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MACSIS BEHAVIORAL HEALTH DATA

BOARD/ PROVIDER/ VENDOR SYSTEM PROCEDURES

Last Revised: October 2001

State of Ohio Behavioral Health System Implementation SYSTEM PROCEDURES Procedure: BH Test and Production File Approval Process Responsibility: ODADAS Management Information Systems Purpose This document outlines the approval process for a Board or Electronic Data Interchange (EDI) vendor to submit Behavioral Health (BH) demographic data electronically for MACSIS. There are two types of testing performed against BH data submissions. The first type of testing involves the EDI vendors submitting test BH files directly to MACSIS for verification. The second type of testing involves the Boards working with their provider agencies to process BH test files successfully. The Board will be responsible for submitting these electronic data files to the BH server located at the State of Ohio Computer Center (SOCC) for verification. If performed correctly, EDI vendor level testing can significantly reduce the workload required of each provider agency in their effort to successfully complete the testing required at the Board level. Regardless of whether or not EDI vendors perform their own BH data transmission testing, any EDI vendor whose software is distributed to licensed provider agencies funded by Boards, is required to work with the provider(s) and the provider's Board to help them test BH data files. This is essential since each provider agency may have a slightly different version of the software installed and implemented which may affect the final outcome of their Board level testing. EDI Vendor Testing Requirements: This voluntary testing is coordinated exclusively between the EDI vendor and the ODADAS Management Information (MIS) staff. Janet Brooks of ODADAS should be contacted by e-mail at [email protected] or fax at 614-752-8645 by any EDI vendor regarding BH test file submissions requirements which are conducted aside from the licensed provider agencies. Created By: Evan Hood Last Revised Date: 07/2001

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Board Testing Requirements: Prerequisites 1. Board Contact Person: Each Board should already have an assigned staff person responsible for receiving provider agency claim files and submitting them to MACSIS for processing. A similar type of person is needed for receiving provider agency BH files and exporting them to the MACSIS system for processing. With each submission of a BH test file, the Board will be required to identify the contact person's name, phone number, fax number and e-mail address on the BH Test Request Form. The assigned person must be familiar with basic Unix commands and the File Transfer Process (FTP). This person should serve as the Board spokesperson for any issues the Board may have regarding the BH specifications, requirements and procedures as documented. 2. Unix Accounts: Each Board staff person responsible for collecting the provider agency BH files and exporting them for processing, should own a Unix account number. Please refer to the MACSIS web site for instructions and procedures regarding the acquisition of an account (go to the MACSIS Home Page, click on Index, then click on the letter F for FTP). 3. BH Test Processing Times: ODADAS will be available to receive and process BH test files Monday - Friday (with State holiday exceptions) between the hours of 7:00 AM to 5:00 PM. 4. Subdirectory Structure for BH Test Files: Each Board has been assigned a unique directory structure on the MACSIS server for uploading BH files. The following BH subdirectories have been established for the BH testing process: /county/<board designation>/bh/ test/ reports/ to be used for uploading agency TEST BH files to be used to hold reports (see Appendix 5) generated when processing TEST BH files

All BH test files submitted by the Boards should be uploaded to their test/ subdirectory. To be processed, BH test files must follow the guidelines as stated in the BH File Standards in Appendix 1. 5. BH Test File Standards and Naming Conventions: · All files must be in ASCII, fixed-length (space delimited) format

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· · · ·

All text should appear in upper case Each row must have a Carriage Return in position 351 Each row much have a Line Feed in position 352 Test Input file naming convention: IBBDPPPPPT.JUL I BB D (10.3 format)

