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Briefing: SIT/OHI Post Deployment – Lessons Learned and What’s Next Date: 20 March 2007 Time: 1300 - 1350

Briefing: SIT/OHI Post Deployment – Lessons Learned and What’s Next Date: 20 March 2007 Time: 1300 - 1350 . Objectives. Learn lessons that can be applied to future changes Know helpful tips for on the job information Aware of resources Provide a forum to express concerns

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Briefing: SIT/OHI Post Deployment – Lessons Learned and What’s Next Date: 20 March 2007 Time: 1300 - 1350

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  1. Briefing: SIT/OHI Post Deployment – Lessons Learned and What’s Next Date: 20 March 2007 Time: 1300 - 1350

  2. Objectives • Learn lessons that can be applied to future changes • Know helpful tips for on the job information • Aware of resources • Provide a forum to express concerns • Generate optimism for corrective proposals

  3. SIT/OHI Conversion Facts: • All Sites were converted by Mid August 2006 • Local business became global business

  4. Lessons Learned In Hindsight.... • Better preparation, communication • Underestimated the enormous task - Step by step vs manuals • Quicker assessment/resolution of site issues - More workflow issues than ticket items - Degree of preparedness varied • Include User teleconference earlier to share strategies

  5. Lessons Learned In Hindsight.... • Identify and communicate what functions would stay, go, change, and what new functions would replace them - Mod Key - Some Accounting reports - Re-pointing • Promote a better understanding of the ramification of the system “defaults” especially the “Coverage Type Codes” - “XM” default for Pharmacy policies - “XM” policy pointed to an “RX” HIC will not allow bill to drop from TPOCS

  6. Lessons Learned In Hindsight • Better strategies to determine what information was lost or did not convert - Incomplete OHI in Private Insurance Information (PII) - OHI with an Inactive SIT - OHI with a Temporary SIT • Minimize the unknown factor

  7. Moving Forward • Clarification • Take Home Tips • Resources • What’s next

  8. Clarification What is the billing relationship with the SIT Table Regarding: • MAC - Medical Affirmative Claim • MSA - Medical Service Account • VA - Veteran Affairs • JAG - Judge Advocate General

  9. Take Home Tips • Health Insurance Carrier (HIC) ID: • Avoid duplicates • Do research. Try variables (Blu or BCB) • Query TPOCS by PO Box • Check Coverage Type • Re-pointing • Print and view list first, reviewing coverage types • Do any changes manually • Establish POC at all sites on Host • Email all POCs of any re-pointing to be done • One site on Host should do re-pointing

  10. Take Home Tips Composite Health Care System (CHCS) • May see duplicate or placeholder coverages • Update, verify all coverages • If patient is a snowbird, may see two policies • Better to place an Inactive date in TPOCS rather than delete in PII Third Party Outpatient Collection System (TPOCS) • May see multiple active coverages • Update and verify all coverages - Add an inactive date that equals the effective date, where appropriate

  11. General TIPS • Do not update any HICs • Clean-up policy coverage types, especially Pharmacy • Provide the user Point of Contact and their commercial telephone number for all HIC entries

  12. Resources TMA/UBO Site http://tricare.osd.mil/ocfo/mcfs/ubo/index.cfm • Business Rules • Post Conversion Guide • Implementation User Guide • PII User Guide • Frequently Asked Questions (FAQ)

  13. SIT/OHI What’s Next?

  14. Proposed plan for SIT Clean-up • Have DEERS run a program to identify HICs that: • Have not been used in 2 years • Do not have any OHI attached • Have multiple entries • Implement an email communication system to send out lists for review • Goal to delete unused, duplicate entries • Provide opportunity for site to save HIC and/or re-point OHI • Work with Managed Care Support Contractors, Pharmacy, to ensure consistency in HIC entries

  15. Dilemma

  16. Other Proposed SIT Changes • Include search and retrieval of OHI with every DEERS eligibility check • Refine the DEERS system identification process to decrease duplicate entries • Automate outcome of each HIC entry in possibly a report format

  17. Proposed Changes to OHI OHI • Add three (3) new fields in CHCS PII (Private Insurance Info), (2) for Pharmacy and (1) for Medical, since this information is being requested by providers on outgoing bills • Billing Identification Number (BIN) # • Processor Control Number (PCN)# • Enrollment/Plan Code  • OHI priority listing of policies

  18. Summary • Learn lessons that can be applied to future changes • Know helpful tips for on the job information • Aware of resources • Provide a forum to express concerns • Generate optimism for corrective proposals

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