NCDMS Frequently Asked Questions
(FAQs)
for the Collection of Commercial Claims Data
- What is the
encryption process?
The encryption application is a web start desktop application written by
the Maine Health Information Center (MHIC) that can be downloaded from the
www.ncdms.org web site. The encryption application serves three basic
functions:
- To perform basic text file level validation,
i.e., checks the header record count with the number of detail records,
checks the correct number of fields in each record, validates payer ID
between data records and header record, etc.
- To encrypt, using a one-way industry standard
hashing function, all direct PHI identifiers put into the data file
(these include the subscriber and member SSN values, subscriber contract
ID and subscriber and member name values).
- To create a zipped output file with a
standard naming convention that is easily identified during the uploading
of the file to the MHIC.
- Should we encrypt
values before putting them into our extract file?
No, the web start encryption algorithm will encrypt all values.
Pre-encryption of any of the values being extract for inclusion in a file
is not acceptable. Pre-encryption of any data element before running the
file through the downloaded encryption software eliminates the possibility
of tracking a member across payers. Any carrier pre-encryption of values
in a file may cause MHIC's encryption process to fail a submitted file.
- How should
prescription drug services rendered within a medical claim be represented?
Any prescription drug services that are rendered as part of the medical
claim should be included in the medical claim file and be represented
using an appropriate revenue code (MC054) and/or J-code reported in the
CPT field (MC055). It is understood that for prescription drug claims
identified through a revenue code will not have an associated NDC code to
indicate the specific drug dispensed. Also, it is understood that these
claims/claim lines will not be present in the prescription drug claims.
- Is there a method to
submit late claims paid during a prior submission period?
Yes there is; however, the MHIC wants to limit these types of submissions
to a minimum as it complicates transferring data to the State. Basically,
if a carrier identifies to the MHIC a block of data that should have been
included in a monthly paid data submission that has already been accepted
by the MHIC but for one reason or another it was omitted, then the MHIC
will issue a temporary submitter code with a new suffix to that carrier.
The carrier will use this temporary code to submit the previously paid
data and the MHIC has a process in place that once this special data
submission has been accepted the data will be migrated to the proper
submitter code. If a carrier's original submitted file has yet to be
accepted by the MHIC then the carrier will be requested to re-submit both
the data from the original data submission and any new data identified in
one file. Also please read the FAQ on how do I determine what should be
included.
- Why do some of the
coded values differ across file types? Why do some code values not have a
value to represent unknown?
Although the HIPAA standard coding schema was adopted for the coding
structure within the state's claims requirements, the HIPAA electronic
transmission coding standards are not standard across the different file
types. Therefore, the prescription drug specifications call for gender
codes of 1, 2 or 3 while the medical and eligibility specifications
require a gender code of M, F or U. This follows the HIPAA requirements
for these data sets. Please use caution when setting up your extract to
code all of these fields appropriately. Similarly, if a coded field does
not have a value to indicate "unknown" it is because HIPAA did
not allow for an unknown value to be reported. In a few instances only a
subset of the HIPAA codes are allowed in the extract. This was done to
restrict the use of non-specific codes.
- Our membership
eligibility data is based on a start and end month. Can we report it in
that manner?
No. The eligibility data is submitted in a monthly format with one record
for each covered life eligible for one or more days of services during the
reported month. Each eligibility record in a given month's file will
represent one active member with all reported data elements representing
either the status as of the end of the reporting month or as of the
premium billing date. For the required historical data feeds carriers will
submit one record per member per month of active coverage during the 15
month period. For the historical data, MHIC is requiring that each month
of eligibility data be submitted in a separate monthly file.
- If the coverage
level code of a member changes during the month, which coverage level code
do you want - the first, the last or all of them in a given month?
The status code for the coverage level field in the eligibility file
should be as of the end of the month or the applicable code for when the
premiums were billed for that member during the month. This same regulation
applies for all the other data elements in the membership file, such as
the employer group/policy number, member zip code, etc. In all cases, only
one value should be reported in a membership record and only one
membership record should exist for a member each month.