- Denotes "Input" Production BH File - Denotes County Number (i.e., 25 for Franklin) - Denotes Board Designation A = AOD for Alcohol & Drug M = MH for Mental Health B = Combined Board PPPPP - Denotes Provider ID Number (leading zeroes apply) T - Denotes "Test" file JUL - Denotes Julian Date of creation (i.e. 1 - 365, 366) · Test Reports naming convention: Follows the Test Input file naming convention with the exception that the first character will begin with "R" (Report) versus "I". Note: BH Test files require a "T" in position 10 of the file name to ensure proper testing and to differentiate BH test files from BH production files. 6. BH Test File Data Requirements: BH test data should be as "realistic" to production mode as possible. All BH test files must be created by the software which the provider agency plans to utilize when in production. ODADAS recommends the following data requirements: · A total of 50 BH records per BH test file from the provider agency 07/2001 Each of the following record/transaction types should be included in a BH test file: A. Admission/Add records - A minimum of 15 records. 07/2001 B. Admission/Change records - A minimum of 5 records. Should change the Admission/ 07/2001 Add records.

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C. Admission/Delete records - A minimum of 5 records. Should delete the previous Admission/Add records. D. Closure/Add records - A minimum of 15 records. E. Closure/Change records - A minimum of 5 records. Should change the Closure/ Add records. F. Closure/Delete records - A minimum of 5 records. Should delete the previous Closure/Add records.

07/2001

07/2001 07/2001

07/2001

Closure/Add records need to relate to the Admission/Add records submitted on the BH test file using the requirements specified in the BH Data Instruction Manual. A Closure/Add record that does not match a corresponding Admission record will reject. It should be noted that these record numbers are recommended for a thorough test of the BH Module. The total number of records submitted by an provider agency for a BH test file can be adjusted to reflect a more "realistic" number as to what might be actually submitted in a production run. However, the number of record types (Admission/Delete, Admission/Change, etc.) should remain in proportion to the total number of records which were submitted. In addition, an explanation must be given in the "Comments" section of the BH Test Request Form why the Behavioral Health recommendations were not followed. 7. BH Test Request Form (see Appendix 4): Whenever a Board wishes to perform testing against an exported BH test file, ODADAS requires that a BH Test Request Form be completed and sent to ODADAS by e-mail to: [email protected] or by fax to 614-752-8645. Completion of this form will ensure the BH test files are processed in a timely manner and the appropriate contact person at the Board is informed of the test results. This form will allow quicker processing of the BH test files and help prioritize (in terms of the order received) the expected workload. Once a BH test file has been processed, ODADAS will complete the "Results" section of the form and either e-mail or fax it back to the contact person at the Board. To obtain a copy of the BH Test Request Form (see Appendix 4), go to the MACSIS Home Page, click on "Project Documentation" and look under the header labeled "Behavioral Health Data".

Procedures for Board Testing 1. Each Board should work with the provider agencies to determine the best method to submit the BH test files to a Board. Once a Board has received a BH test file from a provider agency, it should be logged and verified. Each Board is minimally responsible for the following procedures: 4

·

Ensuring the file name is correct and meets the BH test file formatting requirements as defined in Appendix 1. Verifying the BH test file is not a duplicate. This can be determined through analysis against those BH test files which have been previously logged for the provider agency. The file should be examined with some type of ASCII editor to make sure the file is readable and has a Carriage Return/Line Feed in positions 351/352 of each record.

·

·

In addition, some Boards may choose to have their own pre-editing verifications of the data prior to transferring the BH test files to the MACSIS System. Note: Multiple BH test files from one provider agency or between provider agencies are not to be combined or merged into one file. 2. After logging and verifying the BH test file, each Board should complete a BH Test Request Form for each BH test file the Board is exporting to MACSIS. Failure to complete a BH Test Request Form for a given file will result in that particular BH test file not being processed by ODADAS. All BH Test Request Forms should either be e-mailed to: [email protected] or faxed to the Ohio Department of Alcohol and Drug Addiction Services, Attn: Janet Brooks at 614-752-8645. 3. The Board will then FTP (file transfer) the BH test file to the following subdirectory of the MACSIS server: /county/<board designation>/bh/test/. 4. The BH test files will be processed through MACSIS in their order of arrival. Order of arrival is determined by the following criteria: · The BH test file must be FTP`d into the correct /test/ subdirectory on the MACSIS server. A BH Test Request Form (see Appendix 4) must be sent by e-mail or fax prior to each BH test file uploaded from the Board.

