Meeting Agendas and Documents

Frequently Asked Questions

Claims Data Submitters Group

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Previously known as the Payer User Group (PUG)


New 12/27/16 Reminder about Annual Updates, Validation Resets and Changes

Several important changes to the MHDO Data Warehouse Portal require action from payers starting February 8th. Below is a summary of the purposes and timelines for the upcoming activities.

  1. Registration Updates: Update all portal registration information, including contacts and company business. Action Required from: Administrative Contacts
  2. Validation Override Resets: Evaluate 2017 data submissions against validation rules with all existing Profile – and Exemption – Level validation rule overrides reset. Action Required from: Data Submitters
  3. Validation Rule Additions/Updates: Revised and added a handful of validation rules to improve data quality. See the updated validation rules.

The validation rule changes and validation resets will go into effect on February 8th for January 2017 data submissions. These updates will ensure the accuracy and quality of registration and validation information within the MHDO Data Warehouse Portal.

NOTE: In order to make the transition to the reset and updated validation rules are as seamless as possible, all data submitted from February 1 through February 7 will not be validated until overrides are reset and updated validation rules go into effect on February 8th. Submissions can be made from February 1 through February 7, but they will not be processed until February 8th.

9/19/16 Follow Up to April 20, 2016 Correspondence

Below was sent to Payors (as defined in Title 22 Chapter 1683)by Executive Director, Karynlee Harrington.

This communication is a follow up to the communication I sent to you on April 20, 2016 regarding the non-enforcement of MHDO claims data submissions for the five-month period of March 2016-July 2016. As stated in the April 20th memo, payors that elected not to submit data during this five-month period are required to submit all applicable data for these months, as well as data for the months of August and September 2016 by October 31, 2016.

We expect your submissions to include your fully insured and self-funded non-ERISA claims data, as well as any voluntary self-funded ERISA claims data. Please note all data collected by the MHDO is treated as confidential and subject to the protections of Title 22, Chapter 1683 and released only in accordance with 90-590 CMR Chapter 120.

Below is submission guidance based on different scenarios:

  1. If your data submission triggers an historical volume failure and the volume change is due to the removal of self-funded ERISA claims data, you will need to include this explanation in the exemption request.
  2. If self-funded ERISA claims data is excluded and a specific payor’s submissions fall under the reporting threshold of $2 M of adjusted premiums or claims processed per calendar year, please contact Philippe Bonneau at Philippe.bonneau@maine.gov to request an exemption from submission.

As of October 31, 2016 we will reinstate our enforcement policy and procedures. If you have any questions or concerns please contact me or Philippe.
I thank you in advance for your cooperation. - Karynlee

4/20/16 - Suspension of Claims Data Submission Compliance

This communication is to inform you that the Maine Health Data Organization (MHDO) will take no action to enforce the data submission requirements under Rule Chapter 243, Uniform Reporting System for Health Care Claims Data Sets, for a five month period from the date of the United States Supreme Court decision in Gobeille v. Liberty Mutual (March 1, 2016).

Payors that choose not to submit data during this period must submit all March, April, May, June and July data by October 31. Please note: the data from the months of August and September are also due October 31 per the normal schedule. It is our hope that by September there will be more clarity with respect to data submission requirements in light of Gobeille.

Previous data submitted and data through February 2016 will be subject to enforcement per the requirements in Rule Chapter 243. Any outstanding files that were rejected or contain errors need to be corrected and or resubmitted in the proper format so that all files can be accepted with no failures.

We encourage (and we will continue to send automated reminders) those payors whose data is not affected by the Supreme Court decision to continue to submit data to the MHDO on the normal schedule.

Thank you in advance for your cooperation and please contact me with any questions.

Karynlee Harrington

1/22/16 - Reminder about Annual Registration Updates and Changes in the Portal-ACTION REQUIRED

As discussed during the October 20, 2015 Claims Data Submitter Group webinar, there are several important things happening in the MHDO Data Warehouse Portal starting February 3rd that require action from payers. Below is a summary of the purposes and timelines for the upcoming activities. Detailed instructions are are available as well.

