1. Health Budgets & Financial Policy TRICARE Data Quality Training Course March 1, 2011 DATA QUALITY MANAGEMENT CONTROL (DQMC) PROGRAM (continued)

2. Health Budgets & Financial Policy 1 MHS Data RepositoryMedical Records Paper Records Coding Audit Random Sample 7100 records pulled at random SIDRs SADRs MERHCF Medical Record Copy Audit for availability of record Audit for accuracy of of coding Reliability tests confirmed audit results Intra-examiner (same auditor – reaudit later in time) Inter-examiner (different auditor – reaudit) Random Sample List AHLTA DQMC Program Inspections/External Audits FY 2010 MTF External Coding Audit: Process

3. Health Budgets & Financial Policy 2 AuditType of Record Source of Record ServiceNumber in Sample AnnualSIDRInpatientArmy700 AnnualSADROutpatient, Non-APVArmy700 AnnualSADRAPVArmy700 AnnualSIDRInpatientNavy700 AnnualSADROutpatient, Non-APVNavy700 AnnualSADRAPVNavy700 AnnualSIDRInpatientAir Force700 AnnualSADROutpatient, Non-APVAir Force700 AnnualSADRAPVAir Force700 MERHCFSIDRInpatientMHS wide400 MERHCFSADROutpatientMHS wide400 11 random samples of FY 2008 medical records drawn from across the direct care system Total audit size = 7,100 DQMC Program Inspections/External Audits

4. Health Budgets & Financial Policy 3 External Coding Audit Response Rates FY 2010 (Data Records FY 2008) DQMC Program Inspections/External Audits

5. Health Budgets & Financial Policy 4 DQMC Program Inspections/External Audits External Coding Audit Response Rates FY 2010 (Data Records FY 2008)

6. Health Budgets & Financial Policy 5 DQMC Program Inspections/External Audits

7. Health Budgets & Financial Policy 6 DQMC Program Inspections/External Audits

8. Health Budgets & Financial Policy 7 DQMC Program Inspections/External Audits Note: Quick Fix – send the AHLTA cited documentation