CY 07 Prospective Offeror Technical Overview

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CY 07 Prospective Offeror Technical Overview
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CY 07 Prospective Offeror Technical Overview

• Introduction
• Technical Environment
• Interfaces
• Recipient/Program Contractor
• Encounter
• Pre-Admission Screening
• Provider
• Reinsurance
• Reference
• Testing
• Questions

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Provide all potential offerors with an overview
of AHCCCS technical environment and data
interface and standards.
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TECHNICAL ENVIRONMENT
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Technical Environment
6
QUESTIONS
Technical Environment
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INTERFACES
8
RECIPIENT / Health Plan
ENCOUNTER
CLIENT ASSESMENT TRACKING SYSTEM (CATS)
PROVIDER
REINSURANCE
REFERENCE
Interfaces
9
RECIPIENT / HEALTH PLAN
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DATA
Eligibility/ Demographics Received Daily
Children's Rehabilitative Services Received
monthly
ADHS VITAL STATISTICS DOD Received monthly
Recipient/Health Plan
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DATA
MEDICARE/ MEDICARE HMO EDB Received monthly
MEDICARE PART D/ PLAN ID CMS Received monthly
MEDICARE HIB/SMIB Received monthly
Recipient/Health Plan
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ELIGIBILITY ADDS DISCONTINUANCE CHANGE TO
DEMOGRAPHICS NAME GENDER DATE OF BIRTH CHANGE IN
ADDRESS CHANGE IN PLACEMENT CHANGE IN SHARE OF
COST
AHCCCS
Recipient/Health Plan
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ENROLLMENT DATES
Usually effective the day AHCCCS updates action
EXCEPTIONS
Prospective Enrollments (The Last Daily)
System Unavailable at Notification (Month End)
Administrative Actions (Any Day)
Recipient/Health Plan
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DISENROLLMENT DATES
For loss of eligibility, disenrollment is last
day of month
Normally effective the day prior to update
EXCEPTIONS
Incarceration Institutional (Normal
or Retroactive)
Linking / Duplicate Enrollment (Retroactive)
Date of Death (Retroactive)
Administrative (Normal or Retroactive)
Voluntary Withdrawal (Normal)
Recipient/Health Plan
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ENROLLMENT RULES

• NEWBORNS (Newborns are deemed eligible but they
  are auto assigned to an
• acute health plan and we send mom a letter if she
  wants to change plans for the baby )

• LESS THAN 30 DAYS OF ELIGIBILITY (Enrolled in
  FFS)

• 90 DAY RE-ENROLLMENT (Enroll into same Program
  Contractor that
• member was enrolled within last 90 days, if
  available)

• ENROLLMENT CHOICE (In GSA with more than one
  Program Contractor
• available)

• AUTO ASSIGNMENT (In GSA with more than one
  Program Contractor and
• no choice is made)

• RULE BASED (In GSA with only one Program
  Contractor or DD qualified)

• FULLY RETROACTIVE BLOCK OF ELIGIBILITY (Enrolled
  in FFS)

Recipient/Health Plan
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ANNUAL ENROLLMENT CHOICE (AEC)

• Only available in GSA with more than one Program
• Contractor

• Each member is assigned an anniversary month

• AEC letter generated two months in advance

• Members with Choice file generated to plans

Identifies all plans members who have opportunity
to make a Program Contractor choice

• Member makes choice

• Potential Transitional Listing

Identifies all members who have made a AEC choice
of the Program Contractor
Recipient/Health Plan
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OPEN ENROLLMENT

• Special process when needed

Plan termination
New plan

• Generate letter to selected population

• Member makes choice

• Potential Transitional Listing

Identified all member who have made a choice and
which plan they have chosen
Recipient/Health Plan
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ID CARDS

• A file generated daily to vendor

• Cards created for

Initial enrollment
Change of Program Contractors
On request to Communications Center
Lost / damaged / never received

• When a new card is issued the old card is
  inactivated

• Can be swiped on MEVS verification readers

• Not a guarantee of eligibility or enrollment

Recipient/Health Plan
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CAPITATION

• Capitation types include
• Prior Period Coverage (PPC)
• Prospective
• HIV/AIDS supplement

Recipient/Health Plan
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CAPITATION

• Prior Period Coverage (PPC) and Prospective

• Payment records calculated and reported on daily
• 834 Transaction (roster)

