3. Data Submission/Connectivity/Reports FAQs
FAQs on Data Submission/Connectivity/Reports
Q: On the submitter application: What Connection Type is established (Lease Line, Connect Direct, Dial up/Modem, Gentran)? Our current method is Dial up/Modem. We want to send Direct Data Entry too. Do we check Dial up/Modem for DDE?
A: Yes, the On Line Direct Data Entry is available through the secure web site.
Q: When we perform testing, will we receive all of the RAPS reports?
A: You will receive everything except the summary reports. Those reports depend upon data being saved in the CMS database, which will not happen with test data.
Q: If MA Organizations submit data via UB-92, NSF, or ANSI formats, in what formats will reports be returned?
A: As of October 1, 2007, all data submitted will be processed in the RAPS format only. All reports are returned in the RAPS format.
Q: Will MA Organizations receive error reports through the Palmetto secure website in the future?
A: Yes, Palmetto will continue to send reports to plans via the connectivity that is currently established (i.e., Connect-Direct, FTP or Gentran Mailbox) through the front-end system.
Q: If a MA Organization submits 10 diagnosis clusters and one cluster receives an error, does the entire record need to be resubmitted?
A: No. The diagnosis cluster in error may be resubmitted in one of two ways:
MA Organizations may isolate the corrected diagnosis and resubmit only that diagnosis cluster with identifying information.
OR
MA Organizations may submit the entire record again to include the corrected diagnosis cluster. The nine, accurate diagnosis clusters submitted initially were processed and stored. When the entire record is submitted the second time, only the corrected diagnosis cluster will be stored.
Q: What are the names of the reports, what are the differences between them, and can MA Organizations view them?
A: MA Organizations will receive eight reports. These reports are located on the CSSC Operations Web Site (www.csscoperations.com) and are described below:
FERAS Response Report will indicate that the file was accepted or rejected by the Front-End Risk Adjustment System. This report is a delivered in report layout format.
RAPS Return File will contain all of the submitted transactions whether or not the file contains errors. If there are errors, they will appear next to the data element in error. This is delivered in flat file format and can be downloaded to an Access or Excel database and then converted to display the fields an M+C organization wishes to view.
RAPS Transaction Error Report lists the transactions that contained errors and identifies the errors that were found. This type of report could be beneficial to those M+C organizations that: prefer a manual rather than an automated process of tracking transactions show their providers the errors that they need to correct store the hardcopy reports in a binder for a simple lookup rather that querying the system.
RAPS Transaction Summary Report contains all of the transactions submitted, whether accepted or rejected, and is sent to the M+C organization with the RAPS Error Report.
RAPS Monthly Plan Activity Report is a monthly report that contains a summary list of transactions submitted during that month. The report displays those transactions that were rejected and accepted, total diagnosis clusters stored, total diagnoses stored for the model, and total transactions deleted.
RAPS Cumulative Plan Activity Report is a quarterly report that contains monthly cumulative list of transactions. The information included on the monthly plan activity report is included in the report.
RAPS Monthly Error Frequency Report provides a monthly summary of all errors associated with files submitted in test and production.
RAPS Quarterly Error Frequency Report provides a quarterly summary of all errors on all file submissions within the 3-month quarter.
Q: Are any MA Organization's transaction reports audited by CMS?
A: CMS will simply monitor MA Organization submissions in terms of whether or not the organization needs help submitting data. Upon request, CMS will provide assistance to the MA Organization through an onsite consultation or other form of technical assistance.
Q: What are the procedures for when submitters relocate from one building to another?
A: Whenever any of our current submitters are physically changing locations (from one building to another) they will need to call MDCN to have their connection re-routed. The account manager of their organization will need to have either their AT&T or IVANS invoice number when they contact MDCN to coordinate the move. Normally the submitter will keep their existing account that is already set-up, but their connection will have to be re-routed from the new location.