPRS Fundamentals. Speakers: Paulette Richards Sheri Weis Date: 29 July 2010 Time: 1300 – 1500. WELCOME. Medical Expense and Performance Reporting System (MEPRS) FUNDAMENTALS.

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briefing meprs fundamentals

Briefing: MEPRS Fundamentals

Speakers: Paulette Richards

Sheri Weis

Date: 29 July 2010

Time: 1300 – 1500

slide2

WELCOME

Medical Expense and Performance Reporting System (MEPRS)

FUNDAMENTALS

meprs fundamentals background standard tables financial processing paulette richards

MEPRS Fundamentals: Background Standard Tables Financial Processing Paulette Richards

meprs fundamentals objectives
MEPRS Fundamentals Objectives

Understanding the basics of MEPRS Processing:

Who…

What…

When…

Where…

Why…

And HOW

Financial, Workload and Personnel

slide5

WHY MEPRS

Uniform Chart of Accounts (UCA) aka MEPRS

Joint study tasked to address four concerns:

Anticipated physician shortages.

The quality of systems for planning, management, and evaluation

Increased overhead and support costs

The social equality of military medical care and its compatibility with national health care objectives.

why meprs
WHY MEPRS

Inconsistent & non-comparable data maintained

Valid comparisons between MTF and the Services could not be made

MTFs used separate & independent systems & data bases

  • Different interpretations of common data

UNIFORM CHART OF ACCOUNTS

(UCA) aka MEPRS

Performance

Measurements

UNIFORM CHART OF ACCOUNTS

Reporting

slide7

STANDARD TABLES

FCC Master – Standard to the third position of the Functional Cost Code (4th pos service unique)

Service Element Expense Code (EEIC)

TRICARE MANAGEMENT ACTIVITY

Program Element Code (PEC)

Standard Documentation Code Table

slide8

Functional Categories

A - Inpatient Care

B - Ambulatory Care

C - Dental Care

D - Ancillary Services

E - Support Services

F - Special Programs

G - Readiness

A - Inpatient Care (functional category)

AA - Medical Care (summary account)

AAA - Internal Medicine (sub-account)

AAB - Cardiology (sub-account)

Intermediate Operating

Final

slide9

ASD & EAS IV PROCESSING MODEL

DMHRSI

Labor

ERROR CORRECTION UNIT (ECU)

MEPRS MANAGER

VALIDATION CHECK

EAS IV REPOSITORY

ADJUSTMENTS

CHCS/WAM Workload

ALLOCATION

CRIS

Financial

MHS Management Analysis and Reporting Tool- (M2)

Communication

ERROR CORRECTION UNIT (ECU)

slide10

Account Subset Definition (ASD) Table Fundamentals

  • WHAT is an ASD?
  • ASD table is the dictionary listing of Functional Cost Codes (FCCs) which defines your MTF data reporting . This table defines what goes on in your MTF.
  • HOW is the ASD Created?
  • AF MEPRS SG establishes approved FCC codes with the ASN in a standard table for the entire AF.
  • MEPRS Manager reviews and submits their local table.
  • HOW is the ASD Used
  • Determines if FCC are valid.
  • Contains the ASN which determines the order in which expenses from Intermediate accounts are allocated to Final accounts in the step-down process.
  • HOW is the ASD is STORED
    • The table is stored in the EASi application.
    • NOTE: At the beginning of each year the table is reviewed.
slide11

ASD – CRITERIA FOR FCC CREATION

Expenses – Attributed to work-center. Expenses include: direct, resource sharing, contract and personnel.

Physical space – A location where the services are provided, must be capable of being measured in square.

Personnel – Must have assigned/available personnel as identified in the DoD 6010.13M

Unique Accounts: Service provided must be unique and not duplicated/provided by another work-center.