• Program Contractors receive weekly payments

• Activity based on enrollment actions

• Capitation calculated on

• Program Contractor, County, Contract Type, Rate
  Code

• Capitation calculated on per diem basis

• Rate ? Days in the month ? days of enrollment
• thru end of month

Recipient/Health Plan
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CAPITATION

• Disenrollment (recoupment) records created and
• reported on daily 834 Transaction (Roster)

• Recoupments are subtracted from Program
• Contractors weekly payments

• Activity based on enrollment activity actions

• Recoupment calculated on per diem basis

• Rate ? Days in the month ? days of disenrollment
  thru
• end of month

Recipient/Health Plan
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MASS ADJUSTMENTS

• Ability to change capitation payment for a
• population (Risk Group)

• Payments which were paid in the past

• Program Contractors receive notification on
• weekly 820 Transaction

• No enrollment activity

• Only reflect changes of payment due to change in
• payment rate

Recipient/Health Plan
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MANUAL UPDATES

• Error in record prevents enrollment/disenrollment
• action from appearing on 834 Transaction

• Manual capitation correction on an individual
  record

• Payments will appear on the 820 Transaction

• Activity will not appear on 834 Transaction

• Manual notification to Program Contractor

Recipient/Health Plan
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SUPPLEMENTAL PAYMENTS

• Payments not paid thru the system as regular
• capitation and will not appears on
  Daily/Monthly
• 834 Transaction/820 Transaction

• HIV/AIDS supplement

• PPC Reconciliation Costs to Reimbursement

Recipient/Health Plan
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PROCESSING UPDATES

• Online eligibility and enrollment updates to
  PMMIS
• occur between 6 am and 6 pm daily

• Eligibility data created by AHCCCS by 5 pm will
  be
• process the same day

• In the event a member needs services and the
• Program Contractor has not received the daily
• Enrollment Notification, enrollment for the
  member
• can be verified using one of the automated
• verification processes.

Recipient/Health Plan
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DAILY BATCH PROCESSING CYCLE

• Start at 6pm every evening

• Output files available to plans no later than 7am
• the following morning

• Enrollment activity includes

• Enrollments

• Retroactive enrollment blocks

• Disenrollments

• Disenrollment blocks

• Demographic changes

Recipient/Health Plan
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LAST DAILY PROCESSING CYCLE

• Third day before the 1st of the next month

1/29/06, 2/26/06, 3/29/06, 4/28/06, etc
Recipient/Health Plan
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LAST DAILY
Recipient/Health Plan
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LAST DAILY PROCESSING CYCLE

• Third day before the 1st of the next month

1/29/06, 2/26/06, 3/29/06, 4/28/06, etc

• Starts at noon if on weekdays, 2am on weekends

• Monthly process schedule available on AHCCCS
• Web site

• Activity includes

Enrollments, Retroactive enrollment blocks
Disenrollments, Disenrollment blocks
Demographic changes
Rate Code Changes
Recipient/Health Plan
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MONTHLY PROCESSING CYCLE

• Occurs immediately after Last Daily Cycle

• Monthly Enrollment Notification

Full file of all members enrolled in Program
Contractor as of the 1st of the month

• Basis for prospective capitation payment

• File to be used to validate Program Contractors
  data

Discrepancies in Program Contractors data to be
reported to DHCM

• Management Reports

Recipient/Health Plan
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NEXT DAILY PROCESSING CYCLE

• Start at 6pm after completion of Monthly Cycle

• Output files available to plans by 7am

• Includes all enrollment activity since last daily

• Enrollments Retroactive enrollment blocks

• Disenrollments

Will recoup prospective capitation already paid

• Disenrollment blocks

• Demographic changes

• These must be processed after Last Daily and
• Monthly Enrollment Notifications

Recipient/Health Plan
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NEXT DAILY
LAST DAILY
NEXT DAILY
Recipient/Health Plan
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VERIFICATION

• Obtain Eligibility, Enrollment, Medicare and
• TPL Coverage

• Single date of service

• Range of days

• Automated processes available to AHCCCS
• registered providers

• WEB

• IVR

• MEVS

• 270

• Program Contractors are encouraged to have their
  providers
• use the automated verification processes

• Communications Center available to AHCCCS member
  and
• providers

Recipient/Health Plan
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VERIFICATION
WEB Based Verification