- We cannot break our
provider name information into separate fields, is this acceptable?
When the provider name CANNOT be separated into first name, last name,
middle name and suffix data elements, then the entire provider name should
appear in the "Service Provider Last Name/Organization Name"
field. This should only be done as a last resort.
- What if some of the
data being required is not available within our data warehouse?
In general, all data elements that can have an appropriate blank/null
value have been identified in the layouts for the individual files.
However, it is understood that there are limitations within different
processing and data warehouse structures and any required data elements
that you identify to us as missing or unavailable will have to be
addressed on a case by case basis. Required data elements that can not be
submitted must be approved by the appropriate state officials before the
submission can be accepted.
- How should we
report multiple E-Codes on a claim?
If a given claim contains multiple E-Code values in the diagnosis fields
then the first E-Code encountered in the processing of the claim should be
loaded into the E-Code data field in the extract submission. All other
E-Codes in other diagnosis fields should be listed in the Other Diagnosis
code fields after all other regular ICD-9 diagnosis codes have been
listed. An E-Code should never be listed in the primary diagnosis data
field.
- Should text fields
be padded with blanks and should numeric fields be padded with zeros to
their maximum length?
No padding should occur. Although the record layouts list a maximum length
that will be accepted, the submission is designed to be variable length.
No text field should be blank or space padded on either the right or left
and the numeric fields should not be zero padded to the left of a value.
If this is done, it can cause your transfer rate to slow down. Even though
the file to be transmitted is compressed, there is still space used to
represent the blanks, spaces and zeros and, in a large data file, this
additional space could be substantial enough to lengthen the transfer
time. Also, if the fields to be encrypted have been blank/space padded
then the encryption routine may fail (if the whole field is blank) or may
not properly encrypt the value.
- We padded the
fields to be encrypted with spaces/blanks to the right (or left) of the
value to the field's maximum length. Is this acceptable?
No, this is not acceptable. The encryption software will do one of two
things:
1.
If
the field is all blanks/spaces with no valid characters then you will get an
error message that the field did not contain any valid characters.
2.
If
the field does contain a valid value with blanks/spaces padded onto the end
then those blanks/spaces will be encrypted as part of the member's SSN or
contract number. This causes problems when trying to find unique members across
the state if one insurer submits the data with padded blanks/spaces and then
the member changes to a new insurer that does not pad the field with
blanks/spaces the member's encrypted values will not match. Padding the SSN or
the contract number will require the data to be re-submitted.
- We stripped off the
leading zeroes from the SSN before running it through the encryption
software. Is this acceptable?
No, this is not acceptable. This causes problems when trying to find
unique members across the state if one insurer submits the data with
padded blanks/spaces and then the member changes to a new insurer that
does not pad the field with blanks/spaces the member's encrypted values
will not match. Removing leading zeroes from the SSN will require the data
to be re-submitted.
- What is meant by
the Insured Group or Policy Number?
The Insured Group and/or Policy Number is the employer group or account
number(s) for the contracted employer. There may be one or more of these
numbers for a given employer group according to how your system is set up.
Furthermore, if your plan writes individual policies, this number would be
the actual policy number unless your system uses the subscriber's
identification/contract number for an individual policy number. In that
situation, the individual's insured group or policy number should be
reported as "INDIVIDUAL".
- What is meant by
the Plan Specific Contract Number and how is it different from the
Subscriber's Social Security Number?
These two elements may be the same if the insurer uses the social security
number to uniquely identify the coverage for the subscriber and all
dependents. In that instance, the plan specific contract number should be
blank and only the subscriber's social security number should be
submitted.
- What about
payer-specific provider specialty codes, procedure codes, and diagnosis
codes?