The timelines for the upcoming changes and activities in the portal are:

  1. Registration Updates: Update all portal registration information, including contacts and company business. Action Required from: Administrative Contacts. Updates are required to be completed between February 3rd and February 29th. Although required annually, it is strongly recommended that portal users review and update company profiles, payer details and contact information as changes occur to ensure that communication with payers remains targeted and timely.
  2. Validation Override Resets: Evaluate 2016 data against validation rules with all existing Profile – and Exemption – Level validation rule overrides reset. Action Required from: Data Submitters.
  3. Updated Chapter 243 Implementation: Implement the revised and adopted MHDO Chapter 243 - Uniform Reporting System for Health Care Claims Data Sets for the submission of January 2016 data.
  4. Validation Rule Additions/Updates: Revise validation rules to accommodate changes to Chapter 243 and improve data quality. The updated validation rules were distributed October 28, 2015.

The new file format, validation rule changes, and validation resets will go into effect on February 3rd for January 2016 data submissions. These updates will ensure the accuracy and quality of registration and validation information within the MHDO Data Warehouse Portal.

Note: In order to make the transition to the reset and updated validation rules as seamless as possible, all data submitted from February 1 through February 2 will not be validated until overrides are reset and updated validation rules go into effect on February 3rd. Submissions can be made from February 1 through February 2, but they will not be processed until February 3rd.

11/23/15 Message Re: Testing of Chapter 243 validation rule changes from Karynlee Harrington, Acting Executive Director

As a reminder, testing of the revised Chapter 243 layout and validation rule changes will end in the MHDO Data Warehouse Portal Test Site on Monday, November 30th.

To date only a few companies have utilized this testing opportunity. Instructions for testing, as well as updated validation rules are available.

Below are a few key reminders.

  1. The new file format for the recently revised and adopted MHDO Chapter 243 - Uniform Reporting System for Health Care Claims Data Sets will go into effect on 2/1/2016 with January 2016 data submissions– see Chapter 243.
  2. A recording of the 10/20/15 webinar regarding the upcoming changes is available.
  3. The Frequently Asked Questions (FAQs) within the MHDO Data Warehouse Portal will be updated periodically with questions related to Chapter 243 changes.
  4. Below is a timeline for testing and implementation of the changes

If you have questions, please contact Philippe Bonneau at philippe.bonneau@maine.gov or 207-287-6743. Thank you and happy holidays. Karynlee

10/28/15 Testing of Chapter 243 and validation rule changes begins today

Testing of Chapter 243 and validation rule changes begins today, October 28th in the MHDO Data Warehouse Portal Test Site. Please see the instructions for testing, as well as the updated validation rules. Please note there have been some slight modifications to the validation rules since they were first distributed on September 29th. These changes are noted in the spreadsheet. Below are a few key reminders.

  1. Chapter 243 - Uniform Reporting System for Health Care Claims Data Sets was revised and went into effect 10/6/15. Data submissions from January 2016 forward are required in the new format after 2/1/16.
  2. You may refer to the recording of the 10/20/15 webinar which covered these changes.
  3. Once testing begins the Frequently Asked Questions (FAQs) within the MHDO Data Warehouse Portal will be updated periodically with questions related to Chapter 243 changes.
  4. Below is a timeline for testing and implementation of the changes
Task Start Date End Date
Test Portal Open for Payer Testing of New Chapter 243 Format and Validation Changes – Sample File Layout Available in Portal 10/28/2015 11/30/2015
Resolve issues identified in testing 12/1/2015 1/31/2016
Submissions during this period will be held (not validated) until new rules are in place 2/1/2016 2/2/2016
Production Portal Open - New Chapter 243 Format and Validations 2/3/2016 2/3/2016
Submissions of New Chapter 243 Format Files (January 2016 data) 2/3/2016 2/29/2016
10/23/15 Here are the deck and recording of the 10/20/15 webinar.

9/29/15 Email from Karynlee Harrington

We are quickly approaching the testing period for changes to both the APCD file format requirements under 90-590 Chapter 243 and the APCD validation rules. The Maine Health Data Organization will be hosting a webinar to review these key changes October 20, 2015 from 3:00 to 4:00 PM ET. Here is the tentative agenda.