• Internet based verifications

• Available 24/7

• No cost to providers

• Requires advance registration

• Ability to print information

• Requires input of AHCCCS ID or SSN
• or key demographic information

• Real Time inquiry

Recipient/Health Plan
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VERIFICATION
Integrated Voice Response (IVR)

• Telephone based verifications

• Available 24/7

• No cost to providers

• Information faxed back to local area providers

• Requires input of AHCCCS ID or SSN

• Real Time inquiry

• Single Request

Recipient/Health Plan
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VERIFICATION
Medicaid Eligibility Verification System (MEVS)

• PC or POS based verifications

• Available 24/7

• Hardware/software provided by
• contracted vendors

• Contracted vendors charge providers

• Ability to print information

• Requires input of AHCCCS ID or SSN
• or key demographic information

• Real Time inquiry

• Single or batch request

Recipient/Health Plan
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VERIFICATION
270 Verification

• Internet based verifications

• 24 hour turn around response

• No cost to providers

• Useful for historical research

Recipient/Health Plan
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VERIFICATION
Communications Center

• Staffed by Customer Service Representatives

• Available M-F 7am 9pm Saturday 8am-6pm

• No cost to providers

• Provides service to members and providers

• Accepts Newborn notifications from plans

• Problem research and resolution

• Real Time inquiry

Recipient/Health Plan
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DATA EXCHANGE

• From AHCCCS to Program Contractors

• Daily Files

• Enrollment Notification (HIPAA 834)

• Capitation Notification (HIPAA 820) Weekly

• Rate Code Summary

• Third Party Liability File (in addition to HIPAA
  834)

• Active Care File

• Prior Plan File

Recipient/Health Plan
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DATA EXCHANGE

• From AHCCCS to Program Contractors

• Monthly Files

• Enrollment Notification (HIPAA 834)

• FYI data (included in HIPAA 834)

• Childrens Rehabilitative Services
• AZEIP
• Targeted Support Coordination Population
• Medicare HMO

• Capitation Notification (HIPAA 820) Weekly

• Rate Code Summary

• Members with Choice file

• Potential Transitional Listing

• Management Summary Reports

Recipient/Health Plan
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DATA EXCHANGE

• From AHCCCS to Program Contractors

• Unscheduled Files / As needed

• Open Enrollment

• Potential Transitional Listing

• Mass Adjustment

• Capitation Notification (HIPAA 820) Weekly

Recipient/Health Plan
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DATA EXCHANGE

• From Program Contractors to AHCCCS

• Third Party Leads Referrals

• Electronic file

• WEB referral

• Medicare Discrepancy Alerts

• Paper form

• Newborn Notifications

• Phone call

• WEB referral

Recipient/Health Plan
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TESTING

• Testing must be completed prior to

• Production implementation of a new
• Program Contractor

• Change in service bureau

• Change by AHCCCS resulting in an impact
• to any data exchange

• Must be completed prior to any implementation

Recipient/Health Plan
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QUESTIONS
Recipient/Health Plan
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ENCOUNTER
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WHAT IS AN ENCOUNTER?
An encounter is a record of a medically related
service rendered by a registered AHCCCS provider
to an AHCCCS member enrolled with a capitated
Contractor on the date of service.
Encounter
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WHAT IS AN ENCOUNTER?
The contents of an encounter record must meet the
requirements prescribed by the Centers for
Medicare and Medicaid Services (CMS) and accepted
by AHCCCSA.
These requirements are presented in the AHCCCS
Encounter Manual.
Encounter
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HOW IS AN ENCOUNTER USED?

• Fee-for-service/Contractor capitation rate
• setting
• Reinsurance calculation and payment
• Disproportionate share hospital rate
• calculations
• Contractor evaluation (expected vs. actual)
• Utilization review and reporting
• Quality of care and outcome measurements

Encounter
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HOW IS AN ENCOUNTER USED?

• QISMC/HEDIS reporting and clinical performance
• measurements
• Medical record audits
• Federal (MSIS, HCFA-64, HCFA-416) reports
• Fraud and abuse analysis reporting
• General information management
• Decision support and what-if analysis

Encounter
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FILE TYPES

• NEW DAY ENCOUNTER

• ENCOUNTER STATUS

• PENDED ENCOUNTER

Encounter
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NEW DAY ENCOUNTER

• Submitted by Contractors

• New Day Encounters include

• Encounters submitted for the first time

• Encounters resubmitted after being
• rejected for syntax

Encounter
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ENCOUNTER STATUS

• Created by AHCCCS for Contractors

• Processed and adjudicated new and/or
• resubmitted/corrected encounters

• Passed editing and auditing process

• Also includes cumulative pended
• encounters from current and prior
• cycles.