There is a provision in the regulation to have all carriers submit a
spreadsheet of all carrier assigned provider specialty codes with their
descriptions. The spreadsheet should contain the provider specialty code
and a definition of the code. MHIC also requires a spreadsheet that
contains any home grown or local procedure or diagnosis codes with their
corresponding descriptions. Failure to provide the local codes could cause
your medical claims submissions to fail for the inclusion of procedure and
diagnosis codes that are not recognized by the system.
- The member's date
of birth is not always known/tracked in our system at the time of
enrollment. Is it acceptable to leave it blank if unknown?
Depending upon the Load completeness requirements for the state for which
you are reporting data, this may cause your submission to fail.
- The Claim Status
field contains a code of "04 Denied". However, the state
requirements indicate that "Denied claims shall be excluded from all
medical and pharmacy claims file submissions….only the fully
processed/paid service claims shall be included as part of the health care
claims data set submittal." Can you explain when the 04 option will
be used?
The denied code option is listed for two reasons:
0.
If
one or more service lines within the claim are denied in combination with one
or more service lines that were not denied then we would want to see all lines
for the claim with the appropriate status code.
1.
If
a previous submitted paid claim was later reprocessed and some or all or the
claim lines were denied then we would need to see that claim appropriately
coded so that the original paid dollars will be balanced out of the database
tables.
- How do the Data
Load and Data Quality Edit thresholds work?
Based upon the review of existing claims databases, standards have been
established for the quality of the data to be submitted. In the data load,
each data element has been assigned a minimum percent completeness
threshold. In general the data element's completeness is evaluated by the
total number of valid entries divided by the total number of records
submitted. However, for some data elements, the denominator is a subset of
the data because of the nature of the data element. The specifications for
calculating each data element's threshold and the statewide number for
that data element are documented in the statistical plan. Failure of a
submission to meet one or more of the completeness thresholds will result
in the automatic failure of the submission.
Similarly, the data quality edits are designed to evaluate the content of
the data submitted and frequently involves the comparison of two or more
data elements. The data quality thresholds represent the maximum tolerance
for data issues. The data quality specifications and the tolerance
thresholds are documented in the statistical plan. Failure of a submission
to stay below one or more of the data quality edits will result in the
failure of the submission.
It is understood that system restrictions may prevent a carrier from
meeting all of the data tests. In those situations, MHIC will work with
the carrier to document the source of the problems to present to the
Council for a temporary or permanent exemption. All such deviations from
the statewide quality standards must be approved by the state or
commonwealth.
- In the file layout
you are asking for the charge amount. Our system does not have that value.
What should we do?
The amount/value of this data element should represent the fully loaded
cost/charge of the pharmaceutical dispensed. It should contain at least
the Ingredient Cost/Billed Amount, the Dispensing Fee, any administrative
fee and any applicable tax.
- Are there ways to
determine if our transmission is as safe as possible? What are the
details?
There are two things that you can do to make the transfer as secure as
possible:
0.
Use
the SSL certificate to insure that the web site you are connecting to is, in
fact, the web site that you are supposed to be connecting to. When connecting
to the secure portion of the NCDMS web site (user services including encryption
utility software download, data file upload, and data submission reports), you
should see an icon of a locked golden padlock along the bottom of your browser
window. By clicking on this icon, the certificate can be viewed. You should
examine the certificate and make sure that the certified network address,
organization name, and organization location are what they should be
(secure.mhic.org, Maine Health Information Center Inc, Manchester, Maine, US) and that the certificate date
range is valid. If this information is not valid, or if you see the icon of an
unlocked golden padlock along the bottom of your browser window, you should
contact us before proceeding.
1.
