**INDIAN HEALTH SERVICE**

**Business Office Coordinators, HIPAA Coordinators,**

**Information System Coordinators and Headquarters**

**Minutes for March 18, 2004**

**HIPAA Business Transactions Awareness Conference Call**

**[Present]{.underline}**

*ITSC:* Gail Townsend, and David White

*Headquarters:* Frank Martin and Elmer Brewster, Health Science
Administrator

*Aberdeen: No Response from Area Office*

> *Fort Thompson:* Lovetta Whitemouse

*Alaska:* Lue Rae Erickson, BOC, ANTHC; and Ray Martin

*Albuquerque:* Judy Townsend, IT Specialist; and Sandra Winfrey, AAO
Executive Officer

*Bemidji:* Margo Bahr, Site Manager; Jan Thunder, BOM, Red Lake; and
Charles Tudor, Computer Specialist

*Billings:* Cynthia Larsen, Health Systems Specialist

*California:* Jan Bergemann, Area ISC; Toni Johnson, IT Specialist; and
Cynthia Twiss, IT Specialist

*Nashville: No Response*

*Navajo:* Sharon Brokeshoulder, Accounting Technician, GIMC; and Brenda
Tahe, Billing Clerk, GIMC

*Oklahoma:* Sue Bear-Rollice

*Portland:* David Battese, IT Specialist

*Phoenix: No Response*

*Tucson:* Kurt Priessman, Budget Analyst

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

**Roll Call** Roll call was taken during the Area reports. (Additional
participants were received from the Conference Center that emailed a
participant list to David White.).

**Minutes** The 03/04/04 Conference Call Minutes were approved by the
group and posted to the IHS website.

**AGENDA ITEMS ADDRESSED**

# Item #2 -- Items of Follow up from ITSC Training held in February 2004

# 997/824 Error Report software design

> A one-day meeting is scheduled for March 25^th^ to discuss the
> top-reported errors by sites. The information will be used to develop
> a software application to assist sites with reading, defining and
> correcting errors either through a web-based application. Scheduled
> attendees are: Sandra Lahi, Adrian Lujan, Gail Townsend, Cheryl Smith,
> Dave Walton, Violet Kinney, Brenda Tahe, Kurt Priessman, Sharon
> Sorrell and Mike Pike.

# 

# National TPA/BAA legal guidelines

> The TPA language is complete. There are still discussions with
> Acquisitions to determine who can sign the TPA -- Acquisitions, Area,
> or Service Unit. Frank will continue to follow up with Acquisitions to
> bring closure to this issue.

# National Training Online Modules

The training development team consists of Frank Martin, Sandra Lahi,
Kurt Priessman, and Elmer Brewster. Elmer has identified funding for
developing a training package and he is working with Acquisitions to get
the project advertised for potential bids. The scope of training
involves two phases. Phase I centers on developing the project plan,
learning objectives, and training focus. Phase II consists of developing
training content/materials. If any one has additional training inputs,
please submit them to Frank, Sandra, Kurt, or Elmer.

# Indian Health Service CMS representation -- Contact made with CMS

> Elmer Brewster asked that the group help develop an agenda of concerns
> that can be used in discussions with CMS. Elmer is working with Sandra
> to develop the agenda and suggestions for agenda items should be sent
> to them soon.

# Item #3 \-- Status of ITSC Business Transactions Testing Coordinator Vacancy

> Dyanne Leyba starts as the ITSC Business Transactions Testing
> Coordinator on March 22^nd^. She has a HIPAA background as well as
> private sector business office experience.

[Item #4 \-- Reports from Area Office Leads/ITSC -- (1) What Advances
Have Your Area Made Towards HIPAA Business Transaction Testing? (2) Do
you have a schedule for providing TCS Training sessions? 3) How is
everyone addressing the Trailblazers Part A and B (March 16, 2004
deadline for 837 testing?]{.underline}

**Aberdeen** *No update report provided*

**Alaska** *No update report provided*

**Albuquerque** Sandra Winfrey reported that Area sites are actively
testing. They have not developed a notice of sites in production.

**Bemidji** It was reported that Bemidji is now testing with Medicare
and Medicaid.

**Billings** Cynthia Larsen reported that Billings Area is going live
with Wyoming Medicaid today. They expect to go live with Montana
Medicaid on March 31^st^. She said that they submitted a waiver for
Medicare Parts A and B but Medicare can not find their waiver request.
They will work this out. The Area is having problems with Part B and is
working with ITSC to resolve the issues. Cynthia pointed out that
sometimes ITSC sends information to a facility on how to fix a local
problem and does not share this information with others. She stressed
keeping everyone in the loop when disseminating information because it
can apply to more than one site.