Please register for the webinar. If you are unable to attend, it will be recorded and posted on this page approximately one week later.

Key Notes:
The proposed changes to Chapter 243 were recently adopted by the MHDO Board. A copy of the most recent draft proposal can be found on the Rules and Statutes page. Here is a link to view the proposed validation changes. If you have specific questions that you would like us to address at the October 20th webinar please e-mail Philippe Bonneau at Philippe.Bonneau@maine.gov.

Thank you and I look forward to connecting with you on the 20th. - Karynlee

9/25/15 ICD-10 Testing Update - email from Karynlee Harrington

The official testing period of the new ICD-10 validations will end on September 30th. Below are a few key reminders and the location of testing instructions. Submission and validation of ICD-10 fields will begin in the production MHDO Data Warehouse Portal on November 4th.

Reminders

  • Chapter 243 - Uniform Reporting System for Health Care Claims Data Sets was revised and implemented last year to include new fields for ICD-10 – see Chapter 243 and Final Summary of Changes to Chapter 243. Your file layout already includes space for these fields which you will now populate and will be validated by the system.
  • A reminder of the testing and implementation timeline is below and available on the MHDO Data Warehouse Portal.
  • Testing of the new validation rules for the ICD-10 fields is optional.
  • The Frequently Asked Questions (FAQs) within the MHDO Data Warehouse Portal will be updated periodically with questions related to this topic.

If you have questions, please contact Philippe Bonneau at philippe.bonneau@maine.gov or 207-287-6743. Thank you. Karynlee

8/24/15 ICD-10 Testing Update- email from Karynlee Harrington 8/12/15

As a result of payer and data user feedback we are making some modifications to a few of the validation codes lists being used to validate ICD-10 fields. The revised lists are less restrictive than the original set. Below is a summary of the key points:

ICD-10-CM Fields

  1. Diagnosis Codes: All codes are valid (previously V-Z codes were not allowed).
  2. Reason for Visit Diagnosis: All codes, except V01 – Y99 are valid (previously only Z codes were allowed).
  3. External Cause of Injury: Only V01 – Y99 codes are valid (no changes).

These changes will be implemented and available for testing in the MHDO Data Warehouse Portal Test Site on Friday, August 14. A revised spreadsheet of validation rules and the testing instructions are available. The changes are reflected in the Lists tab of the spreadsheet.

Reminders:

  1. Chapter 243 - Uniform Reporting System for Health Care Claims Data Sets was revised and implemented last year to include new fields for ICD-10 – see Chapter 243 and Final Summary of Changes to Chapter 243. Your file layout already includes space for these fields which you will now populate and will be validated by the system.
  2. Below is a reminder of the testing and implementation timeline. It is available on the MHDO Data Warehouse Portal as well.
  3. Testing of the new validation rules for the ICD-10 fields is optional.
  4. The Frequently Asked Questions (FAQs) within the MHDO Data Warehouse Portal will be updated periodically with questions related to this topic.
8/3/15 ICD-10 Testing Update

Testing of the new ICD-10 validations will begin August 5th in the MHDO Data Warehouse Portal Test Site. Please see the instructions as well as the validation rules (Note: validation rules changed 8/12/15. See revised spreadsheet of validation rules) before you begin.

ICD-10 Testing and Implementation Timeline

Task Start Date End Date
Payer testing of new validation rules in designated payer test environment 8/5/2015 9/30/2015
Resolve issues identified in testing 10/1/2015 10/30/2015
Submissions during this period will be held (not validated) until new rules are in place 11/1/2015 11/3/2015
Begin submissions of ICD-10 fields (October data) 11/4/2015 11/4/2015

June 1, 2015 ICD-10 Validation Rules:

A list of proposed validation rules for the ICD-10 fields are now available.

February 2015 - Annual Registration Updates and Validation Override Resets

As discussed during last month’s PUG meeting there are several important things happening in the MHDO Data Warehouse Portal next month that require action from payers. Starting February 4th companies will need to update their registration within the portal and validation overrides will be reset.

We will be sending targeted communications with detailed instructions to Administrative Contacts and Data Submitters next week. Below is a high level summary of the purpose and timelines for the upcoming activities.Detailed instructions can be found here.

