**INDIAN HEALTH SERVICE**

**Business Office Coordinators, HIPAA Coordinators,**

**Information System Coordinators and Headquarters**

**Minutes for April 15, 2004**

**HIPAA Business Transactions Awareness Conference Call**

**[Present]{.underline}**

*ITSC:* Carl Gervais, Sandra Lahi, and David White

*Headquarters:* Frank Martin, Elmer Brewster

*Aberdeen:* Alice Martell, ISC, Thad Banley, IT

*Alaska: No Response*

*Albuquerque:* *No Response*

*Bemidji:* Jan Thunder, BOM, Red Lake

*Billings:* *No Response*

*California:* Toni Johnson, IT Specialist and company

*Nashville: No Response*

*Navajo:* Brenda Tahe, Billing Clerk; and Roland Todacheenie, BOC

*Oklahoma: No Response*

*Portland:* David Battese, IT Specialist; and Leah Tom, BOC

*Phoenix:* Violet Kenny, PIMC

*Tucson: No Response*

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

**Roll Call** Roll call was taken. Participants who joined the call
after roll were advised to e-mail their names to Sandra Lahi or Dyanne
Leyba.

**Minutes** The Conference Call Minutes for 4/01/04 were approved by the
group. They will be posted to the IHS website.

**AGENDA ITEMS ADDRESSED**

# Items of follow up from ITSC Business Transactions Training held in February 2004 -- UPDATE STATUS REPORTS.

# Item \# 1 - 997/824 Error Report software design -- Sandra Lahi

> Development of the 997/824 Error Report software continues. Testing of
> the software is targeted to begin April 26^th^ for the group members.
> Sandra will be inquiring to find out answers to questions that remain
> on different formats and payers.

# 

# Item \# 2 \-- National TPA/BAA legal guidelines -- Template and Signature -- Frank Martin

> OGC and Acquisitions have agreed on the TPA but there is still no
> decision on who can sign the TPA. This is Robin York's decision.

# Item \# 3 \-- National Training Online Modules -- First phase -- Frank Martin/Sandra Lahi/Kurt Priessman

We are in negotiations with the contractor for development of the
national training online module. Training development should begin soon.
Plan is to meet with the contractor the last week in April to design the
content. Clarification was made that this was not like an existing
on-line training but more towards the information provided at the ITSC
Train the Trainer workshop.

# Item \# 4 \-- Indian Health Service CMS representation -- Issues received/Conference call to be scheduled -- Elmer Brewster

> Frank reports a document has been created to define IHS issues and
> concerns that require CMS guidance. The document was sent to Elmer
> who, in turn, forwarded the document to Rick Freeman at CMS. No
> feedback from Rick yet.

[Reports from Area Office Leads/ITSC -- (1) What advances have your area
made towards HIPAA Business Transaction Testing and which payors are you
working with? (2) Do you have any other RPMS issues you would like to
discuss to get clarification? 3) What other support issues or items of
concern that you foresee with this initiative?]{.underline}

**Aberdeen** Alice Martell reported for Joan Azure. Aberdeen is
continuing to test with ND Medicaid. They are receiving errors relating
to the Tax ID number. Joan has been working with Adrian to resolve this
issue. Plans are to be in full compliance and they are not anticipating
any revenue shortfalls.

**Alaska** *No report provided*

**Albuquerque** *No report provided*

**Bemidji** Jan Thunder reported they are still testing with MN
Medicaid. Still working on errors received on the error report with
Sandra and ITSC staff. Red Lake has not received any revenue for
Medicare Part A and B for two weeks. Red Lake has not tried testing with
payers yet.

**Billings** *No report provided*

**California** Toni reported that more sites have been approved for
production for Medi-Cal. Continue to send files to NHIC, Riverbend and
UGS. UGS in production with one of the sites. NHIC CLIA \# issues. Still
waiting to get approved and in production. In RPMS, changing export
modes back and forth to change in File man to change back to Paper.
Recommend to add a menu option to allow the users to change the export
mode. Need to keep the cash flow going. Have sent a file to Blue Shield
of CA. Had errors and are working errors. Went through Webclaims Net
Clearinghouse, had identified two errors with formats. For PI 837 Dental
claims. Having HIPAA awareness training with all Area staff. Several
sites have submitted their application for 835 process. Plans are to
start with Medi-Cal. Sent an email to Gail to do a Net meeting for
training. Charolett with Phoenix has raised issues with dental
questions. See Toni's email in March.