Encounter
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PENDED ENCOUNTER

• Created by AHCCCS for Contractors

• Processed encounter which fail editing
• and auditing process

• Passed syntax

• Encounter retained by AHCCCS in pended status

• The Pended Encounter File identifies the error
• condition or conditions which caused the
  record
• to fail, assisting the Contractor in the
• identification of the problem.

• Continues to appear on Pending file until
  corrected

Encounter
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PEND CORRECTION

• The correction of pended encounters allows the
• Contractor the opportunity to

• change or modify incorrect encounter data,

• approve encounters that were pended as a
• duplicate of another encounter

• delete encounter data that was submitted in error

• It is the Contractors responsibility to correct
• pended encounters

Encounter
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FORM TYPES

• HIPAA 837P

(also known as Professional)

• HIPAA 837I

(also known as Institutional)

• NCPDP V5.1 or V3.2

(also known as Pharmacy)

• HIPAA 837D

(also known as Dental)
Encounter
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837P (Professional)
Used primarily for professional services,
including physician visits, nursing visits,
surgical services, anesthesia services,
laboratory tests, radiology services, home and
community based services, therapy services,
Durable Medical Equipment (DME), medical supplies
and transportation services.
Encounter
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837I (Institutional)
For facility medical services, such as inpatient
or outpatient hospital services, dialysis
centers, hospice, nursing facility services, and
other institutional services.
Encounter
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NCPDP 5.1 or 3.2 (Pharmacy)
For prescription medicines and medically
necessary over the counter items.
837D (Dental)
For dental services
Encounter
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SUBMISSIONS

• Contractors must submit encounter data within
• 240 days of the end of the month of service,
  or
• the date of enrollment, which ever is later.
• Encounters submitted after this period may be
• subject to timeliness sanctions

• AHCCCSA defines the receipt date for encounters
• as the date the encounter is received on the
• AHCCCS FTP server

Encounter
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SUBMISSIONS

• Claims-type edits processing results
• Finalized encounters no error found
• Pended encounters error(s) found
• Contractors must correct error(s) in order to
• finalize encounters
• Error(s) not timely corrected are sanctionable

Encounter
61
ENCOUNTER VALIDATION AND TRENDS

• CMS requires AHCCCS to collect complete,
• accurate and timely encounter data from
• contractors
• AHCCCS validation study evaluates
• completeness, accuracy and timeliness
• Ongoing review of encounter submission
• trends and data quality

Encounter
62
TECHNICAL ASSISTANCE

• The Encounter Technical Assistance staff are
• available Monday through Friday (excluding
  State
• holidays) to assist Contractors in resolving
  encounter
• errors or to research specific encounter
  issues.

• Contractors are notified of the name and
  telephone
• number of their assigned Technical Assistant,
  who is
• their main point of contact for encounter
  related issues.

• Encounter Unit offers training on how to
  correctly
• submit encounters

• This training is mandatory for new Contractors
  and is
• available to existing Contractors as requested.

Encounter
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SET UP
Before a Contractor may submit encounter data,
AHCCCS requires the completion of certain
agreements, authorizations and control documents.
These documents are as follows
Form 1 Health Plan/Program Contractor Encounter
Submission Notification and Transmission
Submitter Number (TSN) Application
Form 2 Electronic Data Interchange Agreement
Form
Encounter
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PROCESSING CYCLE

• The process is divided into five steps, and is
  the
• same for both New Day and Pended Encounter
• Correction file submissions

• Receipt of encounter files

• Data certification and syntax checks

• Assignment of Control Reference Number (CRN)

• Edits and audits

• File and report generation

Encounter
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TESTING

• New Contractors must go through a testing phase
• before submitting official encounter data to
• AHCCCSA.

• Prior to beginning the testing phase, Contractors
• must have provided all necessary control
• documents to the AHCCCS Encounter Manager.

• Assigned a Transmission Submitter Number (TSN)

Encounter
66
TESTING

• A training session for the Contractor and/or
• designated subcontractor is scheduled during
• which the testing process will be reviewed.

• Technical assistance is available from Encounter
• Unit staff during the testing period.

