Center for Health Statistics Texas Health Care Information Collection Hospital Discharge Data/ Submission Requirements T

1. Center for Health StatisticsTexas Health Care Information CollectionHospital Discharge Data/ Submission Requirements Training Revised November 2008

2. What is covered in the THCIC presentations: • Upload and Download of Data (Secured Server) • Data Correction Process and Data Correction Software • Data Certification Process and CertView Software • KeyClaim Software (at facility requests)

3. Background Information • Chapter 108 of the Texas Health and Safety Code established and authorizes THCIC to collect and report on hospital discharge data. • http://tlo2.tlc.state.tx.us/statutes/docs/HS/content/word/hs.002.00.000108.00.doc • http://tlo2.tlc.state.tx.us/statutes/docs/HS/content/pdf/hs.002.00.000108.00.pdf

4. THCIC rules are found in the Texas Administrative Code: • Title 25. Health Services Part I. Department of State Health Services Chapter 421. Health Care Information • Collection and Release of Hospital Discharge Data §421.11-20, and §421.41-44 • Collection and Release of HMO HEDIS Data §421.31-35 • http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tac_view=4&ti=25&pt=1&ch=421

5. Upload and Download of Data – Secured Server • Agenda for Presentation • Changes to the System 13,formerlyCommonwealth Clinical System (CCS) Helpdesk • Data Submission • Password Change • New System Features • Uploading and Downloading of Data Via Secured Server

6. THCIC Helpdesk THCIC Helpdesk Changes Effective September 2, 2008, the THCIC helpdesk will limit hospitals/submitters to ten minutes per call session.  Hospitals/submitters may have only two call sessions per day, or one e-mail and one call session per day. The purpose of the helpdesk is for basic information. This includes: • Resetting a mailbox password • Obtaining a certification file password • Setting up KeyClaim users header files • Changing “submitter” contact information • Contracting a regeneration of certification file • Additional copies of certification file The THCIC helpdesk should not to be used for the following: • Hospital IT issues • Verifying data submissions (hospital primary contact should be verifying via the FER received in their electronic mailbox 48 hours after a data submission) • Training on submission, correction, and certification • Submission testing issues (after each test file is submitted, a report is sent by e-mail to the submitter detailing the problem areas within the file, which must be corrected before another test file is sent)

7. THCIC Contact Personnel • Contact Dee Roes at 512-458-7111 ext.3374 or Dee.Roes@dshs.state.tx.us if submitter test/production files reject due to a submission address or EIN/NPI number. • Contact Tiffany Overton at 512-458-7111 ext.2352 or Tiffany.Overton@dshs.state.tx.us. If your establishment have questions concerning the submission, correction, or certification of data, or need assistance with data correction or certification software.

8. System 13 Contact Information THCIC HELPDESK • Help Desk Phone: (888) 308-4953 • Fax: (434) 979-1047 • HyperTerminal Dial-in #: (434) 297-0367 • E-mail: THCIChelp@comclin.net • Web site: http://www.thcichelp.com • Address: System 13, Inc. 1648 State Farm Blvd Charlottesville, VA 22911

9. Data Submission - Requirements • Hospitals are required to report: - Data on all inpatients discharged during each calendar quarter. - On a quarterly basis as follows: 1st Quarter (Jan, Feb, Mar) is due June 1 2nd Quarter (Apr, May, Jun) is due September 1 3rd Quarter (Jul, Aug, Sep) is due December 1 4th Quarter (Oct, Nov, Dec) is due March 1 • All claims for discharges in a quarter must be received by THCIC no later than the first day of the third month after the end of the reporting quarter. Reporting frequency must be at least quarterly, although hospitals may request in writing to submit more frequently.

10. Data Submission - Schedule • The hospital reporting schedule and other important deadlines can be obtained from the THCIC Web site at: http://www.dshs.state.tx.us/THCIC/hospitals/schedule.shtm Chronological order of activities

11. Data Submission – Schedule Changes CMS-DRG, APR-DRG Incorrectly Assigned to 4q07 – 1q08 Cert Files (For Hospitals) As published from Volume 11, Numbered Letter 7 sent to facilities October 24, 2008 • System13, Inc., the contractor formerly known as Commonwealth Clinical Systems (CCS) that collects and processes the inpatient discharge data, has found that CMS-DRGs and APR-DRGs were not always correctly assigned for fourth quarter 2007 and first quarter 2008 data. The two assigned DRGs and the severity of illness scores were affected for each facility. • System13 will correct this problem (by re-processing each facilities existing data through the CMS-DRG and APR-DRG software tools) and provide the certification files for 4th quarter 2007 and 1st quarter 2008 containing the corrected reports for your review. These files will be available for download on Tuesday, October 28, 2008. The original submitted data will be the same unless you have contracted with System13, Inc. to have 1Q08 data modified (e.g., late data submissions, physician errors or deletion of duplicate claims) prior to the deadline for corrections at the time of certification. • The corrected DRGs affect only the reports available to you during the certification process. Certification reports C04 and C05 were not affected. Hospitals are encouraged to review the corrected files. If a hospital chooses to change how it certified 4th quarter data (e.g., certify without comments, certify with comments), the deadline for re-certifying the 4th quarter data is December 1, 2008. If a hospital wishes to change a certification comment, it must be sent to System13 by the December 1st deadline. • The deadline for certifying 1st quarter 2008 has been extended to January 2, 2009 and the deadline for corrections at time of certification has been extended to November 15, 2008. Hospitals having already submitted a certification letter for 1q08 do not need to submit another one unless there is a change in how it is certifying. • Questions may be directed to the THCIC Helpdesk at 888-308-4953