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5. Each BH test file will be verified and processed to determine if the file meets the BH Standard of Acceptance. In order for a BH test file to meet the BH Standard of Acceptance, the following must be true:

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·

Verification of all file standards, naming conventions and data requirements as required by MACSIS (See Appendix 1). There should be no records which reject. There should be no records with warnings.

· ·

Requiring that BH test files be error-free and warning-free, will help ensure that the provider agencies and Boards know how to submit consistent and effective transmissions of data prior to going "live" in production. 6. For each BH test file processed, the following items will be returned back to the Board for its review: · Either a error or success report (see Appendix 5) will be generated by the software which MACSIS utilizes to validate and process the files. The error report will depict all record warnings and rejects for a specific BH test file which has been processed. One error report will be generated for each BH test file processed. Reports will be placed in the following subdirectory on the MACSIS server: /county/<board designation>/bh/reports/

·

The BH Test Request Form (see Appendix 4) which was originally submitted by the Board with the "Results" section completed by ODADAS. Attached to this document may also be a report containing a more detailed explanation of the test results. The ODADAS contact person will be responsible for ensuring that the BH Test Request Form "Results" section is completed and e-mailed, along with the error database, to the appropriate Board contact person as indicated on the form.

7. The BH test process will continue to be performed until the BH Standard of Acceptance has been met for a submitted BH test file. In order for a provider agency to be considered fully "live" and production-ready, each provider agency must submit one BH test file for each of the Record types and transactions specified in Appendix 1 which meet the BH Standard of Acceptance. Once the BH Standard of Acceptance has been met for a given BH test file, it will be so documented in the "results" section of the BH Test Request Form.

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Board Production Requirements Prerequisites 1. Board Contact Person: Unless otherwise communicated directly from the Board, ODADAS will assume the Board's contact person(s) for BH production will be the same as during testing. 2. Unix Accounts: Each Board staff person responsible for collecting the provider agency BH files and exporting them for processing should own a Unix account number. Please refer to the MACSIS web site for instructions and procedures regarding the acquisition of an account (go to the MACSIS Home Page, click on Index then click on the letter F for FTP). 3. BH Production Processing Times: BH Production files can be submitted by the Board to the MACSIS server at anytime with the intent that they be processed by MACSIS on Fridays at 12:00 PM (noon) on a bi-weekly schedule. 4. Subdirectory Structure for BH Production Files: Each Board has been assigned a unique directory structure on the MACSIS server for uploading BH production files. The following subdirectory should be where Boards submit their BH production input files to be processed by MACSIS: /county/<board designation>/bh/ input/ reports/ to be used for uploading agency PRODUCTION BH files to be used to hold reports (see Appendix 5) generated when processing BH files

BH production files should follow the guidelines stated in the BH File Standards in Appendix 1. BH production files will not be processed until the formal approval of a successful BH test file submission has been given by the ODADAS contact person within MIS. 5. BH Production File Standards and Naming Conventions: · · · · All files must be in ASCII, fixed-length (space delimited) format All text should appear in uppercase Each row must have a Carriage Return in position 351 Each row much have a Line Feed in position 352

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·

Production Input file naming convention: IBBDPPPPP9.JUL I BB D (10.3 format)

- Denotes "Input" Production BH File - Denotes County Number (i.e., 25 for Franklin) - Denotes Board Designation A = AOD for Alcohol & Drug M = MH for Mental Health B = Combined Board PPPPP - Denotes Provider ID Number (leading zeroes apply) 9 - Denotes Number of files submitted per day (i.e., 1, 2, etc.) JUL - Denotes Julian Date of creation (i.e. 1 - 365, 366)

·

Production Reports naming convention: Follows the Production Input file naming convention with the exception that the first character will begin with "R" (Report) versus "I".