• When AHCCCSA verifies that a Contractor has
• successfully completed the testing process,
  the
• Contractor will be allowed to submit
  encounters.

Encounter
67
DATA EXCHANGE

• From AHCCCS to Program Contractors

• Acknowledgements
• TA1
• 997
• 824
• Processing Acknowledgements
• 277U
• 277U Supplemental
• Pend
• Comment
• Detail Aging
• Duplicate

Encounter
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DATA EXCHANGE

• Reports
• Adjudication status summary
• Adjudication status detail
• Pended encounter age summary
• Pended encounter age detail
• Pended error count
• Pended encounter count
• Duplicate errors
• Pended error summary

Encounter
69
QUESTIONS
Encounter
70
PREADMISSION SCREENING
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PRE-ADMISSION SCREENING (PAS)

• In addition to financial eligibility an
  individual must meet the medical eligibility
  criteria as established by the Preadmission
  Screening tool (PAS).
• The PAS is conducted by an AHCCCS registered
  nurse or social worker with consultation by a
  physician, if necessary, to evaluate the persons
  medical status. The PAS is used to determine
  whether the person is at risk of placement in a
  nursing facility or an intermediate care facility
  for the mentally retarded.

Pre-Admission Screening
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PAS INTERFACE

• Daily file of PAS Information

• Initial assessments

• Reassessments

• Formatted report containing

• Intake/Assessment Information
• Demographic Information
• Functional Scores
• Medical Assessment
• Summary/Evaluation
• Physician Review/Comment

Pre-Admission Screening
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QUESTIONS
Pre-Admission Screening
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CLIENT ASSESSMENT TRACKING SYSTEM (CATS)
Client Assessment Tracking
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CLIENT ASSESSMENT TRACKING SYSTEM

• Cost Effectiveness Study (CES) a CES must be
  completed for all E/PD members with potential for
  placement in HCBS and for those in a NF with
  discharge potential in order to compare the cost
  of HCBS against an amount equal to the net
  Medicaid cost of institutional care for a member.
  
• Placement History - placement information,
  including begin and end dates, and a Behavioral
  Health identifier for all members must be
  maintained.

Client Assessment Tracking
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CLIENT ASSESSMENT TRACKING SYSTEM

• ACE Critical Data member demographic, Share of
  Cost, TPL and past Behavioral Health enrollment
  information is available for inquiry.
• Member Income the amount and source of a
  members income is available for inquiry. This
  information is useful in determining Room Board
  for Assisted Living Facility placements.

Client Assessment Tracking
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QUESTIONS
Client Assessment Tracking
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PROVIDER
Provider
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PROVIDER
AHCCCS has contracts and agreements with Program
Contractors, the AHCCCS Pharmacy Benefit Manager
and other AHCCCS contractors to deliver medically
necessary services to members.
The AHCCCS Division of Health Care Management
(DHCM) is charged with the responsibility of
monitoring the provider networks of these
entities to assure that they are adequate and
that they meet the minimum contractual
requirements.
Provider
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PROVIDER INTERFACE

• Consists of two files

• Provider Profile

• Provider Record

• Created twice a month

• Available to Program Contractors during the
• following week

Provider
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PROVIDER INTERFACE

• Provider Profile

• Provider Includes all provider types, service
• codes, and categories of service

• Provider Record

• Includes all AHCCCS registered providers

• Includes active, terminated and suspended
• providers

Provider
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PROVIDER INTERFACE

• Data included

• Demographic data

• Provider status

• Categories of service

• Service rates

• Licenses/certifications

• Specialties

• Medicare coverage

• Restrictions

• Service/billing addresses

Provider
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QUESTIONS
Provider
84
REINSURANCE
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WHAT IS REINSURANCE?

• Reinsurance is a method of partially reimbursing
• Program Contractors when the cost of care for
  a
• member for Reinsurance covered services
  exceeds
• pre-determined deductible amount within a
• Contract Year.

• The deductible is based on the statewide
• enrollment of the Program Contractor.

Reinsurance
86
WHAT IS REINSURANCE?

• Members enrolled in a Program Contractor
  incurring
• Reinsurance covered services and meeting the
• appropriate deductible level are eligible for
  
• reinsurance.

• Not all AHCCCS covered services are
• covered under Reinsurance.

• AHCCCS establishes Reinsurance cases using a
• monthly process which scans the Encounters
  database
• for adjudicated Reinsurance eligible
  encounters for
• each Program Contractors members.