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

**Navajo** Roland Todacheenie and Brenda Tahe. Still testing TB Part A
and B, AHCCCs and Kidscare (all sites are testing). Two are in
production with AHCCCs (Winslow and Kayenta). Some problems with
Medicare with zz where ISA file is at. Should be 33. Several sites are
having the problems. Numbers with AHCCCs is still a problem. Brenda is
also having problems getting IT assistance to add information via file
man. An example was that AHCCCs in the X12 trading partners ID \# field,
AHCCCs wants two leading zeros and two in the end. It is recommended
that this be added as a menu option TM in third party. Site-managers are
slow in responding to requests. Target date to get the Navajo Area in
compliance is April 30, 2004. Brenda, Roland and Sharon Sorreel made
site visits to all eight hospitals and found that all sites had
different software and but were using consistently. Roland gave an
update on the Quovadx project. Quovadx came out and did a demonstration
on clearinghouse capabilities. Navajo Area has processed PO for
additional modules. To include PI payers. The 270 is working currently.
Navajo Area is still waiting to complete the testing for the 271
functionality once ITSC processes a task order to CMI

**Oklahoma** *No update provided.*

**Portland** Leah Tom, David Battese. Still testing with WA and OR
Medicaid. Idaho is still okay. For Medicare Part B, diagnostic labs and
Radiology still need referring provider. For Washington Medicaid, IHS
sites have begun billing WA in 837. WA 835 will be available by end of
month in 835 format. Oregon Medicaid recalled the 835 guidelines so it
looks like they are still having system issues. Western Oregon is
submitting 837 files. CLP1 record and cannot identify it back to RPMS.
Reissued 835 this morning and has transposed numbers. Testing the Medco
Health POS 835 file at Warm Springs. Working on PNC. To test 835 for TB
at Warm Springs as well. Each of the states, Idaho, Oregon and WA,
facilities have submitted claims electronically in 837 format. Still
have issues with RPMS and addressing locally. A lot of stuff has to be
corrected in File-man and correct. Have staff to cancel the claim,
correct the data and re-approve it. Inflates A/R reports when this is
done. RPMS is working well with Oregon

**Phoenix** Violet Kenny, PIMC, reported that PIMC is currently in
production with Medicaid and Medicare Part B. Sent Part A Medicare files
including 1200 claims which RTP'd due to UPIN #s are populating with Tax
ID #s. PIMC had to manually correct over 900 claims online. Shonda did
have a fix to this issue in RPMS. AHCCC has noted that no one is in
production for Phoenix Area except PIMC. Question was made as to how
PIMC is labeling their files for AHCCCs? . Violet explained how she
labeled files that were sent to AHCCCs.

**Tucson** *No update provided.*

**ITSC**

**Sandra Lahi** [837 Third Party Billing, p6 status]{.underline}

> Plans are to work hard to get ABM Patch 6 into testing by the first
> week in May. If you want to start testing with any payer, you will
> need the updated routines installed at your site before you begin. If
> you need these updated routines sooner than the patch release, please
> contact Sandra/ITSC.

**Sandra Lahi** [835 AR Version 1.7 patch 5]{.underline}

PNC Bank has been working with test sites on Medicare Part B. ITSC is
still working with PNC to receive some valid files. ITSC is still
working the issues.

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

Status Quo. No further progress made with this transaction.

**Sandra Lahi** [Testing Reports Updating]{.underline}

ITSC wants to keep current on the status of Area transaction testing.
This will help tracking progress and reporting to IHS Headquarters.
Dyanne has been contacting Area coordinators to obtain the latest
transaction information.

**QUESTIONS/CONCERNS/DISCUSSION**

Toni Johnson (CAO) -- Do we have a crosswalk document for UB92s/HCFA
1500s to 837s? Sandra reported that there is a type of document that
Shonda is working on. Sandra will check and see if this is feasible.

Brenda Tahe (Navajo Area) -- Is anyone having problem with eligibility
information pulling from page 1 of Patient Registration instead of page
4? This is happening at Ft Defiance and Crownpoint with Medicare for the
DOB & SS# and patient name. Sandra will check on this.

Violet Kinney -- PIMC cleaned out their Patient Registration database by
having their local developer, Jim Gray, design a software to print this
type of report. The report included Policy name, Address information,
Insurer name and M/M or PI status. A request was made to distribute this
routine to sites. Sandra would check to see how this can be
accomplished.

Violet Kinney (PIMC) -- Thanks to Adrian, Gail, and Shonda for all of
their support. Brenda and Toni concurred. It was announced that Gail
will be leaving ITSC on April 30^th^ and plans are to cross-train Dyanne
to provide the HIPAA support until Gail's position can be filled.

**NEXT CONFERENCE CALL**

The next call is scheduled for Thursday, 04/29/04 at 10:00 AM (MDT). The
conference call-in number is: (888) 531-9517 (Passcode: 46879). This
call will require a numeric code to allow users to have more timely
access to the call.