12. Data Submission – Methods • Hospitals may submit for themselves or use a submitting agent* • If your hospital is using a submitting agent, this must be reported to THCIC. (Mail or fax a notice onhospitalletterhead to the THCIC office.) • Each hospital is responsible for complying with regulations and reporting requirements even if they use a vendor or if their corporate office is submitting the data. * A submitting agent can be a vendor, another (parent) hospital, or a corporate office.

13. Data Submission – File Formats • Discharge data needs to be submitted in one of the following formats: • ANSI X12N 837 (electronic), with THCIC required data elements • KeyClaim (electronic), THCIC data entry tool • Claims data are required to be submitted electronically via the secured server (Internet.) You must have a Submitter ID and Submitter Password in order to submit any data.

14. System 13 E-mail Format The red box below shows you the format that you need to use when E-mailing System 13. You have to be the contact person for the facility to correspond with System 13 by e-mail. Place your Submitter ID or your Provider ID in the first line of the message text, then your facility/ hospital name.

15. E-mail Responses Facility contact information System 13 contact information The text box below is a new feature to System 13. It will be used to provide important information. Your THCIC electronic mailbox contains the following information that is waiting to be downloaded or sent to you on diskette. Gives a detailed reviewed on previously submitted data. Provides information on how to change provider information

16. Data Submission – Secured Server • Secured Server • All data and comments can be submitted and retrieved via Secured Server • See the uploading and downloading training session or the “THCIC Secured Server Procedures Manual”

17. Data Submission – Data Validation • Claims submissions are received on a daily basis by System 13. Submissions are subjected to: • file and claim format validations to ensure that the data submissions are processable and complete (no incomplete claims are accepted).

18. Data Submission –Acceptance/Rejection • If data is rejected due to file format errors, submitters have 10 days from the date of notification of rejection to correct the problems and resubmit the data. Note: The 10 day resubmission deadline is if you submitted the data close to the data submission deadline. If you do not resubmit within 10 days, you will be out of compliance. If you test properly this should not be an issue for you.

19. Data Submission – E-mail Receipt Notice • This is an example of the Receipt Notice that the submitter will receive from CCS via e-mail for every production file submitted. • If you are not a submitter then you will not receive this E-mail notice.

20. Data Submission - Notification • When the file format is readable the Hospitals will receive reportson the results of the audit process are developed: • Hospitals are sent notifications of claim submissions received and whether errant data is in their provider mailbox via: • E-mail • Fax (only if E-mail is not available) • The audit result and error claims reports are returned to providers via: • the hospital's electronic mailbox at System 13 • diskette (this is a chargeable item by System 13)

21. Data Submission – Required Data Elements • 25 TAC Part 1 §421.9 (d) specifies the required data elements. The list can be found on the following URL:http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=25&pt=1&ch=421&rl=9 • 25 TAC Part 1 §421.9 (d) specifies the required data elements. The list can be found on the following URL:http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=25&pt=1&ch=421&rl=9

22. Data Submission – Error Definition • ERROR • An error indicates that the data element does not meet established standards. The data element or it’s qualifier should be corrected and resubmitted to System 13. Note: If the data element marked as error is accurate according to hospital records then leave it alone, or mark it “Accept ‘as is’” when you use the data correction software (DCS).

23. Data Submission – Warning Definition • WARNING • Warning messages indicate that one or more data element(s) may be incorrect in regards to established standards. • Example the Practitioner’s first letter of first name or first three letters of last name does not match what is in the THCIC reference file for the identification number submitted for the practitioner.

24. Data Submission - Reminders • Claim submissions using a vendor: • A submission response report is created for the submitter and E-mailed or faxed. Check the claim count to verify all data was submitted to the System 13 Submission mailbox. • Hospitals must ensure that data is not lost even if you are using a submitter/vendor or corporate office. • Correct format errors as soon as possible, especially if you are close to the due due date for the quarter. There is only a ten calendar day window for making those corrections. Data files can be submitted to System 13 as replacement claim files (XX7) or void/cancel (XX8) and submission of corrected original files (XX1).

25. Logging into the System/ Password Change

26. Provider ID/ Submitter ID Provider ID • You will log in as a ‘provider’, when downloading error and encounter files. • Log in as a ‘provider’ when you’re uploading data corrections and certification comments. Submitter ID • You will log in as a ‘submitter’, only when uploadingdata for the first time. • This is the only time that you will log in as a ‘submitter.’