Procedures for Board Production Runs 1. Once a Board has received a BH production file from a provider agency, the file should be logged and verified. Each Board is minimally responsible for the following procedures: · Ensuring the file name is correct and meets the BH Production file formatting requirements as defined in Appendix 1. Verifying the BH production file is not a duplicate. This can be determined through analysis against those BH production files which have been previously been logged for the provider agency. The file should be examined with some type of ASCII editor to make sure the file is readable and has a Carriage Return/Line Feed in positions 351/352 of each record.

·

·

In addition, some boards may choose to have their own pre-editing verifications of the data prior to transferring the BH production files to the MACSIS system.

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Note: Multiple BH production files from one provider agency or between provider agencies are not to be combined or merged into one file. 2. The Board can then FTP (file transfer) the BH production files to the following subdirectory of the MACSIS Unix server: /county/<board designation>/bh/input/ 3. All BH production files residing in each Board's input subdirectory will be retrieved, edited and processed on a bi-weekly basis on Friday at 12:00 PM (noon). Once a Board's input BH Production files are retrieved successfully for processing, a delete will take place against all files residing in the input folder. This is necessary so that the input BH production files do not get reprocessed. For these reasons, ODADAS recommends that Boards do not submit any further BH production files until the following Monday morning at 8:00 AM. 4. Should a BH Production file fail to meet the BH file specifications requirements, the Board's contact person will be notified by ODADAS. 5. The Boards will have available by the following Monday morning at 8:00 AM the Error Reports depicting all warning and rejected records for each BH production file submission in the following subdirectory: /county/<board designation>/bh/reports/ 6. Reports will be retrieved and distributed by the Boards to their respective agencies.

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Appendix 1

Summary of File Specification Requirements BH File Specification Type File Type File Name Format File Input Name Structure File Input Directory Report Name Structure Report Output Directory Carriage Return/Line Feed Recommended Number of Total Records 07/2001 Recommended Number of 07/2001 Admission/Adds Recommended Number of Admission/Changes 07/2001 Recommended Number of Admission/Deletes 07/2001 Recommended Number of 07/2001 Closure/Adds Recommended Number of Closure/Changes 07/2001 Recommended Number of 07/2001 Closure/Deletes Test Environment ASCII 10.3 format (14 bytes) (space delimited) IBBDPPPPPT.JUL /county/<board designation>/bh/test/ RBBDPPPPPT.JUL /county/<board designation>/bh/reports positions: 351/352 50 15 5 5 15 5 5 Production Environment ASCII 10.3 format (14 bytes) (space delimited) IBBDPPPPP9.JUL /county/<board designation>/bh/input/ RBBDPPPPP9.JUL /county/<board designation>/bh/reports positions: 351/352 N/A N/A N/A N/A N/A N/A N/A

Appendix 2

Summary of System Test Procedures Step # 1 Board Responsibilities Board receives BH Test file from provider · · · Record file in logbook Verify file is not a duplicate Verify file meets ODADAS file and data specifications Perform edit verification against the data records (optional) State Responsibilities

·

2

Board transfers the file to ODADAS · E-mail/Fax BH Test Request Form FTP file to appropriate folder (Monday-Friday 7:00-5:00 PM) Update file status in logbook

·

·

Step # 3

Board Responsibilities

State Responsibilities ODADAS accepts the BH test file for processing: · Logs and processes file in order of arrival as indicated on BH Test Request Form Analyzes to see if file meets ODADAS file and data specifications Perform edit verification against the data records (Monday-Friday 7:00-5:00 PM)

·

·

4

If, BH test file fails the basic file and data specifications: · ODADAS will indicate as to why in the results section of the BH Test Request Form and e-mail/fax back to the board ODADAS will FTP the error report to the board ODADAS will perform no further testing on the file until all basic file specifications and data requirements are met ODADAS will not transfer the invalid BH test file back to the board Records status of file in logbook

·

·

·

·

Step # 5

Board Responsibilities If ODADAS indicates, via the BH Test Request Form, that the BH test file failed basic file specification and data requirements: · · Record status of file in logbook The board will need to work with the provider agency in correcting the errors and receiving a valid BH test file Return to Step 1