The purpose of the upcoming registration updates and validation override resets is to:

  1. Update all portal registration information, including contacts and company business. Action Required from: Administrative Contacts
  2. Evaluate 2015 data against validation rules with all existing Profile – and Exemption – Level validation rule overrides reset. Action Required from: Data Submitters
  3. Revise a handful of validation rules to improve data quality.

These updates will ensure the accuracy and quality of registration and validation information within the MHDO Data Warehouse Portal.

Timelines:

Annual registration updates are required to be completed between February 4th and February 28th. Although required only once annually, it is strongly recommended that portal users review and update company profiles, payer details and contact information as changes occur to ensure that communication with payers remains targeted and timely.

Validation Overrides will be reset, and updated validation rules will go into effect on February 4th for January 2015 data.

Webinar Meeting Was Held December 11, 2014 2:00 - 3:00

Please see the agenda and PowerPoint Presentation.

Submission of New Chapter 243 Format In Production - October 2014 data

All data for the period of October 2014 forward is to be submitted in the new MHDO Chapter 243 format. October files (in the new format) are to be submitted in the production portal (https://mhdo.maine.gov/portal/) starting on November 6th.

Important Reminders

  1. Beginning November 6, 2014, regardless of data period, submissions to the production portal will only be accepted in the new MHDO Chapter 243 layout.
  2. If you have outstanding structural issues to resolve or missing data to submit for data prior to October 2014 you must do so no later than November 5, 2014 since we will no longer accept the old format after that date.

Please contact the help desk at 866-315-7125 or mhdohelp@norc.org or Philippe Bonneau if you have any questions. Thank you!

September 30, 2014 - Important Dates for New Chapter 243 Format

Testing the New Chapter 243 Format

Thank you to everyone who participated in the September testing period. While the official testing period will end today, September 30, 2014, the test portal will remain open and available for use until changes are moved to production. As a reminder, the Payer Test Instructions are still available.

Submission of New Chapter 243 Format In Production –October 2014 data

All data for the period of October 2014 forward is expected to be submitted in the new Chapter 243 format. October files in the new format are only to be submitted in production portal (https://mhdo.maine.gov/portal/) starting on November 6.

Beginning November 6, 2014, regardless of data period, submissions to the production portal will only be accepted in the new Chapter 243 layout. If you have outstanding structural issues to resolve or missing data to submit for data prior to October 2014 you are strongly encouraged to do so no later than November 5, 2014 since we will no longer accept the old format after that date.

Thank you.

August 29, 2014 - Test Portal For Ch. 243 Format Changes Will Be Available Tuesday September 2nd

Explicit directions can be found in the Payer Test Instructions. Please remember the site Will Not Be Available Until 9/2/14.

August 25, 2014 - Sample Text Files For Ch. 243 Changes Are Available

Sample text files which conform to the new APCD file format requirements of Chapter 243 are now available on the Data Warehouse Portal under the Resources Menu. These file formats will go into effect beginning with the submission of data for October 2014 and can be used to prepare files for the upcoming testing period which will begin September 2nd. Instructions for testing will be distributed by Friday, August 29th.

August 12, 2014 - Video is Now Available

The video from the 7/31/14 meeting is now available under Training Videos within the Resources menu of the MHDO Data Warehouse Portal.

August 5, 2014 - Updated Presentation and Documentation from July 31, 2014 Chapter 243 Webinar

July 25, 2014

Just a quick reminder that the Maine Health Data Organization will be hosting a webinar for our Payer User Group July 31, 2014 from 2:30 to 3:30 PM ET. See the Agenda which also includes information to log into the webinar. You may review the Powerpoint document and the validation changes spreadsheet we will cover. I hope you can join us next week and look forward to the discussion.

Please e-mail Philippe Bonneau at Philippe.Bonneau@maine.gov with specific questions regarding the changes to Chapter 243 that you would like us to address during the July 31 webinar.

