**INDIAN HEALTH SERVICE**

**Business Office Coordinators, HPAA Coordinators,**

**Information System Coordinators and Headquarters**

**Minutes for October 30, 2003**

**HIPAA Business Transactions Awareness Conference Call**

**[Present]{.underline}**

*ITSC:* Susan Bowman, Sandra Lahi, Carl Gervais, Gail Townsend, Kenneth
Russell

*Headquarters:* Frank Martin, Elmer Brewster

*Aberdeen:* Raymond Grandbois, HIPAA Coord; Thad Banley, IS Security
Ofcr

*Ft.* *Thompson Service Unit:* Jackie Spier

*Wagner PHS:* Sandy Patterson, Med Recs

*Alaska: No response*

*Albuquerque:* Sandra Winfrey, BOC

*Jemez Pueblo*: Chris Thweatt, BOC

*Acomita-Canoncito Laguna:* Demetrius Vallo, BOC

*Bemidji:* *Peter Christensen Health Center:* Pam Ahlborn (Billing and
HIPAA Coord)

*Red Lake Service Unit:* Margo Bahr, IT

*White Earth:* Julie Heisler, BOM

*Billings:* LeeAnn Christianson, ISC; Cindy Rupe, HIPAA Coord

*California: No response*

*Nashville: No response*

*Navajo:* Mariva Plummer, GIMC

*Oklahoma:* Mary Beaver, BOC

*Portland:* David Battese, IT Splst, BOC John Hubbard, DIRM, ISC;

Cheryl Bittle, HIPAA Coord

*Phoenix:* Charolett Melcher

*Tucson:* Bernie DeAsis, HIPAA Coord, Barbara LaCroix, BOC

**[Other Participants Present]{.underline}**

Steve Bird

**[Meeting Began at 10:00 AM]{.underline}**

Roll Call -- Participant names will be sent via email to Susan Bowman
from dial-in operator. Area facilities with more than one participant
were asked to email their list of participants to Susan Bowman, so they
could be added to the roll call list.

Minutes were approved, noting title change for David Battese, Portland.
David is IT Splst, BOC, and John Hubbard is the DIRM, ISC. The final
minutes will be posted next week to the IHS website.

**AGENDA ITEMS ADDRESSED**

[Item #2 -- Update on HIPAA Website Postings]{.underline}

**Frank Martin** **HIPAA Compliance Package and Testing Documents**

**Headquarters** The HIPAA compliance package and testing documents have
now been posted to the IHS website. The website highlights all of the
documents.

Any new or updated HIPAA compliance information will be posted to the
IHS website on Tuesdays or Wednesdays.

Redesign of the IHS website is underway to add improvements to it. If
you have a recommendation for improving the website, please email Frank
Martin at Headquarters.

Also posted to the IHS website is On-line Privacy Training. Changes are
underway that will record your name when taking the on-line training.

**Sandra Lahi** A list of identified Area HIPAA Coordinators/Leads will
be posted to the IHS website as contact information. The IHS website
address is: [www.ihs.gov](http://www.ihs.gov/). HIPAA information can be
found in the "Special Announcements" box on the left side of the screen,
and clicking on the second hot key under (HIPAA). If anyone has any
comments or recommendations to the current website, email to Frank
Martin so he can work with Joye to get the changes made.

**Sandra Lahi** [Item #3 -- Review of Transactions Testing/Payers/NCPDP
Payers Report]{.underline}

This report is updated and posted weekly on the IHS website.

1.  Focus has been on the 837 (Electronic Claim Form), Third Party,
    Version 2.5, Patch 4

> Patch 4 is being finalized for Medicare Part A Trailblazers, Medicare
> Part B Trailblazers, AHCCCS, Medi-Cal, Oregon Medicaid and Idaho
> Medicaid. However, this may not encompass all sites. Don will be
> submitting patch 4 to five testing sites: Hopi, CA; Yakima, WA; Sells,
> AZ; PIMC, AZ and WW Hastings, OK. OK is testing Part A&B for Medicare.
> Patch 4 is being tested, released, and sent out IHS-wide. Release of
> this patch will not solve all the errors with these Insurers because
> each facility submits claims based on different services provided, but
> it will help to correct errors that have been identified to date.

