Copyright 6.2014: Scientific Cowboys – Nancy C Everitt, PMP

If you are a new ACO, the ACO Managed File Transfer Process with CMS can feel like a puzzle that’s made of sky pieces only. Hmm…more like a puzzle, in which the kids have misplaced a few pieces.

Below are three key tips that we use to better manage the process and ensure an error free file upload the first time.

1. KEEP a log. Since the system automatically stamps key information AFTER FILE TRANSFER UPLOAD it’s important to keep a log and versioning history for your files, since multiple uploads may all have the same name in your system. Then after submission, save a copy of the file with the send date and time for your records.

  • P#EFT.ON.ACO.AXXXX.BNPRF.20140424 1023am
  • P#EFT.ON.ACO.AXXXX.BNPRF.20140424 1144am

2.  FORMAT-SPACING: Do not copy the file formats directly from the HTTPSMANAGED FILE TRANSFER USER GUIDE. If you copy the page, your spacing will be off and result in an upload error. YEP, it’s a pain, but necessary to read the directions and pay special attention to the spacing requirements. Appendix H is your friend.

When we troubleshoot  XML files, key failure points are spacing and header/footer construction.

3. RESPONSE CODES – The Good, Bad and The Ugly. After the upload and everyone is eagerly awaiting the response file from CMS. Lower anxiety by letting the team know that there will be response codes on all records and that a response is not necessarily bad. Below are just a few to be aware of…

  • GOOD: “00” this is accepted!
  • BAD: “20” beneficiary cannot be identified. Typically we find that this is a birthdate or Gender issue and needs to be corrected.
  • UGLY: “10” “11” “12” “13” Your file format is off! Review Appendix H.

Good luck and let and share your tips for ERROR Free file uploads…

 

About the Author:

Nancy C. Everitt, MBA, PMP  is the President and CEO of HEOPS, Inc., CentEO of CENTIPEDE Health Network and Editor in Chief of Scientific Cowboys. Ms. Everitt is lead strategist to Clients’ on the design and fulfillment of patient access solutions such as network development and provider engagement, quality analytics, Medicare Advantage STARS strategy, disruption analysis and mapping. Ms. Everitt has been involved in the strategy of each engagement and provides significant perspective on industry best practice.

In addition to serving as Editor in Chief on Scientific Cowboys, Ms. Everitt is a frequent contributing writer to the publication sharing real world advice and operational insights on process and performance improvement. Questions on this article may be addressed directly to neveritt@heops.com.

 

 

 

 

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