The Medical Data Call Manager was recently modified to incorporate a new edit category. These changes represent title and presentation changes only and no changes have been made to the existing edits. Edits which involve more than one data element have been re-labeled as Relational edits. Users will observe the new Relational edits in the Quality Tracking – File Level and Quality Tracking – Aggregate Level options. The Relational edits will be displayed in a similar format as the Critical, Priority and Low edits.

An updated Medical Data Call Manager User’s Guide is available within this web application and is also available in the Help Section located in the Application Login area of the Bureau’s website.

Carriers should visit the Bureau’s website periodically for additional information regarding the Medical Data Call.

Effective June 6, 2011, the Bureau will begin to strictly enforce the Medical Data Call transaction file reporting schedule as shown below. This schedule remains consistent with the reporting rules as published in the Pennsylvania Medical Data Call Manual. For those data providers continuing to send files outside the appropriate transaction submission period, please note that such files will be rejected.
 

Carriers should visit the Bureau’s website periodically for additional information regarding the Medical Data Call.

The Medical Data Call Manager was recently updated to include an industry benchmark feature. The Quality Tracking – Benchmark option allows users to view aggregate quality statistics as compared to the industry aggregate quality statistics. The aggregate quality statistics are refreshed as additional files are received during the same reporting quarter for the carrier group. Within this option, the industry is comprised of all carrier groups who are eligible to participate in Pennsylvania Medical Data Call. The Bureau will refresh this report on a twice weekly basis.

An updated Medical Data Call Manager User’s Guide is available within this web application and is also available in the Help Section located in the Application Login area of the Bureau’s website.

Quarter End Validation will be made available to carriers in the near future in the Medical Data Call Manager.

The Medical Data Call Manual has been republished with an important revision. This republication includes a clarification regarding the Record Total in the Section V - Reporting Rules for Delete File transactions.

The Bureau added a new section on the Medical Data Reporting web page which is the Medical Data Call Manager. This section provides information on how to access the Medical Data Call Manager as well as a summary of the features of the Medical Data Call Manager application.

The Bureau added a new section on the Medical Data Reporting web page which is the Medical Data Call Transaction Reporting Calendar. The calendar may be used by carriers as a reference tool for data file submission due dates.

Carriers should visit the Bureau’s website periodically for additional information regarding the Medical Data Call.

The Medical Data Call Manager was recently updated to include an aggregate quality tracking function. The Quality Tracking – Aggregate Level option allows users to view aggregate quality statistics which are refreshed as additional files are received during the same reporting quarter for the carrier group. The Bureau will refresh this report on a twice weekly basis.

An updated Medical Data Call Manager User’s Guide is available within this web application and is also available in the Help Section located in the Application Login area of the Bureau’s website.

Quarter End Validation will be made available to carriers in the near future.

The following are a few important reminders regarding data submissions for Medical Data Call:

• The Submission File Identifier in the Submission Control Record (trailer record) must be unique for every data submission -- including any submission following a rejected submission or a test submission. The only exception to this rule is when the data submission is a file replacement transaction. For file replacement transactions, the Submission File Identifier must match the Submission File Identifier from the data submission to be replaced.
• Verify that prior transaction files have been processed successfully before sending the next transaction file.
• Quarterly Data Submitters: Please separate quarters into distinct data submission files. Do not combine multiple quarters into a single data submission file.

Carriers should visit the Bureau’s website periodically for additional information regarding the Medical Data Call.

The Medical Data Call Manual has been republished with several important revisions. This republication includes details on two new key field changes which are required for the proper linking of individual medical transactions.  Policy Number Identifier and Policy Effective Date are now being treated as key fields.  The update also describes the addition of two new Paid Procedure Code types: Compound Drugs and Per Diem.  Lastly, the refresh includes clarifying language, updated references, and revised formatting.  All of the changes are highlighted in green within the Manual.

The Medical Data Call Manager is now available on the Bureau's website.  This new web application will provide carriers, and their data providers, a central location to monitor their medical data call submissions, review quality statistics and download returned medical data call records.  The Medical Data Call Manager User’s Guide is included within the application and is also available in the Help Section located in the secure portion of the Bureau’s website.