**Carl Gervais** Until patch 4 is installed; it is not worth running
anymore testing because of the multiple errors that this patch will fix.
There were two sites in AZ asking AHCCCS to start testing and without
this patch they will be dealing with multiple areas. It is important for
them to wait until this patch is released.

**Sandra Lahi** 2. 835 \-- Providing good testing. Don't know what
flavors will be coming up. Linda is working with A/R, patch 4 through
RPMS Database now.

-   Medicare TB Part A -- Billings Area and Tuba City to start testing
    ERA through A/R patch 4. These sites are testing direct and not
    going through PNC Bank

-   PNC/Web MD solution -- Sells SU is the test site.

-   PNC/Patch 4 -- Installed A/R patch 4 at Red Lake and Parker.
    Awaiting Sterling FTP software to be installed. Testing will be
    beginning next week.

    3.  270/271 -- Trying to get Quovadx set up to test with Navajo test
        sites. Working on different issues with FTP software, VPN forms
        and VPN access.

    4.  834 -- Phoenix area is using 560 Eligibility Roster
        (non-compliant) Form. AHCCCS approved waiver until 11/1. Testing
        on the 834 will begin next week. Cimarron will have the GIS
        Patch submitting to ITSC this week. Per Carl, testing will start
        the week of 11/10 with San Carlos SU from Phoenix Area.

    5.  276/277 -- Not tested at all. ITSC is aware that Trailblazers
        Medicare offers this functionality and we will look to start
        testing this feature once the 835 testing is stabilized and
        Patch 4 is released.

**Carl Gervais** 6. 278 -- Contract for Health Service Referral is a
small file with 5-6 fields. Working on business process to incorporate
it into Contract Health Services today.

> 7\. NCPDP v5.1 (Pharmacy Billing) -- Today, IHS has 54 trading
> partners tested with 34 live. 75-80% POS is up on sites and running
> v5.1.
>
> Each insurer has a different requirement for fields. Even with their
> companion guide, there are still tweaks happening. Patch 8 will be
> distributed in the next couple of weeks.

**Sandra Lahi** [Item #4 -- Update on Provider/Location Taxonomy File
HIPAA Requirements]{.underline}

The two documents entitled instructions and Taxonomy crosswalk was
reviewed. These documents are located on the IHS website.

There is also a document listing all RPMS Provider codes which provides
all RPMS users a precoded crosswalk and how to populate the Provider
Taxonomy files. (Tuesday's website posting will be more complete).

Located at the bottom of the document you will find the non-facility
taxonomy codes which is based on the Facility Type that CMS recognizes
each site, not an RPMS table. *[Note]{.underline}:* WPC updates the
taxonomy file every three to six months. When this occurs, IHS will make
sure the updates are posted to the IHS website.

The documents have been provided as guidance tools. If you have
questions on the taxonomy instructions or crosswalk, email Adrian Lujan
or Sandra Lahi at IHS ITSC for clarification.

On the updated table, in a few of the Provider disciplines, you will
have to review the Provider Taxonomy Version 3.1 manual to complete this
field. This was due to different levels of taxonomies that can be
assigned to a specific type of provider. Currently, you have to populate
the fields manually, but hopefully in the near future, you won't have to
do this manually. Don Jackson is working on this issue.

**David Battese** Commented that the Provider Taxonomy was a mess. Did
not offer any solutions or recommendations but did state they would work
on this locally. Charolett Melcher stated he could contact Ann Fugat
from the Phoenix Area if he needed assistance.

**Sandra Lahi** [Item #5 -- Training Update for HIPAA Business
Transactions Testing]{.underline}

ITSC talked about setting up training for the Area HIPAA
Coordinators/Leads.

ITSC is trying to hire another ITSC technical person to work on more
detail of the IT requirements regarding HIPAA Business Transactions and
testing. It was recommended that this person also be tasked to provide
training. This person may be providing the training to the Area HIPAA
Leads, so the Leads can then provide training to the sites. Sandra would
continue to find a mechanism to get this done.