Karynlee Harrington, Acting Executive Director

July 11, 2014 - Communication of Chapter 243 Changes

From Karynlee Harrington, Acting Executive Director, Maine Health Data Organization:
How time flies! We are quickly approaching the testing period for the new APCD file format requirements under 90-590 Chapter 243. The Maine Health Data Organization will be hosting a webinar July 31, 2014 from 2:30 to 3:30 PM EST for a Payer User Group meeting for the limited purpose of discussing recent Chapter 243 changes.

Tentative Agenda
July 31, 2014
2:30 p.m. - 3:30 p.m. EST

  1. Opening Comments
  2. Overview of Chapter 243 Changes, including Clarification of Requirement for Specific Elements
  3. Implementation Timeline, including Testing
  4. Validation Updates
  5. Payer Q&A

Additional details will follow soon. In the meantime, please e-mail Philippe Bonneau at Philippe.Bonneau@maine.gov with specific questions regarding the changes to Chapter 243 that you would like us to address during the July 31st webinar.

May 19, 2014 - Chapter 243 timeline For Testing

From Karynlee Harrington, Acting Executive Director, Maine Health Data Organization:
As the formal approval process for Chapter 243 nears completion, we are taking the opportunity to provide payers with an update to the MHDO Chapter 243 timeline for testing. If you have questions, please contact me or Philippe Bonneau at 207-287-6743 or philippe.bonneau@maine.gov.


Maine Health Data Organization Chapter 243 Timeline
Task Start Date End Date
MHDO Board reviews and provisionally approves adoption of rule changes. Final approval pending approval from the Attorney General's Office (expected by end of May). 5/1/2014 5/1/2014
Notify Payers of Chapter 243 Validation Revisions 7/15/2014 7/15/2014
Payer Testing of new Chapter 243 format and validations in designated test environment 9/1/2014 9/30/2014
Resolve issues identified in testing 10/1/2014 10/31/2014
Deploy new Chapter 243 format and validations to Portal 11/5/2014 11/5/2014
Begin submissions of new Chapter 243 format files (October 2014 data) 11/6/2014 11/6/2014
 

April 22, 2014 Status of:
I. The MHDO Data Validations (profile, exemption and ad-hoc) and Next Steps
II. Naming Files and a New Structural Validation

I. Data Validations (profile, exemption and ad-hoc) & Next Steps

Background:
All claims data submitted to the MHDO (through our Portal) are evaluated against a set of rules before they are allowed into our data warehouse. As you may remember, when we first released the validation rules for the new MHDO Portal we promised that we would assess how the validations are working in the system and against the data. After six months of data had been submitted through the Portal we began this assessment. Note the assessment included the deployment of the Validation Reports in the Portal so Administrative Contacts and Data Submitters could view the results of the validations against their data. Our assessment included reviewing all Profile, Exemption and Ad Hoc Level validation rules. With respect to each rule, the following options were possible: 1) do not change; 2) eliminate the rule, 3) lower the threshold; or 4) modify the rule logic.

Results:
Changes to the validation rules, by file type, are presented in this validation summary spreadsheet. Based on our assessment of the 310 current Profile, Exemption and Ad Hoc Level validation rules, we are eliminating 30 (9.7%) validation rules, lowering 101 (32.7%) thresholds and modifying the logic of 23 (7.4%) rules. We have not added any new validations or made validations more stringent, but there were some validations that weren’t working correctly that have been fixed. These fall into the category of modifying rule logic.

Implementation and Timeline:

  • All current exemptions will expire on April 30, 2014
  • We plan to release the revised validations into the Portal on May 8, 2014
  • All profile validation overrides that you have set up in the Portal will remain in effect until the annual review at the end of the year
  • In order to make the transition to the updated validation set as seamless as possible, data submitted from May 1 – May 7 will not be validated until the new rule set goes into effect on May 8th. NOTE: During the May 1 - May 7 time period, submissions can be made but they will not be processed.
  • On May 8th we will also release an enhanced validation exemption manager that will allow you to more easily review and request updates to exemptions. The user guide will be updated to reflect these changes.

