Transcript Welcome to the November User Group

2007 / 2008 Monthly
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Risk Adjustment
User Group
July 2008
Welcome to the July
User Group
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Introduction
Payment Process
Operations Update
Data Validation
Technical Assistance Update
Questions and Answers
Closing
2007 / 2008
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INTRODUCTION
2007 / 2008
User Group Process
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All attendees must pre-register
It is only necessary to register once
Retain unique PIN for all sessions
Session will last for one hour
Session slides will be available by
the Tuesday before the session
• Panel will answer questions during
the Q&A portion of the session
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INTRODUCTION
2007 / 2008
• The 2008 monthly Risk Adjustment
User Group Q & A and Notes
documents are posted at the CSSC
Operations website.
www.csscoperations.com/new/usergroup/usergroupinfo.html
• Please continue to review the
website for updates to this
information.
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PAYMENT PROCESS
(PART A-ONLY OPTION)
2007 / 2008
• Effective for 2006 payments, organizations may elect
to have CMS determine payments for all “Part A-only”
enrollees using either new enrollee factors or full risk
adjustment factors.
• Plans may not elect to move some eligible “Part Aonly” enrollees into full risk adjustment, while retaining
others as new enrollees.
• Once elected, this option will remain turned “on” until
CMS is otherwise notified prior to August 31st of any
successive year.
• This option is applied during reconciliation for a
payment year only (i.e., it will not be applied
prospectively).
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• Plans interested in this option must contact
[email protected] by August 31st.
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PAYMENT PROCESS
(PART A-ONLY OPTION TABLE)
2007 / 2008
Beneficiary entitled Beneficiary entitled
under Part A
under Part A
Beneficiary
enrolled in
Part B
0 – 11 months
>= 12 months
0 – 11 months
New enrollee
factors
New enrollee of full
risk factors
>= 12 months
Full risk factors
Full risk factors
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DATA VALIDATION
2007 / 2008
• Calendar Year 2007
• Calendar Year 2006
• Calendar Year 2005
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OPERATIONS
2007 / 2008
Connecting to the FERAS
• To establish an IP connection with the
FERAS, you must be connected to the
Medicare Data Communications Network
(MDCN), which is provided by AT&T
Global Network Services. The MDCN is
the secure network linking the Risk
Adjustment data processing entities.
• If you are not connected to the MDCN,
please contact AT&T at 1-800-905-2069.
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OPERATIONS
2007 / 2008
• All submitters with IP network access
have been authorized to connect to the
FERAS.
• In order to submit claims to the FERAS
via the MDCN, you must be enrolled with
the CSSC Operations. If you are not
enrolled, please contact the CSSC
Operations Help Line at (877) 534-2772.
Once enrolled with the CSSC, to submit
and retrieve data electronically, you will
receive a Submitter ID and a password.
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TECHNICAL ASSISTANCE
UPDATES
2007 / 2008
2008 Monthly
Technical Assistance Sessions
• Enrollment & Payment Session
– July 30th
• Due to Regional Technical Assistance
Sessions, the August Monthly Technical
Assistance Session is canceled
Register today at
www.tarsc.info
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REGIONAL TECHNICAL
ASSISTANCE SESSIONS
2007 / 2008
Limited Availability…Register Soon!
CHICAGO, IL
August 11 – August 14
LAS VEGAS, NV
registration is closed
NEW ORLEANS, LA
September 9 – September 10
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TECHNICAL ASSISTANCE
UPDATES
2007 / 2008
*For detailed information
and to
register online
log on to
www.tarsc.info
Technical Assistance
Registration Service Center
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RESOURCES
2007 / 2008
• Sean Creighton (Director, Division Risk
Adjustment Operations)
[email protected]
• Henry Thomas (Training, Project Officer)
[email protected]
• Lateefah Hughes (Data Validation, Team
Lead) [email protected]
• Louis Johnson (FERAS,GTL)
[email protected]
• Chanda McNeal (Payment Issues)
[email protected]
• LTC www.tarsc.info
• CSSC www.csscoperations.com
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