**Carl Gervais** [Item #6 -- Third Party RPMS Patch 4 Local
Modifications]{.underline}

As a follow-up from the last conference call, Carl reported that Don
created a local modification file for each area. If the site or Area
populated this file, when a national package is released, the changes
within the patch will not overwrite it. The only other exception that
Don did not put into the Local modifications files was the rendering
provider vs. attending provider requirement. You have to fill in the
rendering physician vs. attending physician.

Don volunteered to populate the local modifications for each test site
that is testing this patch.

**Sandra Lahi** Will check with ITSC to see when Patch 4 will be ready
for testing.

***ACTION ITEM*** David requested that this patch be tested soon as he
will be out of the office next week.

[Item #7 \-- Reports from Area Office Leads/ITSC \-- What's Happening
with Testing for Your Area?]{.underline}

**Jackie Spier** Ft Thompson put in taxonomy codes, not testing yet.
Sandra will start

**Joan Azure** an email to include Ron Redwing, Jackie, Joan and Don
Jackson

**Aberdeen** to verify that the most recent KIDS file was installed
before they submit another test file).

**Alaska** *No response.*

**Sandra Winfrey** Sites are working on the taxonomy files and there has
not been any

**Albuquerque** new updates re: NM Medicaid testing. The state is to
respond to unresolved issues.

**Margo Bahr** Margo reported that they are waiting on the State of MN.
Red Lake

**Bemidji** will be testing the 835 with PNC bank once the Sterling
software is installed.

**Brian Schafer** Peter Christensen Health Center (Lac du Flambeau, WI)
Brian talked

**Bemidji** to Sandra and reported that Wisconsin Medicaid is sending an
email to let them know what needs to be done to start testing. They have
also contacted United Government Services Medicare FI (UGS) but have not
heard from them yet. Sandra to send them the UGS contact information.

**Billings** *No response.*

**California** *No response.*

**Debra Burkybile** Deborah was not on the call but Sandra reported the
recent

**Nashville** information received from Nashville Area. There are four
tribal sites billing electronically now. The remaining sites are billing
on paper to the remaining Payers. These sites bill to NY Medicaid, MS
Medicaid, NC Medicaid and Maine Medicaid. The site names will be added
to the spreadsheet.

**Muriva Plummer** GIMC is testing for AZ AHCCCS and it is pending

**Sharon Sorrell** GIMC will be testing with NM Medicaid using PayerPath

**Navajo** Testing 270/271 with Quovadx and waiting for feedback.

**Mary Beaver** Oklahoma Medicaid has been tested and in production
since February.

**Oklahoma** WW Hastings is testing with Medicare. WW Hastings is doing
all their testing for their transactions. Oklahoma Area is submitting
all of their PI claims electronically through the Infinity clearinghouse
and will continue to do so.

**David Battese** Portland Area is working on OR Medicaid. Test files
submitted

**Portland** Western Oregon and Warm Springs failed. Sent Don the test
files to review. Idaho Medicaid is making the testing process at a
different level of testing now which requires new testing and possibly
new FTP software. (This translates to more expense for the Portland
area.)

OR Medicaid requires recertification for each software patch that is
released so testing will have to be repeated. Waiting for Patch 4, once
it is up and running, Portland will planning to provide training to
tribal sites.

**Charolett** Hopi and San Carlos still testing Part B, Medicare.
Waiting to finalize

**Melcher** BA Agreement for NV Medicaid using First Health. The test
site will

**Phoenix** be Elko SU. Ann Fugatt has been involved with the taxonomy
files. Sandra stated that she had an inquiry from Fallon Tribal Facility
regarding billing for UGS. She would be forwarding the information to
Charolett to assist the site.

**Bernie DeAsis** AHCCCS, Sells passed Medicaid (P). Still waiting for
Medicaid

**Tucson** (I) and (D). Sells also testing 835 with PNC Bank/Web MD.

**QUESTIONS/CONCERNS**

No questions or concerns surfaced.

**Sandra Lahi** Sandra thanked everyone for participating in the call as
well as providing all of the support and recommendations.

**NEXT CONFERENCE CALL**

Due to I H S national Awards ceremony next week, the next conference
call will be scheduled in two weeks for Thursday, 11/13/03 at 10:00 AM
MST. ITSC will provide an (800) call-in number.

***MEETING ADJOURNED AT 11:00 AM***