II. Naming Files:
There are some payers that are submitting duplicate healthcare claims data files with the same name to the Portal. When the version numbers in the file names are not properly incremented, duplicate files are created. Unfortunately, this causes confusion regarding which file submissions are valid. In order to eliminate the confusion we are adding a new structural validation rule to check for duplicate file names on submission. Duplicate file names will result in structural failures that must be resolved by renaming and resubmitting the files. The rules for naming files, particularly resubmissions can be found at: https://mhdo.maine.gov/portal/Home/UserManual#naming.

Payer FAQ's Regarding Proposed Changes to Chapter 243 are now available.

Follow Up Documents from 2/6/14 Meeting

The Revision of the Draft Proposed Rule Chapter 243 is now posted on our Rules and Statutes page. Also available is the HealthCost Project Abstract.

We are still accepting survey responses: If you have not yet completed the warehouse portal satisfaction survey, please take a moment to do so. We value your feedback!

Please take a moment to complete a Satisfaction Survey for the Data Warehouse Portal.

1/30/14 - The deadline for completing the survey has been moved to February 4th. If you have not yet completed the survey, please take a moment to do so. We value your feedback.

1/17/14 - In order to continue to improve our Portal and service to you we have prepared a satisfaction survey. The information you provide will help us with future enhancements.

Survey responses will be shared on the February 6th webinar.

12/6/13 - Waiver of Annual Registration Requirements for Payers not Required to Submit Claims Data.

At the MHDO December 5, 2013 Board of Directors meeting, the Board made the decision to suspend operation and requirement of Chapter 243 Section (2)(A)(9)(a) “but shall comply with the annual registration requirements of Section 3(A)”.

Until further action of the MHDO Board of Directors, including rulemaking, health care claims processors that are excluded from filing health care claim data sets shall not have to register under Section 3(A).

11/15/13 - Reminder Regarding Data Submission Deadlines and Help Desk Availability

If you are a monthly submitter your October 2013 claims must be submitted by November 30, 2013. If you have questions or concerns about this deadline please contact Philippe Bonneau, Compliance Officer, Maine Health Data Organization at philippe.bonneau@maine.gov or 207-287-6743.

The Portal Help Desk will be closed Thursday November 28th and Friday the 29th for Thanksgiving.

10/25/13 - Reminder Regarding Data Submissions Deadline

If you are a monthly data submitter your September 2013 claims must be submitted by October 31, 2013.
If you are a quarterly data submitter your 2013 third quarter (July, August, and September) claims must be submitted by October 31, 2013.

If you have questions or concerns about these deadlines please contact Philippe Bonneau, Compliance Officer, MHDO at philippe.bonneau@maine.gov or 207-287-6743.

9/20/13 - Important Upcoming Date and Tips on Data Submissions

It has been a week since we opened our new portal and we hope your experience has been positive during this transitional time. Please read further to see a reminder about an important upcoming date and data submission tips that you may find helpful when submitting your data and dealing with validation issues.

The User Guide Part 2 has been updated with additional guidance for file naming and updates to the SFTP information. You can find the User Guide on the Portal at: https://mhdo.maine.gov/portal/ under the Resources tab.

IMPORTANT DATE: Monday, September 30

  • Update your Company Registration and Contact Information in the Portal. Each company must have at least one Administrative Contact, one Compliance Contact, one Eligibility Contact and One File-specific Contact. These may be the same person.
  • Submit your data. If you are a monthly submitter, both the July and August 2013 files are due to be submitted and all validation issues resolved.

Data Submission Tips

  • File Naming Conventions: Leading zeros must be used in the sequence and version number.
  • Profile Level Validation Issues: If an issue is raised as a profile level issue and the validation is not appropriate for your book of business, you can override the issue yourself and you will bypass the validation. Threshold levels will not be adjusted. For more information on overriding profile level validations, go to User Manual 2, Section 7.1.4 which can be found under the Resources tab on the Date Warehouse Portal
  • Relationship Codes: For fields MC011, DC011, ME012, the code 34 is no longer a valid code under the 5010 standard. These should be re-coded as G8 for the file to pass validation for those fields.
  • Structural Failure: Do not include extra * at the end of rows. The system will detect it as an extra field and cause a structural failure on the file.
  • Required Field Lengths: Do not submit anything longer than the required field length or it will cause a validation issue.
  • If the data standard includes capitalized letters, the letter(s) must be capitalized or the file will fail.
  • Leading zero must be included on all numbers that require it according to the standard.
Help Desk

8/30/13 - We are happy to announce that the MHDO Data Warehouse Portal is now open and accessible at: https://mhdo.maine.gov/portal

The User Guide is available in the Portal under “Resources”, along with the Training Video and transcript from Wednesday’s training.