State Responsibilities

·

Step # 6

Board Responsibilities

State Responsibilities If BH test file passes basic file specifications and data requirements, but data editing fails ODADAS Standard of Acceptance: · ODADAS will FTP the generated error report to the /reports/ BH subdirectory ODADAS will indicate what the errors are by completing the "results section" of the BH Test Request Form and e-mail/fax back to the board ODADAS will continue to participate in any further explanation needed to correct the errors as indicated on the returned BH Test Request Form ODADAS will not transfer the invalid BH test file back to the board Records status of file in logbook

·

·

·

·

Step # 7

Board Responsibilities If ODADAS indicates, via the BH Test Request Form, that the BH test file data editing failed the ODADAS Standard of Acceptance: · · Record status of file in logbook FTP the error report from the /reports/ BH subdirectory Analyze the returned BH Test Request Form and error report in correcting the errors with the provider and submitting a new BH test file Return to Step 1

State Responsibilities

·

·

Step # 8

Board Responsibilities

State Responsibilities If BH test file passes basic file specifications and data requirements, and data editing passes the ODADAS Standard of Acceptance: · ODADAS will indicate that the file passes in the "results section" of the BH Test Request Form and e-mail/fax back to the board and FTP's the success report ODADAS will not transfer the valid BH test file back to the board Records status of file in logbook (partially or fully approved for production) Prepare for production files to be accepted by the board for that particular provider

·

·

·

Step # 9

Board Responsibilities If ODADAS indicates, via the BH Test Request Form, that the BH test file data editing passes the ODADAS Standard of Acceptance: · Record status of file in logbook (either partially or fully approved)

State Responsibilities

·

Communicate to the provider to begin submitting production data on a bi-weekly basis.

Appendix 3

Summary of System Production Procedures Step # 1 Board Responsibilities Board receives BH Production file from provider · · · Record file in logbook Verify file is not a duplicate Verify file meets ODADAS file and data specifications Perform edit verification against the data records (optional) State Responsibilities

·

Step # 2

Board Responsibilities Board transfers the file to the MACSIS Server · FTP file to appropriate subdirectory at anytime within the required schedule Update file in logbook

State Responsibilities

·

Step # 3

Board Responsibilities

State Responsibilities ODADAS accepts the BH production file for processing: · Perform edit verification against the data records (Bi-Weekly, Friday at 12:00 PM) ODADAS will FTP the generated error report to the /reports/ BH subdirectory (By Monday at 8:00 AM) ODADAS will not transfer the BH production file back to the board Records status of file in logbook

·

·

·

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If an error report is returned by the following Monday at 8:00 AM: · Record status of files submitted in logbook The Board will need to work with the provider agency in resolving the errors and resubmitting the data records in subsequent BH production files

·

Step # 5

Board Responsibilities If a success report is returned: on the following Monday at 8:00 AM: · The assumption should be that all BH production files processed successfully Record status of files submitted in logbook

State Responsibilities

·

Appendix 4 Behavioral Health Test Request Form

For Board Testing PLEASE PRINT CLEARLY. Fax this form to: The Ohio Department of Alcohol and Drug Addiction Services, Attn: Janet Brooks at 614-752-8645. Or, E-mail this form to the following address: [email protected]

Board Name and Type (MH, ADAS, ADAMH):

Contact Person's Name: E-mail:

Phone: Fax:

Agency Name: BH Test File Name: Date and Time Sent:

Diamond UPI:

/county/

/bh/test/

Number of Admission/Add Records

:

Closure/Add Records

:

Number of Admission/Change Records: Number of Admission/Delete Records :

Closure/Change Records: Closure/Delete Records :

Total Number of Records: Comments:

Software Package Utilized:

Version:

================ Results To be completed by ODADAS

=============== Date: File Failed Specifications

BH File Specification Results: ODADAS Staff Initials:

File Passes Specifications

BH File Testing Results:

