2023.02.08 EQRS Program Working Group Meeting

This session will be recorded for the purpose of documenting the meeting minutes and action items. If there are any objections to the recording of this session, please make it known now. Absence of an objection to the meeting being recorded will count as consent to recording this meeting. 

https://us06web.zoom.us/rec/share/5EfN6XvyCJmNfSCOLT8341a8aSWnc0TvnfPtUzpCDjpLqkJOhRtZEYx8AzjvKbO5.c33a4P9bC2yudRqQ
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Program Working Group_20230208-155533_Recording_1920x1080.mp4

Q&A Discussion: Medicare Status and Medicare Status Effective Date values in EDI submissions

EQRS Program Working Group Meeting Minutes 11123 - Q&A.msg

• EQRS no longer uses what EDIs send in our submissions to populate the registry or for any patient/record matching. This data comes only from EDB.
  • This statement is not corrrect
  •  EQRS does use the identifiers that is send in the files.  They are used for patient matching
  • EDB also uses them
• If we send these fields blank we generate an error and the patient record is rejected
  • This statement is not correct
  • When there is not an SSN or MBI or Medicare claim number; it is not sent and the files process accurately
  • Medicare status field is similar to employment status, school status. 
  • For example, if patient has not status, the system accepts whatever status you send until the patient is synced to EDB and at that point, if you send a status when the patient is synced with EDB or you send an SSN or MBI and the patient is synced with EDB, you don't get an error message.  You get a warning message and that record still processes.
  • If a new patient is sent, a status needs to be included
• If either value we send doesn’t align with what is in EQRS (from EDB) we generate an error and the patient record is rejected
  • This statement is not correct
  • A warning message is generated and the patient record still processes
• If we completely remove the tags for these fields from our file structure the whole file will be rejected
  • No, you do not have to send SSN and MBI.  It's not going to reject the file
• Response files, when an error is triggered for one of these fields, don’t tell us what the value in EQRS is.
  • The only value that EQRS can tell them is the MBI
  • SSN cannot be sent in the feedback file
  • When a patient does have an MBI from EDB, you get a warning message and it tells you what it is but EQRS will not tell you what the SSN is because EQRS cannot send the SSN information in the feedback file

Additional Questions:

• Geraldine Bojarski (DCI)
  • Having problems with the information that's coming from the Social Security Administration
    • It won't let they change it
    • When they call the EQRS helpdesk, they are told to send the patient to the SS Administration
    • Scenario - patient is dead and the Medicare start date is after the death date so it won't let the clinics enter the 2746 death form
    • Per Yvette - another team is working on removing the validation were the Medicare status can't be a future date; once the validation is removed, you will still be able to add the 2746 or make other edits to the patient record; Yvette will let the group know when this will be completed (Action Item Yvette)
    • To resolve this particular situation now, need to contact the helpdesk and then it will be assigned to a team to be able to help on the back end
    • When contacting/emailing the helpdesk, suggest to include that it's an issue with the Medicare status dates being after the patient date of death and then ask to route the ticket to the data team
  • Patients who lose their Medicare status
    • Scenario - it's been greater than 3 years since their transplant and they went back to work
    • Will the Social Security Administration going to automatically send in the file that the MBI number needs to be removed so that the patient does not appear to have Medicare again?
      • Per Yvette - No, SSA will send EQRS updated data
      • Scenario - A clinic has a patient who came back after 10 years transplant, young patient so they don't have Medicare any more; they had their employer plan but they were not able to remove the MBI number and so it looks like the patient actively has Medicare; not sure if the status has been updated to say the patient does not have coverage. Send the patient Id to Yvette.  (Action item Geraldine)  
      • When children who are using their parents MBI number becomes of age, the new MBI number will be updated in EQRS; EDB will send EQRS the new number and it will be updated in EQRS
  • DCI asked their clinics not to even start their 2744s until after Feb 15th.  What are the dates that Medicare does their upload into EQRS?
    • Per Yvette - believes it happens nightly
    • A change has been made for the 2744s - Now that EDB is the source of truth the 2744 has been updated to be able to derive a status by either checking the patients 2728 form.  If they don't have a 2728 EQRS checks their admission information such as the admission effective date and EQRS uses that as the "as of date" and put them under no coverage
    • If the patient has a 2728 form and field 10 is 'Yes', then EQRS will put the patient under pending status
    • If the 2728 for is 'No', we put the patient under not covered status
    • Will the status that EQRS derives, show up on the patient record or is it only calculated on the backend?
      • Per Yvette, its only calculated on the backend
      • Additional example/scenario - listen to recording 21:39 - 23:20
  • An issue encountered with a DCI clinic submission of 2728
    • Example/scenario - listen to recording 23:23 - 24:35 
    • Geraldine will send Yvette the patient ID so Yvette can research (Action Item Geraldine)
• Leah Skrien
  • Is everything done with Medicare updates?  Any more enhancements coming?
    • Per Yvette - Medicare claim number will be coming
      • EDB will be the source of truth for the Medicare claim number 
  • Will we ever see prior statuses for the future effective dates in that patient record
    • Should be seeing those now
    • One the patient syncs with EDB, you should see the history
    • Leah is not seeing anything prior to those effective in 2023
    • Leah will send Yvette some examples (Action Item Leah - Complete)

      • For those calculations of prior status performed for the 2744, there were not prior statuses created on the patients actual record (patient attributes or patient attributes history) if Medicare was effective in 2023. Those calculations are just performed in the backend.

• Kathleen 
  • There was mention in the last meeting that Medicare numbers were being generated correctly on the 2744 form and there was a fix going in.  Any status on this?
    • Kathleen still having issues with the Medicare number being generated correctly
    • Per Yvette - she is not aware of the issue.  Another team may have been working on it
    • Kathleen will send Yvette a facility number for her to research (Action Item Kathleen)

Next meeting scheduled for 22 Feb 2023