ASD CRITERIA

Workload Measure – Must have ability to measure meaningful workload identified in the DoD 6010.13M

Work-center: Must meet definition as outlined in DoD 6010.13-M

slide12

D&E FCCs require ASN

Clear Descriptions

Make sure all RC/CCs are current

slide13

ASD CREATION MODEL - OVERVIEW

ASD CREATION PROCESS

DATY QUALITY VALIDATION RESULTS

PEOPLE MANAGEMENT

DMHRSI

  • MEPRS MGR
  • BUDGET POC
  • CHCS DBA
  • MANPOWER POC
  • VALIDATE EACH PROJECT AND TASK

ASD STRUCTURE

CHCS/WAM

FCC CRITERIA

MEPRS/EAS

LEADERSHIP

CLEAN MEPRS/EAS TABLES

  • VALIDATE SITE DEFINABLE TABLE
  • FISCAL YEAR
  • DMIS ID
  • MEPRS/FCC CODES
  • FCC DESCRIPTIONS
  • ASN
  • ACTIVATION DATE
  • INACTIVATION DATE
  • DEACTIVATION DATE
  • EXPENSES
  • PHYSICAL SPACE
  • MANPOWER
  • MEASURABLE WORKLOAD
  • AIR FORCE MEPRS PROGRAM OFFICE
  • AFMOA MEPRS STAFF
  • MTF STAFF

PE-MAP

ASD CHECKLIST

  • VALIDATE ALL FCCs
  • REVIEW ASN
  • ALIGN EXTERNAL TABLES
  • ADDRESS DUPLICATE FCCs
  • VALIDATE AF SG FIINANCIAL GUIDANCE
  • RCCC/MEPRS TABLE

MEPRS/EAS DATA QUALITY RELATIONSHIP LEARNING

slide14

ASD STAKEHOLDERS

CHCS DBA – Ensure the CHCS table is properly reporting workload for each MEPRS/FCCs

Budget Office – Involved with correcting and identifying expenses associated with the work-center

PEOPLE MANAGEMENT

MEPRS MANAGER

RMO

Logistics Office – Ensure proper reporting of supplies, equipment, square footage and depreciation

Manpower Office – Ensure the Activity Manning Document is up-to -date .

slide15

ASD CHECKLIST HELPFUL NOTES

INACTIVATE an FCC: This is a TEMPORARY date and can only occur in the current fiscal year.

* The date range must be within the current FY

DEACTIVATE an FCC: This is a PERMANENT date.

* Date cannot be before the beginning of the current year (30 Sep FY)

ADD an FCC: Ensure MEPRS/FCCs are aligned with DoD 6010.13M

D and E FCC require ASN

INACTIVATE DATES will cause a warning in the error correction unit (ECU) during the initial validation process.

TEAM EFFORT - All FCCs should be reviewed by RMO team and validated against the AF FCC Master Table.

FCCs can be added or reactivated in mid-year. Ensure the default date is changed.

REACTIVATE an FCC: You will need to re-enter a current dat within the current fiscal year.

* Change the inactivate Date Range.

slide16

PURPOSE & IMPACT

  • Summary
    • The ASD is the roadmap which defines MTF unique data used by Expense Assignment System (EAS ) processing.
  • MEPRS utilizes Standardized business rules for collecting, calculating and reporting data used for clinical and management decisions.
  • Standard tables are published and maintained by TMA ensure MHS follow standardized business rules.
slide17

Resource Manager

ERROR CORRECTION UNIT (ECU)

MEPRS MANAGER

VALIDATION CHECK

EAS IV REPOSITORY

BUSINESS RESULTS

FINANCIAL PROCESSING

ADJUSTMENTS

ALLOCATION

CRIS

Financial

Results

ERROR CORRECTION UNIT (ECU)

commanders resource intergration system cris

AF four-tier structure for handling funds:

Budget Activity Group

COMMANDERS RESOURCE INTERGRATION SYSTEM CRIS

Program Element Code

Responsibility Code

Cost Center

Service Unique Expense Element

slide21

CRIS & EASIV PURE DATA ELEMENTS

CRIS

EASIV Pure File

Eff Date

BQ Site

Field Site (OPLOC)

