The Integrated Care Resource Center, an initiative of the Centers for Medicare & Medicaid Services Medicare-Medicaid Coordination Office, provides technical assistance for states coordinated by Mathematica Policy Research and the Center for Health Care Strategies.
Medicare-Medicaid Plan (MMP) Enrollment Assistance –
Introduction to the Infocrossing Web Portal
March 25, 2015
2:00-3:00 PM Eastern
Participants
• Michael Kettaneh, Infocrossing
• Giman Kim, Medicare-Medicaid Coordination Office, CMS
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Agenda
• Welcome, Introductions, and Roll Call
• Overview of Upcoming Software Changes and Infocrossing Web Portal Enrollment Tools
• Questions and Discussion
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© 2014 Infocrossing, inc.4
MMP Enrollment Assistance:
Introduction to the Infocrossing
Web Portal Tool
March 25, 2015
© 2014 Infocrossing, inc.5
Agenda
• Overview of existing automated batch file exchanges with
Infocrossing
• Review of the MMP technical guide version 2.2 software changes
• Review of the CMS BEQ changes as explained in the CMS HPMS
announcement of the May 2015 software release
• Introduction of the Infocrossing Web Portal tool and demonstration of
some of the most useful functions
• Q&A session
© 2014 Infocrossing, inc.6
Overview
• Nine MMP demonstration states (CA, IL, MA, MI, NY, OH, SC, TX and
VA) are currently in production mode; RI is scheduled for
implementation in July 2015
• States and MMPs must be aware of all existing Infocrossing and CMS
services and resources to maximize efficiencies
• Contact the Infocrossing help desk to obtain the necessary Web
Portal User ID that you will need to login to the Web Portal tool
(877) 833-3499
© 2014 Infocrossing, inc.7
Overview of Existing File Exchanges
• Automated batch file transfers via SFTP connections
- Enrollment input submissions and response file retrieval
- BEQ and MBD eligibility batch file processing
- Retrieval of CMS generated files
• Web Portal tools are underutilized. They can prove to be valuable in
complementing all automated file transfer processes.
© 2014 Infocrossing, inc.8
MMP Technical Guide Version 2.2 Changes
Version 2.2 Software changes will be implemented on April 27, 2015.
• Currently, when MMP Sponsors and state organizations submit data files
containing invalid or missing header record information, the Infocrossing
edits abort the process and the help desk notifies the end-user that the file
must be corrected and resubmitted. As of Monday, April 27, 2015, both
automated FTP and manual Web upload file submissions will
automatically reject all detail transactions when invalid header record
information is submitted.
• For eligibility files, the HICN Found/Not Found field in position of 26 of the
eligibility response file will have a new value of “F” (Failed) populated for
all detail transactions. No eligibility match will be attempted against the
Medicare beneficiary database.
© 2014 Infocrossing, inc.9
MMP Technical Guide Version 2.2 Changes
• For enrollment file submissions, all detail transactions will be rejected with a
new error code of “60”. The file must be corrected to contain a valid header
record and resubmitted for processing.
• The edit requirement for the TC 90 Implementation date to be at least 30 days
after the Notification date has been removed. The corresponding error code
“3A” has been disabled.
• The editing of a 4RX TC 72 effective date has been improved by ensuring that
the date falls within valid enrollment periods for the given contract. The
historical CMS TRRs will be reviewed as necessary to accomplish this and help
ensure that CMS does not generate a TRC “209” rejection response. Wipro will
reject 72 transactions that do not show a valid enrollment period with a new
error code of “59”.
© 2014 Infocrossing, inc.10
CMS BEQ Changes – May 2015 Software Release
Refer to the CMS HPMS memo dated February 25, 2015
SUBJECT: Announcement of the May 2015 Software Release
CMS is adding the following data elements to the BEQ response file:
• PBP Number
• Plan Type Code
• EGHP Indicator
• ESRD Indicator
BEQ response file layout increasing from 750 bytes to 1,500 bytes.
Expected implementation date is CPM cutoff week-end of Friday May the 8th.
© 2014 Infocrossing, inc.11
Web Portal Demonstration
• Infocrossing Web URL is:
http://www.Medicare-Solution.com
Contact the Infocrossing Help Desk to get started with the process of
obtaining a Web User ID.
© 2014 Infocrossing, inc.12
Web Portal Demonstration
Key takeaway points:
• Web Portal tool can and should be used as a complement to any existing
automated file transfer processes with Infocrossing.
• Medicare transactions processed through the Web portal share the same
database environment and the same data transmission
turnaround/response as the scheduled FTP process.
• For example, a transaction submitted in a batch file early in the
morning can later be modified manually by using the web portal as
long as it has not been submitted to CMS.
• All users need to be aware of CMS transmission schedules (10:00AM,
7:00PM, AND 11:00PM EST) and fully understand the Current
Calendar Month rules (CCM submission window).
• Web Portal can be used on an emergency basis and/or after hours to
obtain a copy of a specific CMS report.
• Please contact the Infocrossing help desk to provide a list of authorized
users that will need access asap.
© 2014 Infocrossing, inc.13
Help Desk Information
Infocrossing Help Desk:
(877) 833-3499
CMS directed questions:
- Plan specific questions:
- State specific questions:
Questions and
Discussion
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About ICRC
• Established by CMS to advance integrated care models for Medicare-Medicaid enrollees
• ICRC provides technical assistance (TA) to states, coordinated by Mathematica Policy Research and the Center for Health Care Strategies
• Visit http://www.integratedcareresourcecenter.com to submit a TA request and/or download resources, including briefs and practical tools to help address implementation, design, and policy challenges
• Send additional questions to: [email protected]
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