Reinsurance
87
WHAT IS REINSURANCE?

• RI cases are generated automatically by
• AHCCCS based on encounter data and recipients
• eligibility. There are no special submission
• requirements, with the exception of
  catastrophic and
• transplant cases.

• Upon the creation of a Reinsurance case, the
• encounters are processed through the
  Reinsurance
• edits/audits.

• The Reinsurance system then associates
  Reinsurance
• eligible encounters to Reinsurance cases.

Reinsurance
88
PROCESSING

• After the edit/audit and case creation process,
  the
• Reinsurance system generates four monthly
  reports
• Reinsurance Case Initiation
• Reinsurance Reconciliation
• Reinsurance Case Summary
• Reinsurance Remittance Advice

• After a Reinsurance encounter passes edits/audits
• and is approved, the Reinsurance payment
  process
• calculates the amount due the Program
  Contractor.

Reinsurance
89
PROCESSING

• The Reinsurance Remittance Advice is then
• processed by the Finance system for payment
• on the Reinsurance case to the Program
  Contractor.

• Program Contractors are required to notify AHCCCS
  of
• any third party coverage or reimbursement
• identified in a Reinsurance case.

• Reinsurance payments to Program Contractors are
• made monthly.

Reinsurance
90
CATASTROPHIC REINSURANCE

• Provided to partially reimburse the Program
  Contractor for
• the cost of care for a member who meets the
  criteria and
• requirements for Catastrophic Reinsurance.

• The Program Contractor is responsible for
  identifying
• Catastrophic members and submitting required
  written
• notification to the Division of Health Care
  Management,
• Medical Management Unit.

• Supporting medical documentation must accompany
• request.

Reinsurance
91
TRANSPLANT REINSURANCE

• Provided to partially reimburse Program
  Contractor for the
• cost of covered care for a member who meets
  the criteria
• and requirements for Transplant Reinsurance.

• Covers members eligible to receive AHCCCS
• covered solid organ or tissue transplants.

• The Program Contractor is responsible for
  identifying
• members and submitting required written
  notification to
• the Division of Health Care Management,
  Medical
• Management Unit.

Reinsurance
92
QUESTIONS
Reinsurance
93
REFERENCE
Reference
94
REFERENCE

• AHCCCS produces the following reference files
• twice a month

• Contains all active HCPCS procedure Codes

• Includes

• Procedure descriptions

• FFS Fee schedule amount

• Age and Sex restrictions

• Frequency restrictions

• Allowed modified

• Coverage Indicators

Reference
95
REFERENCE

• Three Encounter Reference files produced

• Internal Field Information

• Provides mapping of Field name on a
• specific Form to an Internal table and Field
• name/number

• Error to Internal Field relationship

• Provides mapping for each Error Code on a
• specific Form and which Fields are used

• Error Codes and Descriptions

• Provides each Error Code and description

Reference
96
REFERENCE

• Three Procedure Reference files produced

• File 1

• Provides Procedures, Descriptions, Age
  Limitations,
• FFS Fee Schedule amounts, Coverage Indicators

• File 2

• Provides Procedures, Descriptions, Service
  Gender
• Limitations, Allowed Modifiers FFS Fee
  Schedule

• File 3

• Provides Procedures/Services, Descriptions, Other
• Insurance indicators, Age/Gender Service
• Limitations, FFS Fee Schedule Amounts,
  Bundling
• Correct Coding Initiatives

Reference
97
REFERENCE

• TPL Master Carrier Reference File

• Produced Weekly

• Provides listing of all TPL Carrier names and
• their assigned carrier ID number

• Full File listing provided weekly

Reference
98
QUESTIONS
Reference
99
TESTING
100
TESTING

• NEW PROGRAM CONTRACTOR

• Five Phases

• Unit Testing

• System and Integration Testing

• User Acceptance Testing

• Certification Testing

• Business to Business Testing (Pilot
• and Full Trading Partner)

Testing
101
TESTING

• General Testing (system modification)

• Three Phases

• Unit Testing

• System and Integration Testing

• User Acceptance Testing
• Including testing with Program
• Contractors, if necessary

Testing
102
QUESTIONS
Testing
103
FUTURE CHANGES
104
FUTURE CHANGES

• National Provider ID
• Claims Attachment
• Enhanced HIPAA Transactions

Future Changes
105
QUESTIONS
Future Changes