Operating Agency Code (OAC)

OAC Desc

Operating Budget Account Number (OBAN)

OBAN Desc

FY (4 Char)

OBY (4 Char)

Fund Type (FT)

Fund Code (FC)

Program Element Code (PEC)

Element of Expense/Investment Code (EEIC)

Resource Center/Cost Center (RCCC)

BQ Amount

Bal ID (E & U)

Bal ID Desc

Row Count

DMIS ID (OBAN)

FCC

RC/CC

SEEC (EEIC)

BSL (FC)

PEC

SOF

Schedule Type

Oblig. Fiscal Year

Oblig. YTD

Expense YTD (BQ Amount)

easiv imports cris data

EASIV IMPORTS CRIS Data

$2,999,999 $2,999,999

slide25

ALLOCATION PROCESS IN THE EAS IV PROCESSING

MODEL

ERROR CORRECTION UNIT (ECU)

DMHRSI

Labor

VALIDATION CHECK

EAS IV REPOSITORY

BUSINESS RESULTS

MEPRS MANAGER

ADJUSTMENTS

ALLOCATION

CRIS

Financial

Results

ERROR CORRECTION UNIT (ECU)

slide26

ALLOCATION OVERVIEW

DEFINITION: Allocation is the reassignment (step down) of intermediate operating accounts (D & E ) expenses to final operating accounts (A, B, C, F and G) on the basis of the ASN from the ASD.

  • WHY WE DO COST ALLOCATION: Provides the “Total Cost of Doing Business”
    • Incorporates overhead expenses (Utilities, depreciation, housekeeping, etc.)
    • Determines total “unit cost”
    • Provides comparability with the civilian sector cost allocation methods
slide27

ALLOCATION OVERVIEW.......

DEFINITION:

The reassignment of intermediate operating (D & E) expenses is performed on the basis of assignment factors or ratios that measure the amount of services rendered by intermediate work centers to the other work centers.

  • WHY WE DO COST ALLOCATION:
  • Provides the “Cost of Doing Business”
    • Incorporates overhead expenses (Utilities, depreciation, housekeeping, etc.)
    • Determines real “unit cost”
    • Provides comparability with civilian sector cost allocation methods
slide28

PURIFICATION PROCESS

ACA%

ADA%

Text

ABA%

Expense from FCC’s with an ‘X’ in the third position (COST POOLS) are distributed to final accounts based on the ratios calculated using the cost pool data set

AAA%

A_X

slide29

STEPS in the ALLOCATION PROCESS

Stepdown E expense data

Stepdown D expense data

Calculate expenses contributed (X)

Calculate personnel contribuited

Create personnel allocation ratios Purfy expense data

Accumulate data sets

Accumulat e personnel data

Create allocation ratio

Purify personnel data

Accumulate expense data

Copy Personnel allocated expense

Delete previous job

Create Resp/Pulm data sets

Create ADM data sets

Preallocation validation

Update Service Unit Cost Mappings

Accumulate DRG data

Calculate DRG cost data

Initiate Allocation

stepdown aka allocation
STEPDOWN aka ALLOCATION

E & D $2,559,987

E%

D%

A%

B%

C%

F%

G%

E & D $0

Intermediate accounts are stepped down based on the order of the assignment sequence number (ASN) listed on the ASD

slide31

ALLOCATION SCENARIO

FCC: EBAA – Command & Admin

DSI: FTEs

EBAA Total

Ratio

DSI Workload

100

50

150

45

35

26.31579

13.15789

39.47368

11.84211

9.21053

AAAA

BAAA

BGAA

CAAA

DAAA

100

50

150

45

35

380

380

380

380

380

EBAA Total: 380

slide32

ALLOCATION SCENARIO

FCC: EBAA – Command & Admin

DSI: FTEs %

Total Expenses: $10,000

EBAA Expense

to be Distributed

Expense distributed

Ratio

AAAA

BAAA

BGAA

CAAA

DAAA

$2,631.58

1,315.79

3,947.37

1,184.21

921.05

26.31579

13.15789

39.47368

11.84211

9.21053

X

$10,000

slide33

Expense received from step-down:

