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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


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


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


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


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


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)


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.


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


D&E FCCs require ASN

Clear Descriptions

Make sure all RC/CCs are current


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


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 .


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.


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.


  • 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




    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



    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)


    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


    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


    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


    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


    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


    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


    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


    $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


    ALLOCATION REPORTS

    • Allocation Summary

    • Allocation Ratios ASN Verification

    • Expense Accepted/ Allocated Detail

    • Expense Allocated

    • Personnel Accepted/ Allocated

    • Data Set Accepted/Allocated


    Meprs fundamentals workload and personnel processes sheri weis

    MEPRS Fundamentals: Workload and Personnel Processes Sheri Weis


    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 system generated data wam1
    EAS Processes: WorkloadSystem Generated Data: WAM


    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 datasets
    EAS Processes: WorkloadDatasets

    Example


    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 workload stakeholders
    EAS Processes: WorkloadStakeholders

    MEPRS

    EAS



    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


    Eas processes workload stakeholders1
    EAS Processes: WorkloadStakeholders

    MEPRS

    LCA Manager

    EAS



    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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