The Medical Data Call Manager is being rolled out in two phases.  The current release (Phase I) includes Submission Tracking functionality. Phase II will include Quality Tracking and Quarter End Validation functionality.  Phase II will be made available to carriers in the near future. 

By using the secure portion of the Bureau’s website, carrier users can request access to the Medical Data Call Manager from their Carrier Group Administrator (CGA) via the “Request Access to Application” link located within the blue or green side bar.  The user will then be prompted to select the Medical Data Call Manager.

The Medical Data Call Electronic Submission Guidelines document has been updated to clarify the electronic transmission record (ETR), and to provide additional guidance regarding the file naming conventions.  There is also refreshed content on the file acceptance and carrier notification process as well as information on the Bureau’s Medical Data Call Manager web application.

In the weeks ahead, the Bureau will be contacting you regarding your Medical Data Call preparedness which includes either determining your plans to submit test files or discussing the results your test file submissions.

Carriers should visit the Bureau’s website periodically for additional information regarding the Medical Data Call.

The Medical Data Call Implementation Guide has been republished as the Medical Data Call Manual. This republication includes some clarifying language and examples, and provides additional information on the certification, editing and validation processes.

The Medical Data Call Manual completely replaces the release of the May 15, 2009 Medical Data Call Implementation Guide and continues to include the reporting layout, general rules, participation requirements and business exclusions, reporting frequencies and responsibilities, editing strategy and other essential information needed for subject carriers to continue to prepare for the submission of medical data transactions. The Medical Data Call Edit Matrix on the website has also been updated and is available for download. This matrix contains details on edits that will be performed on Medical Data Call submissions by the Bureau.

Additionally, a Medical Data Call Electronic Submission Guidelines document has been added to the list of available medical call information posted on the Bureau’s website. This document outlines the electronic testing process and requirements. Data providers are reminded that mandatory testing (certification) begins April 2010 and must be completed by July 2010. If a data provider is ready to test prior to the mandatory testing period please email us at medicalcall@pcrb.com or contact us by phone at (215) 568-2371.

We also invite and encourage Medical Data Call reporters to attend the Medical Data Call training sessions at NCCI’s 2010 Data Educational Program on Data Reporting Fundamentals (January 26-27th) and/or Data Provider Forum (January 28-29th) to learn more about the Medical Data Call. Both programs are free of charge and will be held at the Palm Beach County Convention Center in West Palm Beach, Florida. If you are interested in registering for these programs, please visit NCCI’s website at www.ncci.com. Note that these programs are specifically intended for entities that will be reporting the NCCI Medical Data Call. However, NCCI has graciously invited independent bureaus and/or their Medical Data Call reporters to participate in these sessions.

The Medical Data Call Implementation Guide has been updated to include some clarifying language and examples. The updated guide replaces the prior January 6, 2009 release and continues to include the reporting layout, general rules, participation requirements and business exclusions, reporting frequencies and responsibilities, editing strategy and other essential information needed for carriers to continue to prepare for the submission of medical data transactions.

Additionally, a Medical Data Call Edit Matrix has been added to the website and is available for download. This matrix contains details on the edits that will be performed by the Bureau.

Carriers should visit this website periodically for additional information regarding implementation of the new Medical Data Call.

The Bureau has adopted a Medical Data Call beginning with medical transactions occurring during 3rd quarter 2010.

The Medical Data Call Implementation Guide is now available. This guide includes the reporting layout, general rules, participation requirements and business exclusions, reporting frequencies and responsibilities, editing strategy and other essential information needed for carriers to begin preparing. The posting of this document completes Phase I on the documentation process.

Phase 2 will occur in the first-half of 2009, when the Bureau will expand on the Medical Data Call Implementation Guide and reformat the guide into a Medical Data Call Manual. The Medical Data Call Manual will be comparable to the Bureau’s other manual products such as the Statistical Plan Manuals.

The Bureau will continue to publish industry announcements, timelines, and other important information including training information as we proceed with the implementation of the Medical Data Call.

Carriers should visit this website periodically for additional information regarding implementation of the new Medical Data Call.