Total expense to be distributed:

ALLOCATION OVERVIEW

DSI: PHARMACY

DAAA - Pharmacy

$921.05

$100,921.05

SAS 301 Workload

DAAA Total

Ratio

175

175

175

175

175

50

10

25

75

15

28.57143

5.71429

14.28571

42.85714

8.57143

AAXA

AAAA

BAAA

BGAA

CAAA

DAAA

50

10

25

75

15

25

200

Total:

-25

175

slide34

$100,000.00

Direct Expenses:

$921.05

Expense received from step-down:

$100,921.05

Total expense to be distributed:

Data Set ID: Pharmacy

DAAA - Pharmacy

% of Data Set

Total

Expense distributed

DAAA Expense

to be Distributed

28.57143

5.71429

14.28571

42.85714

8.57143

$28,834.59

5,766.92

14,417.29

43,251.88

8,650.38

AAAA

AAAA

BAAA

BGAA

CAAA

X

$100,921.05

slide35

ALLOCATION REPORTS

  • Allocation Summary
  • Allocation Ratios ASN Verification
  • Expense Accepted/ Allocated Detail
  • Expense Allocated
  • Personnel Accepted/ Allocated
  • Data Set Accepted/Allocated
eas processes workload
EAS Processes: Workload

System-Generated Data

and

Non-System Generated Data

eas processes workload system generated data
EAS Processes: WorkloadSystem Generated Data
  • CHCS: Workload Assignment Module (WAM)
    • Data Sets:

ADM

Dispositions

Occupied Bed Days

Outpatient Visits

Pharmacy (DAAA)

Total Visits

Radiology (DCAA)

Pathology (DBAA)

(only Lab and Rad provide CPT workload data)

eas processes workload system generated data wam
EAS Processes: WorkloadSystem Generated Data: WAM
  • WAM is a Tri-Service component of CHCS that standardizes and streamlines workload reporting for MEPRS/EAS.
  • Workload templates are created at the beginning of each month using the Initialization action.
  • All Data Set Identification (DSI) must be in Approved status for the ASCII file to be either created or re-created.
  • The ASCII file must be generated, before it’s transmitted to EAS via electronic interface.
eas processes workload non system generated data
EAS Processes: Workload Non-System Generated Data
  • Dental Services Account Data Sets
  • Ancillary Services Accounts Data Sets
    • Lab/Rad/Pharmacy are system-generated
  • Support Services Accounts Data Sets
  • Special Program Accounts Data Sets
  • Readiness Program Accounts Data Sets
  • Square Footage and Square Footage Cleaned
eas processes workload non system generated data1
EAS Processes: Workload Non-System Generated Data
  • Ancillary Services Accounts Data Sets (D***)
eas processes workload non system generated data2
EAS Processes: Workload Non-System Generated Data
  • Support Services Accounts Data Sets (E***)
eas processes workload non system generated data3
EAS Processes: Workload Non-System Generated Data
  • Special Program Accounts Data Sets (F***)
eas processes workload non system generated data4
EAS Processes: Workload Non-System Generated Data
  • Readiness Program Accounts Data Sets (G***)
  • Captures only War Reserve Medical (WRM) readiness workload performed at your local facility- $ amounts. (GEAA)
  • Square Footage and Square Footage Cleaned
    • The Facility section should provide square footage information.
    • Be sure to make all corrections in the first month of the fiscal year.
    • Compare Square Footage with the Square Footage Cleaned to ensure the correct values are being reported.
eas processes workload steps
EAS Processes: Workload Steps
  • Import monthly CHCS/WAM file
  • Validation: select “ Available to Validate”
  • Address Errors and Warnings in the ECU: research, correct and re-validate
  • Enter Non-System Generated Reports under Adjustments-Workload-Data Sets
eas processes workload reconciliation
EAS Processes: WorkloadReconciliation
  • CHCS Reports:
    • World Wide Workload Report (WWR):
    • Validate monthly CHCS WAM workload prior to transmittal to EAS IV
    • Follows the same business rules for calculating workload as WAM
    • Can be used to validate Occupied Bed Days and Admissions
    • Monthly Statistical Report:
      • Count and Non-Count for In-/Out-Patient areas by MEPRS Code; in-depth look at discrepancies between the WWR and EASIV
      • End of Day processing must be completed before the MSR can be generated
eas processes personnel1
EAS Processes: Personnel
  • Good, basic stuff to know:
  • 1 FTE = 168 hours /month
  • Where are they?
  • Available/Non-Available Time
  • 5 Skill Types + Occupation Codes-what are they?
eas processes personnel2
EAS Processes: Personnel