27. Logging into the System 13 system If you are using bookmarks, please bookmark this page instead of bookmarking the log-in pages. Bookmark http://www.thcichelp.com/SecureWeb.htm

28. Submission of Data – Secured Server • The THCIC secured website is located at https://sys1.comclin.com/thcic/. Make sure you get the “s” on the end of the “http” that indicates the site is a secured transmission site. • Note: Either type https://sys1.comclin.com/thcic/ into your address line on you web browser and press <enter> or click “Go” (at the end of the address line) or you can probably click on the hyperlink on the electronic version of this training document or the Hospital Procedures and Technical Specifications Manual – Secured Server Procedures and it will probably open your web browser and the following screen should appear.

29. Submission of Data – Secured Server • This screen should appear for you type in your Submitter ID (e.g. thsub000) or your THCIC (Provider/facility) ID (th000116). Note: Use lowercase letters on both username and passwords

30. Submission of Data – Secured Server • Type in your submitter ID (thsub### for example thsub000) or your THCIC facility ID (th#######, for example th000116) in the “User name” field. • Tab to the “Password” field and type in your password (the password you or your primary contact have provided. The click “OK” or press <enter>. Note: We recommend that you leave the “Remember my password” unchecked otherwise anyone who accesses your computer would be able log into your submission or facility mailbox and either upload or download data. Note: You also need to allow cookies to be placed on your machine from this site this allows for your computer to be identified. Note: Use lowercase letters on both username and passwords

31. Submission of Data – Secured Server • If you use an incorrect “User name”, the following error message page will appear. You will need to exit out of your browser (e.g., Internet Explorer) and open a new window and login again. If you are unsuccessful a second time contact the THCIC HelpDesk. Note: If you put in a correct “User name” and an incorrect “Password” the “Connect to sys1.comclin.com” (Login) screen will reappear with “Password” blank.

32. Password Change / Reset • Passwords will now expire in 120 days, instead of every 30 days. You will start receiving notice to change your password every 60 days. (This is the same for both the submitter and provider mailbox.)

33. Changing Password You must put in your old password and re-enter your new password twice.

34. Re-enter Your New Password Twice Enter old password then new password. You will have to re-enter new password to verify you entered the same thing twice.

35. Password Change After you have entered your new password twice, you will be required to sign in using your new password.

36. Successful Password Change

37. First page after the password change.

38. Make sure you close completely out of your Explorer when you close down your Internet connection. If you do not and try to go between log THCIC “boxes” you will keep going back to whatever “box” you last logged into.

39. Forgotten Passwords • If you forget your password or have to have it reset, you will have to contact the System 13 Helpdesk by phone at (888) 308-4953 or e-mail at THCIChelp@comclin.net • Please be advised to have the password reset by phone or e-mail you must be a contact person for the facility.

40. New System Feature

41. New Feature The text box below is a new feature to System 13. It will be used to provide important information regarding data processing, data submission, new data software, data delays or new features to the System 13 system.

42. Data Submission

43. Submission of Data – Secured Server • The following page will appear each time you log into the secured server. The only time there will be files to download is when your facility is in the testing phase. The files awaiting download will pertain to your submission test results. Click the button to start this download. The only time you will have “files waiting to be downloaded” (in your submitter box) is when you are testing your data for submission. And you are in ‘testing’ phase.

44. Submission of Data – Secured Server • The following page will appear each time you log into the secured server, once you’ve entered the production phase. (This picture is for a submitter mailbox as indicated.)

45. Submission of Data – Secured Server • To upload a file first you need to place the filename including the path in the vacant window. Click the “Browse” button to search for your file or type in the path and filename to upload your file.

46. Submission of Data – Secured Server • “Choose file” screen will appear and you will need to select the appropriate directory and the file within that directory. • Generally the first time it will open up in a default directory/folder “My Documents”. You will need to locate and select the directory/folder where you have your files located, you may need to open one or more directories/folders seen below to get to your folder.

47. Submission of Data – Secured Server • Select the file by highlighting directory /folder (you may need to click on/open more than one directory/folder) then the filename and clicking on the “Open” button or pressing <enter>. The file will be place for upload on the next screen. • Note:Once you have selected the file from the directory/folder and uploaded the file, each subsequent time for the session upload or download a file it will open in the last folder transferred a file to or from.

48. Submission of Data – Secured Server • You will be returned to the upload screen and the path and filename will be placed in the Upload a file to the Data Warehouse window (you may not be able to read all of it in the on screen). Click the “UPLOAD” button and the file will be transferred to the THCIC Data Warehouse

49. Submission of Data – Secured Server • After you press “Upload” the screen should show you that the upload process has completed and provide you with receipt information the filename and the time.

50. E-mail Responses • E-mail response indicating files are located in the provider mailbox. Files to Download Certification Files Error Correction