AUC Logo

Minnesota AUC Administrative Simplification
 

Two Digit Program Code Technical Advisory Group

Meeting Information
(Note: No TAG meetings are scheduled at this time)

Policies

SBAR and work request forms


Chair

 • Trisha Schirmers  trisha.schirmers@allina.com  612-262-4719


Charge and mission statement

To assess current state, impacts and Provider/Plan operations while developing best practices for a consistent methodology to accurately gather Prepaid Medical Assistance Plan (PMAP) information needed for various reporting needs of the Minnesota Department of Health (MDH), Department of Humans services (DHS) and Noridian-Medicare.

Work plan and/or accomplishments

Phase I – completion 2010:

  • Develop Best Practice for the Eligibility Inquiry and Response (270/271) and Payment Remittance Advice (835) transactions for reporting of two-digit DHS program code data.

Phase II – completion 2011:

  • Develop Best Practice for Information Sharing of claims and encounter Data between Providers/Plans/State and Federal Agencies
  • Discuss sources and uses of PMAP claims data to comply with reporting requirements of MDH (Hospital Annual Report (HAR) and Medical Education and Research Costs (MERC)), DHS (Disproportionate Share - Hospitals (DSH)), and Noridian-Medicare (DSH).
  • Mapping data flow from the Plans to DHS, to MDH and validation of data against Provider/Minnesota Hospital Association records.

Scope of work

  • Definitions
  • Forms
  • Best Practices related to claims submission
  • Best practices related to eligibility inquiries and responses, and remittance advices (270/271 and 835 )

Work product to be developed

  • Map of data flow/needs for PMAP data from Plans to various regulatory reporting agencies
  • Procedures for 270/271 and 835 data needs
  • Procedures for information sharing of claims and encounter data between provider/plans/state and federal agencies.

Activation or re-activation date: 12/08/2009

Inactivation date: N/A

Back to top

 
 Most Viewed