Good basic stuff to know:

  • 1 FTE = 168 hours /month
  • Are personnel assignments correct
  • Report all Available/Non-Available Time
  • 5 Skill Types + Occupation Codes-what are they?
eas processes personnel dmhrsi
EAS Processes: PersonnelDMHRSi
  • LCA Specialist: DMHRSi Output File
    • DoD Create EASIV Extract File_XXXXXX (Text file for importing into EAS)
    • After creating the DMHRSi output file, run the EAS IV Assigned Personnel and EAS IV Summary View reports- will help you to investigate errors
  • Note: Personnel errors cannot be adjusted in EAS. They must be corrected in the source system (DMHRSi), then re-imported.
eas processes personnel steps
EAS Processes: Personnel Steps
  • All personnel time has been processed for the month!
  • DMHRSi-DoD EASIV CREATE FILE : save as text file for import
  • Upload Personnel file

4. Import Personnel file

5. Validation: select “ Available to Validate”

  • Address Errors and Warnings in the ECU: research, make corrections in DMHRSi, re-import and re-validate
eas processes personnel reconciliation
EAS Processes: PersonnelReconciliation
  • Compare the DMHRSi EAS IV Summary View Report with the EASIV Personnel Allocated Report to ensure that the total FTEs match
fhi implementation
FHI Implementation

20 “Homes” to be “built” in 2010

Barksdale McGuire

Charleston Offutt

Columbus Ramstein

Davis-Monthan Randolph

Goodfellow Shaw

Hickam Spangdahlem

Hurlburt Travis

Keesler Vance

Langley Wright Patterson

Luke Yokota

13 Sites completed by end of 2009

  • Edwards & Ellsworth (2008)
  • Scott Misawa
  • Patrick FE Warren
  • Andrews Bolling
  • Hill Sheppard
  • Laughlin
  • Elmendorf
  • Lakenheath

56

resources
Resources…

M E P R S S

DoD 6010.13-M

USER GUIDE

Air Force Instructions 41-102

Vector Check

DoD 6010.13-M - Medical Expense & Performance Reporting System for Fixed Military & Dental Treatment Facilities Manual

AF MEPRS Users Guide - MUG

Defense Health Services Systems - Expense Assignment System IV (EAS IV) Application Functional Users Guide (FUG) December 2009

Secretary of the Air Force – Air Force Instructions 41-102 31 March 2008 – Air Force Medical Expense & Performance Reporting System for Fixed Military & Dental Treatment Facilities

SGY & AFMOA – Air Force MEPRS Support Staff (Washington/San Antonio)

Vector Check - https://vc.afms.mil/AFMOA/SGA/SGAR/SGAR_MEPRS/default.aspx

Air Force

questions
Questions?
  • MEPRS
  • Personnel
  • Workload
  • Financial

Data Quality

Data Quality

  • Patient
  • &
  • Provider
  • Coding
  • SIDR/SADR
  • MSDRG/RWP
  • RVU/CPT
  • UBO
  • Other Health Insurance
  • Eligibility
  • Demographics

Data Quality

Data Quality

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