Welcome to the Winter 2010 edition of the Onpoint CDM (Claims Data Manager) Newsletter. This edition focuses on all-payer claims databases, work in Vermont, an introduction to a member of the Onpoint CDM team, state rule changes and data harmonization, and state-specific news for submitters from Maine, Minnesota, New Hampshire, Tennessee, and Vermont.

01/31/2010 -- Data submissions for December 2009 are due to Onpoint CDM.

02/28/2010 -- Data submissions for January 2010 are due to Onpoint CDM. Please note that this submission will be using the new format for all states.

03/31/2010 -- Data submissions for February 2010 are due to Onpoint CDM. Please note that this submission will be using the new format for all states

 

Onpoint CDM is owned and operated by Onpoint Health Data, and our staff is here to help you every step of the way. From questions about online registration to data intake and validation, our team is expert not only in system process but in client service, making sure you have the tools and answers you need to get the job done. Take a moment to meet a member of the Onpoint CDM team:

Terry Danowski joined Onpoint in late 2009, signing on as our Director of Health Data Services. Terry leads our claims and hospital database operations, including client support, and oversees the data submission process and deployment of our technical solutions, including Onpoint CDM.... Read more »

In previous newsletters, we've focused on system process. This time, we'll pull back for a big-picture look at the what and why of the databases themselves.

Most states that build all-payer claims databases have a specific goal in mind for the data -- often offering it to inform policy, making it available for research, or a combination of the two.... Read more »

 

State and private initiatives collecting healthcare claims or encounter data are doing so for similar purposes: to review healthcare use, cost, and performance. Forward-thinking Vermont lawmakers developed just such an initiative in 2009: the Vermont Healthcare Claims Uniform Reporting and Evaluation System (VHCURES).... Read more »

State agencies in Maine, New Hampshire, and Vermont have finalized legislation changes to bring collection layouts for member enrollment information and medical and pharmacy paid claims into a consistent, standard format. Dental claims information will be collected only for Maine and New Hampshire, but again using the same format. These changes take effect on February 1, 2010, for all three states.

To prepare submitters for these state rule changes, a test system is being hosted by Onpoint CDM from November 1, 2009, through January 31, 2010.... Read more »

New Rule Update - Chapter 243 Data Collection Rule
Maine submitters should note that the Maine Health Data Organization has finalized rule changes to Chapter 243 Uniform Reporting System for Health Care Claims Data Sets. These changes are designed to clarify the rule regarding who is required to report and what elements are required to be reported.... Read more »

 

Ending the Use of DEA Numbers to Identify Prescribing Physicians
The Minnesota Department of Health (MDH) has received several questions related to the use of a Drug Enforcement Administration (DEA) number to identify prescribing physicians for pharmacy claims submitted to the Minnesota Health Care Claims Reporting System (MHCCRS). Generally, these questions are related to whether the DEA may legally be used as a unique identifier for prescribing physicians.... Read more »

Changes to Institutional Claims References
During review of medical claims reference documentation in the Minnesota Carrier Communication Package, we have identified inconsistent references for institutional submissions for service provider fields MC024 through MC035.... Read more »

Key Dates for Minnesota Submitters
12/31/2009 -- Enrollment and paid claims are due for the period 04/2009 through 09/2009. Read more »

 

New Hampshire submitters should note that the New Hampshire Insurance Department (NHID) has finalized rule changes in association with legislation relating to Chapter Ins 4000 Uniform Reporting System for Health Care Claims Data Sets. This is the legislation that governs the submission of claims data sets to Onpoint CDM.... Read more »

Consolidated Data Sets
The latest release of the consolidated data sets containing incurred data from 2005 through September 2009 has been delivered to the New Hampshire Department of Health & Human Services and the NHID. Continued work with existing and new payers helps us to validate and improve claim roll-up methodology and identify potential shortcomings in the data.... Read more »

 

Onpoint CDM Welcomes Tennessee Submitters
Onpoint Health Data is pleased to announce a new partnership with Tennessee State, which has begun the process of implementing its own all-payer claims database (APCD). We're excited to be part of the process and look forward to working with submitters and the state as lawmakers finalize details and procedures.... Read more »

Key Dates for Tennessee Submitters
05/01/2010 -- Claims data are due for the period January 1-31, 2009.

 

Vermont submitters should note that the Vermont Healthcare Claims Uniform Reporting & Evaluation System (VHCURES) is nearly complete with submitters providing production data. VHCURES also contains historical data from January 2007. Data analysis and review is ongoing on this data set. Most payers have been reviewed and verified, and consolidation has been carried out for most payers.... Read more »

 

 
For basic questions about Onpoint CDM, including system requirements, scheduled maintenance, and upgrades, try our Support pages. For in-depth FAQs, both general and state specific, visit our client pages for Maine, Minnesota, New Hampshire, and Vermont.

If you need additional help with questions regarding the new data collection rules and testing process, inquiries should be sent to the appropriate state-specific e-mail address for Maine, Minnesota, New Hampshire, and Vermont.

Onpoint CDM also can be reached directly by e-mail or phone (207 623-2555).

 

Onpoint CDM is owned and operated by Onpoint Health Data, an independent nonprofit providing reliable data, trusted research, and independent analysis to the healthcare community.