File Passes BH Standard of Acceptance Comments: File Failed BH Standard of Acceptance

APPENDIX 5

BEHAVIORAL HEALTH SUCCESS REPORT EXAMPLE

Page 1 of 1

Behavioral Health Validation Report

PRODUCTION_BH - I09B101751.163

Date: Time:

6/25/01 10:54 AM

Statistical Summary

Add Input Records: Accepted: Rejected: 19 19 0

Admission Change 0 0 0 Delete 0 0 0 11 11 0

Closure Add Change 0 0 0 Delete 0 0 0 30 30 0

Total Add Change Delete 0 0 0 0 0 0

------ File Successfully Validated -----No Errors Found

APPENDIX 5

BEHAVIORAL HEALTH ERROR REPORT EXAMPLE

Page 1 of 1

Behavioral Health Validation Report

01274/. PRODUCTION_BH - i31m012741.164

Date: Time:

6/25/01 10:54 AM

Statistical Summary

Add Input Records: Accepted: Rejected: 10 9 1

Admission Change 0 0 0 Delete 0 0 0 1 1 0

Closure Add Change 0 0 0 Delete 0 0 0 11 10 1

Total Add Change Delete 0 0 0 0 0 0

Most Common Rejection Causes

Count Error Number 1 F1-R-1C 1 F1-R-1F Error Description UCI DOES NOT MATCH DIAMOND UCI NUMBER NOT 7 CHARACTERS LONG

Most Common Warnings

Count Error Number 2 F25-W-25F Error Description PRIMARY DIAGNOSIS TYPE ADJUSTED

Page 1 of 1

Behavioral Health Validation Report

01274 PRODUCTION_BH - i31m012741.164

UCI No: 9999999 PCN: 99999999 Level of Care: NA(MH Admiss Only Not AOD Services)

****Error Messages**** PRIMARY DIAGNOSIS TYPE ADJUSTED

Date: Time:

6/25/01 10:54 AM

Status:

1

ACCEPT

Name: XXX Admit Date: 20010418

Sex: F

Birth Date: 19860526

Rec Type Tran Type Field Reject Error Code Admission Add

****Contents of Field(s)**** Submitted: DSM-IV: 30900 Diagnosis 30900 Matched: DSM-IIIR

!

F25-W-25F

Status:

10

REJECT

UCI No: 999999

PCN: 99999999

****Error Messages**** UCI DOES NOT MATCH DIAMOND

Name:

YYY

Sex: F

Birth Date: 19830616

Level of Care: NA(MH Admiss Only Not AOD Services)

Rec Type Tran Type Field Reject Error Code Admission Admission Admission Add Add Add

Admit Date: 19990205

****Contents of Field(s)**** 110293 110293 Submitted: DSM-IV: 30900 Diagnosis 30900 Matched: DSM-IIIR

! ! !

F1-R-1C F1-R-1F F25-W-25F

UCI NUMBER NOT 7 CHARACTERS LONG PRIMARY DIAGNOSIS TYPE ADJUSTED

Note: Information on this report has been altered including UCI Number, PCN and Name in an effort to protect Client confidentiality.

State of Ohio Behavioral Health System Implementation Vendor File Specification Requirements BH File Specification Type Required File Type Required File Name Format Required File Input Name Structure Test Environment ASCII 10.3 format (14 bytes) (space delimited) IVVVVVVVT9.JUL I - Denotes Input V(7x) - Denotes abbreviated Vendor name T - Denotes Test 9 - Denotes Number of file submitted that day JUL - Denotes Julian Date of creation Required Report Name Structure RVVVVVVVT9.JUL R - Denotes Report Required Carriage Return/Line Feed Recommended Number of Total Records Recommended Number of Admission/Adds Recommended Number of Admission/Changes Recommended Number of Admission/Deletes Recommended Number of Closure/Adds Recommended Number of Closure/Changes Recommended Number of Closure/Deletes positions: 351/352 200 50 25 25 50 25 25

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