Administrative Contact
If you are your company’s Administrative Contact you should have received a system email from: portal@mhdo.maine.gov with your login credentials. Please check your junk and spam filters if you did not receive an email. If you did not receive it, please contact the Portal Help Desk.

Other Users
If you are not your company’s Administrative Contact, please refer to the User Manual for more information about requesting an account from your Administrative Contact or you can wait until you receive an invitation from your Administrative Contact.

Portal Help Desk
Email: mhdohelp@norc.org
Toll-Free Phone: (866) 315-7125

8/22/13 Important announcement regarding data submission process changes.

It is hard to believe that we are weeks away from going live with our new ETL claims platform. I want to thank all of you that have been engaged in the process from the beginning. Your feedback has been instructive and has ultimately helped us build a system that is more responsive and efficient.

Those of you who have been involved in the beta testing process or the Payer Users Group may already be aware of many of the following items. For others, this may be your first introduction to our new system. This message provides a summary of some of the key activities that will be occurring over the next few weeks as we gear up for the go live date. This development effort is all part of MHDO’s agency transformation effort that we rolled out in February. Please continue to visit this page for timely updates and direction.

We are opening the new MHDO Data Warehouse Portal in two stages.

Stage 1: Starting August 28th, the MHDO Data Warehouse Portal will open for company registration. We will be preloading existing company information into the portal and will be sending out usernames and passwords to your company’s Administrative Contact. This information will allow the Administrative Contact to log into the system to set up their registration and add additional system users.

Note: The Portal will require an assignment of an Administrative Contact. The Administrative Contact is responsible for:

  • Setting up additional users.
  • Determining access levels.
  • Providing answers to the registration questions.
  • Serve as the primary point of contact.

The new data validations (formally referred to as “edits”) will also be available in the Data Warehouse Portal in stage 1-You will be able to review data validations and set up your company validation profiles.

Stage 2: Starting September 12th, users can begin to submit their July and August 2013 files using the new system. Note: July and August 2013 files are due by the end of September 2013. File submissions thereafter will follow the normal submission schedule.

Important Dates, Activities and Training Sessions:

User Account Set-up – Administrative Contact

In order to setup user accounts we need you to identify one user as the Administrative Contact for your company by COB, Monday, August 26th. Please send the person’s name and email address to: MHDO@hsri.org.The Administrative Contact person you identify will receive their credentials via email to sign-in to the portal the afternoon of Wednesday, August 28th. The Administrative Contact will be responsible for adding additional users as needed. You will also have the ability to register additional Administrative Contacts. If you participated in Phase 4 testing, you can skip this step and continue to use the accounts setup during testing.

Portal Registration System User Training - Wednesday, August 28th 1:00-2:00 PM EST This training session will be conducted via a webinar and is available for all system users. If you are unable to join this training session or would like more information, a training video and user manual will be made available. Please use the link below to register for this event by close of business, Tuesday, August 27th. Those who are registered for the training session will be e-mailed a copy of the User Manual the day of the training.

Data Submission and Validation System Training – Thursday, September 12th 1:00-2:00 PM EST This training will be available for all system users who will be submitting or validating data in the system. Data submissions can be either uploaded through the portal or through a SFTP connection. The information needed to establish an SFTP connection for data submission, including how to obtain an encryption password, will be distributed at this time. Once data are submitted through either method, interactive validation reports will be made available through the portal. If you are unable to attend this training or would like more information, a training video and user manual will be made available. Please use the link below, prior to 9/12/13 1:00 PM EST, to register for this event.

System Help Desk - Opens Thursday, August 28th

Starting on August 28th, a MHDO Data Warehouse help desk will open for any technical issues that system users may encounter.

