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ATAG: FFQ Overview and Update Date: 3/12/2015. FFQ Overview and Update  Goals of FFQ  Initial reporting  What we have learned.

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Presentation on theme: "ATAG: FFQ Overview and Update Date: 3/12/2015. FFQ Overview and Update  Goals of FFQ  Initial reporting  What we have learned."— Presentation transcript:

1 ATAG: FFQ Overview and Update Date: 3/12/2015

2 FFQ Overview and Update  Goals of FFQ  Initial reporting  What we have learned

3 Goals of Implementing FFQ System  Customization  Submitters can directly request exceptions for non-catastrophic failures  Exceptions can be granted with more flexibility:  Single file only  Exception granted for a period of time  Exception granted, but new thresholds defined  Timing  Files are checked prior to being loaded to decrease the response time to data submitters  Reporting  Timing  Results  Potential new quality checks

4 Initial Submissions  Receipt of initial submission  2014Q4 submissions were due 1/31/2015  31 initial submissions received on time  Average day of receipt: 1/21/2015  11 submissions received in final week  4 submissions received late  4 submissions had approved APAC-3  Challenges  Files must adhere to the current Data Layout specifications

5 Initial Submissions  Field Level Checks  Challenges  Files must adhere to the current Data Layout specifications  Upfront file checking – spaces in fields  Example: NPI that contains spaces after data  “ ” vs “ ”

6 Initial Submissions  Quality Checks  Similar success rates on quality checks when compared to prior validation process.  Feedback from submitters resulted in a change to the quality checks  Provider file – NPI or Taxonomy

7 File Resubmissions  Resubmissions as of 3/1/2015  137 files had been resubmitted  Average turnaround time per file was 7.1 days  Average turnaround for overall submission was 16.0 days  Challenges:  Naming conventions .TXT files  2015Q1 naming convention  Resubmitting previously approved files  Potential for exception requests to be overwritten  Some files failed second time through  Additional processing time for system

8 Exception Requests  Exceptions requested on 22 files  Working with submitters on a few exception requests  Challenges:  Prior exception requests were not ported over  Resubmissions of previously accepted files

9 Latest Status of Submissions  Many issues have been resolved, although 19 of 34 submissions are still outstanding.  8 files still have catastrophic failures as of 3/1/2015  Working with submitters on exception requests  Challenges:  Turnaround time on follow up by Milliman with data submitters  Some exception requests may require a discussion over the phone prior to ruling

10 Lessons Learned  Report validation  Milliman reviewed/confirmed each of the reports prior to sending to data submitters.  This will not occur for future submissions which will result in quicker feed back.  New process for checking files  Upfront file checks surfaced a number of “new” issues for data submitters.  Process now in place; hopefully this does not cause issues for future submissions.

11 Lessons Learned  Naming conventions  Stricter guidelines needed for file naming conventions, specifically: .txt files will be immediately rejected  Files submitted for the incorrect quarter will be rejected (example: naming convention of 2015Q1 for 2014Q4 files)  Communication will be sent prior to any validation of the file so immediate resubmission can occur.  Resubmitting previously approved files  Previously, it was up to data submitters whether or not they would resubmit an entire set of files in the event a single file had an error.  With the new process, Milliman now prefers that only the needed file(s) be resubmitted (note that control files may need to be submitted if changes are made to accompanying files)

12 Lessons Learned  Turnaround time on follow up by Milliman with data submitters.  We are looking to incorporate automated reminders into the system that will:  Remind submitters of upcoming due dates  Remind submitters of outstanding files  Timing TBD  Some exception requests may require a discussion over the phone prior to ruling  Working with OHA and data submitters on best approach.


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