**California** Current 837 testing: **UGS** (United Government Services
(FQHC)), Riverbend Medicare (RHC), NHIC Medicare **(**National Heritage
Insurance Company**),** MediCal and Blue Shield of CA. CLIA Number
problems; 837P format requires CLIA \# for labs. Currently there isn't
an option to enter the CLIA Number in RPMS; they are working with Shonda
on CLIA numbers. Greenville is in production with UGS. Having problems
with the 837D (dental) transactions; dental related questions in claim
editor P3 are missing. Claim editor problems; having to go into table
maintenance to change export mode for test file, then change back
afterward the test file is created. Three sites are in production with
MediCal. Second local HIPAA Awareness conference call was held yesterday
and a NetMeeting session was conducted to review RPMS set up
requirements with seven sites for HIPAA EMC testing. One site wants to
go the clearinghouse (Envoy or WebMD) route for private insurance.

**Nashville** *No updated report provided.*

**Navajo** The Area is not having any problems. Plans are to use the
clearinghouse services of Quovadx. They are having sender ID problems
with the 837. They are still having problems reading error reports. The
response time from Arizona AHCCCs is slow. There are minimal problems
with NM Medicaid.

**Oklahoma** BOM meeting planned for reading/understanding 997 error
report. One site is using Claredi to read error reports.

**Portland** David Battese reports they are still testing Medicare Part
B in Washington. Portland has gone straight into production with
Medicare Part B and has incurred minimal problems. They are getting a
message "Procedure requires provider number" and ITSC is working to fix
the problem. David suggests that someone completely fill out a claim and
see if it makes it through the entire process. They are testing
dental/special service claims with Washington federal sites using the
Professional format. They have tested in Idaho and Oregon submitting the
claims in 837P format. Have had several 837 dental batches go through
but needed to submit in professional format, not the dental format.

**Phoenix** *No updated report provided.*

**Tucson** The Area has had success with submission of the 837 for
AHCCCs. They are in production for Medicare Part A and are not having
problems. The Area is having problems with Medicare Part B. They are
trying to get 835s working with AHCCCs but have experienced problems.
Test of remark codes using AR Patch 5 -- worked fine. They are beginning
to test the 837 with BCBS of Arizona. The Area has asked insurers if
they can parallel bill while in the test mode but have not received an
answer yet. They are also having 835 problems with PNC Bank. Tucson is
down \$1.2M in Medicaid payments.

**ITSC** [837 Third party billing, p5 status]{.underline}

**Gail Townsend** Third party billing patch 5 is in testing. This was
modified to includes EHR and Pharmacy POS issues.

Third party billing patch 6 is in development status. 837 edits will be
included in this patch as well as CLIA #s.

**Gail Townsend** [835 AR Version 1.7 patch 5]{.underline}

Accounts Receivable v1.7p5 is in testing at GIMC, two California Area
sites, and Sells. This patch includes the AR Remarks Code & Inquiry
option. Also includes Pharmacy POS Remarks code identified at Portland
Area.

> The PNC Bank initiative is also being testing. Payers for the 835
> format with PNC Bank include Medicare Part B, MEDCO Pharmacy, Aetna,
> Mailhandlers, MN Medicaid, CIGNA, Oklahoma Medicaid.

[270/271 -- Eligibility Inquiry & Response]{.underline}

**Gail Townsend** Status Quo. Getting inquiries on Infinity from
Oklahoma and Medifax from the Phoenix Area.

**QUESTIONS/CONCERNS/DISCUSSION**

> David Battese says he still needs the Fileman write-up populating the
> taxonomy and this will be an issue needing attention soon. PC is not
> mapped to the taxonomy file. Gail will check with Adrian on the status
> of this documentation.
>
> Kurt suggested that sites individually certify their Medicare Part B.
> Cynthia Larsen suggested that sites send small test files for
> certification. Kurt then suggested that sites send production files
> instead**.** It was heavily stressed that there needs to be a better
> exchange of information between the group and ITSC**.** Not all sites
> are getting the same valuable information.

**NEXT CONFERENCE CALL**

The next call is scheduled for Thursday, 04/01/04 at 10:00 AM (MST). The
conference call-in number is: (888) 531-9517 (Passcode: 46879).