  • Phone number: (866) 315-7125
  • Email Address: mhdohelp@norc.org

Information about the New System:

  • The current file layout will not change in the new system.
  • Payers will have a choice of whether to submit via SFTP or via the new portal (HTTPS).
  • There will be a change in the file naming convention.
  • Sensitive information within files will no longer be protected using field-level encryption; instead, file-level encryption will be used.
  • Payers will use commercially available, payer-approved file compression and encryption software, rather than proprietary software created and distributed by the vendor.
  • HSRI will provide system documentation and training for payers prior to the submission of files, and a help desk has been established specifically to assist payers with technical questions and issues once submission of healthcare claims data resumes.

Details about the Data Submission/Transfer Process:

Below is information about the new process of transferring data to MHDO for the new data warehouse. As a reminder this process will not require you to install new software on your computer.

Compression and Encryption of Files

In order to ensure the security of personally identifiable information and personal health information that is submitted to the MHDO Data Warehouse and to reduce file transmission times, MHDO will be requiring submitters to compress and encrypt all files before uploading to the warehouse. This file-level encryption will ensure the confidentiality of all data that is submitted to the warehouse, not just certain sensitive fields. This compression and encryption can be accomplished by a number of industry standard tools, such as WinZip or 7-Zip which already may be deployed within submitters’ infrastructure. Submitters will no longer be expected to run a custom MHDO-provided application to perform encryption.

Compression and Encryption Requirements:

  • Each file that is to be uploaded to the MHDO Data Warehouse portal should be added to a separate zip archive.
  • The archive should be encrypted using 256-bit AES encryption using the submitter’s unique encryption password. This password can be obtained within the MHDO Data Warehouse Portal.

Transfer Options

Once the files to be submitted have been compressed and encrypted, as outlined above, they need to be transferred to the data warehouse for validation and load. There are two ways that files can be transferred: the SFTP Process and via the MHDO Portal.

SFTP Process

The SFTP process is designed primarily for users who want to set up an automated transfer of files, however, it is available for any payer who wishes to make use of it. The MHDO Data Warehouse Portal has established an SFTP server to receive files. Payers may make use of any third-party SFTP tool (such as WinSCP or FileZilla) to send files.

In order to use the SFTP process, payers will have to request an SFTP ID. This request can be initiated via the Account section of the MHDO Portal. Once a request is received, an email with links to securely download their account credentials will be sent back to the requester. This will be reviewed in the training session.

All files transferred will be automatically associated with the proper account. However, it is important that the files be named according to a standard naming convention to ensure that the file type and submission periods can properly be discerned. Details of this naming convention will be provided in the user manual and during the training session.

Connection Information for SFTP Server

  • Server Name: transfer.norc.org
  • User: the email address of the user who requested the SFTP password through the portal (Available after September 12th)
  • Password: Leave blank – a private key will be used to authenticate

Data Upload for transferring claims data via MHDO Data Warehouse Portal

All users will also be able to submit files via the MHDO Portal by going to the “New Submission” menu option. They will then be prompted to enter the location of the file to upload. The file will then be uploaded to the warehouse and validated.

This process is designed to be used interactively. The file transfer will only continue while the web browser is kept open. The transfer process will be suspended if the transfer window or browser is closed, so it may be most appropriate for smaller files.

May 20, 2013

With your guidance, over the last few months we have addressed the following:

  1. The mechanics of the file submission process - based on your feedback the design will be flexible.
  2. The structure of the file validation process - based on your feedback the goal of the structure is to reduce the number of iterations and to give more control to the plans over validations which are dependent on your individual books of business. In our proposal approximately 75% of the validations are in the control of the plans.
  3. Received feedback on the individual validations - based on your feedback we have made some revisions and we will be sending to you by the end of the month a revised document which will include proposed threshold levels
  4. The PACDR and the EDI structure - based on your feedback (some plans supporting the adoption of the PACDR and the EDI and other plans uncertain at this time) we have decided to delay the implementation of the PACDR standard to the fall of 2014. We need to continue this discussion once our new ETL is operational.

PUG Meeting Agendas and Pertinent Documents

2/6/14 meeting

7/24/13 meeting

5/8/13 meeting

4/24/13 meeting

4/10/13 meeting

3/27/13 meeting