Use
the highest supported level of encryption when transmitting data to us. There
are two levels of encryption that are supported by the SSL standard (50-bit and
128-bit). Some web browsers support only the lower level of encryption
(50-bit). Our web server supports higher level 128-bit encryption but will
negotiate with the web browser that is asking for a connection and will drop
down to the lower level 50-bit encryption if that is all that your browser can
support. The 128-bit encryption is significantly harder to crack than the
50-bit and if you are concerned about security, you should make sure that the
browser you are using supports 128-bit encryption. You can check this by
clicking on the help option in Internet Explorer and going to the "about
Internet Explorer" drop-down menu option. On the pop-up screen, there will
be an entry titled "cipher strength" which will say either 50-bit or
128-bit. If your browser is using 50-bit encryption, you can download the
128-bit version of Internet Explorer at no cost from Microsoft.
- Do we have to use
the asterisk (*) as the field separator in the files? What if a text value
contains an (*) within it?
The use of the asterisk (*) as the field separator is a HIPAA standard and
a regulation specification requirement and MUST be used to separate each
field within the required files. Although, not specifically stated in the
regulation, it is perfectly valid to enclose any or all text/alpha fields
within double quotes - ex: "abc". If a text value that is
required actually contains an (*) as one of the characters then that field
MUST have double quotes around the entire value - ex: "ab*cd".
- How do I report a
double quote in a data value?
Double quotes may not be reported as a data value. A submission containing
a double quote for any purpose other than enclosing a data value will
fail. If double quotes exist in your incoming data they must be removed
prior to submission of the data.
- How
will I find out if my submission failed?
All registered contacts for a carrier will receive emails from NCDMS for
submissions automatically failed by the system. The email will briefly
explain the reason for the failure. The details of problems associated
with the data can be viewed by logging on to the system and looking at the
system entries associated with that submission. Emails may also be sent by
MHIC staff to the contacts for data quality issues. These emails are
customized and contain specific information about the problems identified.
An email initiated by MHIC staff often results in opening a dialogue
between the carrier and the MHIC staff.
- Where
do I populate capitated services?
Estimated FFS
Payments for capitated services should be reported in the Prepaid field
(MC064).
- Are workers’ compensation claims
to be reported?
No, workers’ compensation claims are
not reported.
- What does the message “Error:
date out of range.” mean from the encryption software?
The encryption software checks to
ensure that the dates specified in the HD record HD005 (Begin Date) and HD006
(End date) encompass the data in the file.
The message indicates you have submitted data outside the range of the
HD record. For eligibility data we
verify that the Year (ME004) and Month (ME005) are within the begin and end
dates. For claims data we verify that
the AP Date/Paid Date (MC017, PC017) are within the begin and end dates. Your submission may also fail if you use the
wrong format for the dates in the HD record.
The format must by YYYYMM as indicated in both the regulation and the
documentation.
- What is meant by the Plan
Specific Contract Number and how is it different from the Subscriber’s
Social Security Number?
These two elements may be the same if
the insurer uses the social security number to uniquely identify the coverage
for the subscriber and all dependents.
In that instance, the plan specific contract number should be blank and
only the subscriber’s social security number should be submitted. If the plan specific contract number is
required to be submitted it is to be reported at the subscriber level and not
the individual person level.
- The Inclusion Rule says to
include all paid claims, please define what is meant by ‘Paid Claims’.
A paid claim is any claim that has
been processed during a given month regardless of whether the claim results in
an actual payment to a provider or member except for the specific exclusions
identified in the rule. A carrier does
not need to submit any identified fully denied claims or suspended/pending
claims where the final outcome of the claims has not yet been determined. Carriers must submit all adjustment records
that are used to offset previously submitted claims and newly created payment
claims.
Example: A claim is 100% paid by the
carrier in January and then in March the claim is both “backed out” (a negative
offset claim is created) and a new claim is created to split the payment of the
service to 80% carrier liability and 20% member liability. For January the carrier must submit the
original paid claim where all of the payment was made by the carrier. Then in the March paid data file the carrier
must submit both the adjustment claim with negative values to back out the
original claim payments and quantity amounts and the new payment claims with
the paid dollars reported appropriately for the carrier and member fields.