SELF-PAY DATA RECONCILIATION GUIDE

Pennsylvania Health Care Cost Containment Council January 2016 ay Status Report for

TABLE OF CONTENTS Overview Purpose of this Manual ................................................................................................................. 1 Communication ............................................................................................................................. 1

Data Reconciliation Process Self-pay Web Application .............................................................................................................. 1 System Requirements ................................................................................................................... 1 Login ............................................................................................................................................. 2 Main Menu .................................................................................................................................... 3 Edit Records .................................................................................................................................. 3 Identify New Self-pay Case ........................................................................................................... 4 Preview Records ........................................................................................................................... 5 Send Records to Excel ................................................................................................................. 6

Confirmation .................................................................................................................. 6 View Records ............................................................................................................................... 6

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Self-pay Reconciliation

OVERVIEW Purpose of this Manual This manual will provide instructions on how to use the Pennsylvania Health Care Cost Containment Council (PHC4) Self-pay Data Reconciliation Web Application. The ultimate goal of this process is to capture a more accurate data set that can be sent to the Pennsylvania Department of Human Services (DHS), to be used as part of their calculations for the extraordinary expense portion under ACT 77, otherwise known as the Tobacco Settlement Act.

Communication While the Council is sensitive to the burdens of the reconciliation process, it is important to realize that the Council has established timeframes and deadlines for both the Council and facilities. As such, the Council will be unable to grant any extensions. Therefore, you are strongly encouraged to understand all material sent to your facility and to resolve problems expediently. Facilities should notify Council staff immediately of any problems so that resolution and data reconciliation process delays are avoided. The Council is committed to capturing accurate and useful data, and the Council staff is available to assist you in understanding the reconciliation process. If you have questions regarding the data reconciliation process, contact JoAnne Z. Nelson at 717 / 232 – 6787 or e-mail [email protected].

DATA RECONCILIATION PROCESS Self-pay Web Application The Web application contains all inpatient records from July 1, 2013 through June 30, 2014 that your facility submitted to PHC4 in your quarterly data submissions. Your primary task is to indicate whether any of the self-pay records were later paid by some third-party payer, or to change any records that were originally coded as a third-party payer that are now considered self-pay. The modifications you make will be submitted to the Pennsylvania Department of Human Services (DHS).

System Requirements The Web application is optimized for Microsoft Internet Explorer 6.0 or greater. Accordingly, be sure to check that your browser version is adequate before you begin, otherwise you may receive an error. If you need to upgrade your browser and/or install Adobe Acrobat Reader, links are provided on the login page for free downloadable upgrades of these products. Cookies and JavaScript must also be enabled to properly utilize this application. Please contact your IS/IT department if you need to enable these items.

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Login To begin using the Web application, go to the login page at https://www.phc4submit.org/selfpaysubmit. Enter the PAF Number and Password assigned to your facility and click on the Proceed button. Note: You will be given an error message and redirected back to the login page if either the user name and/ or password are incorrect.

Once you have successfully entered the correct PAF Number and Password the following message box will appear. Please read it and click on the OK button.

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Main Menu You will be directed to the self-pay Web application menu screen shown below. You may logout and return to the Web application as many times as necessary at anytime during your session using the Logout button until the site is disabled. Once you confirm and submit the data for processing the system will not allow you to reenter the site.

Edit Records The Edit Records page, pictured on the next page, will list only the records that are identified as self-pay in the PHC4 database. Your primary task is to indicate whether any of these self-pay records were later paid by some third-party payer. To do so for those cases, select the button under the N column that corresponds to the record. All records have been defaulted to Y to start, you only have to modify those that need changed. Please click on the Save button after completing each page. The save button saves only the changes made to the current page. You may click on the save button as often as you wish. If you do not click the Save button on every page, changes you made will not be applied. No further action is required for records that are still self-pay. A threshold value was calculated for the hospital and it is displayed in the upper right part of the page (PHC4 2X Average Total Inpatient Charge Threshold). This is made available as a guide in reviewing the records. The value is double the hospitals average total inpatient charges. This is a voluntary process. If you choose to participate it is up to each facility to determine if they want to reconcile every record or only those that fall above the PHC4 2X Average Total Inpatient Charge Threshold value. To help you locate records the Web application has a couple of features. You may search for a Control/Billing number by entering just the last few digits instead of the entire number in the Find Record box at the top of the page. Clicking on the Find Record button begins the search. To return to the previous page select the Show All Records button (not shown).

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Additionally, you may click on any column heading to sort the records by that column, except for the Y and N columns. The small arrow to the right of the column heading indicates in which direction it is sorting. It displays an up arrow for ascending and a down arrow for descending.

Note: If records were added to the list of self-pay cases through this reconciliation application process by using the Identify New Self-pay Case function from the main menu screen, the Y and N column for these records in the Edit Records page will be disabled. This indicates that it was an added record during this reconciliation process. If you add a self-pay record in error return to the Main Menu, click on the Preview button and click in the delete column for the corresponding record and then click on the Remove Checked button.

Identify New Self-pay Case The Identify New Self-pay Case page allows you to identify additional self-pay cases. In order to change a payer to self-pay, the record had to be included in the original submission to PHC4. Enter the Control/Billing Number of the record you want changed to a self-pay case. The following screen will be displayed, if you wish to add this record click on the Add as Self-pay box and click Add Record(s) then a confirmation message will be displayed. If you want to view all non-self-pay records downloaded into an excel file click the click here link. (We do not recommend this option due to the volume of records involved. It will take a considerable amount of time to load all the records and has the potential to create an error if your submission is too large.) Note: If you add a self-pay record in error return to the Main Menu, click on the Preview button and click in the delete column for the corresponding record and then click on the Remove Checked button.

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Preview Records At any time you may preview all changes made up to that point. To do so, click on the Preview Records button located on the Main Menu. Every record that has been changed from Y to N will appear with a red X and every record that was added will appear with a green checkmark in the New/Changed column. If a record was originally marked as a self-pay record and you changed it and then changed it back, it will not appear on the preview page. If you would like to view all self-pay cases that will be included in the data sent to DHS, return to the Main Menu and click the Send Records to Excel button. To return to the Main Menu from the Excel page use the back button on your browser. (This is the only area of the application you should use the back button). Note: If you added a self-pay record in error in the Preview Records page you can delete the record by clicking in the delete column and then click on the Remove Checked button.

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Send Records to Excel The Send Records to Excel page allows you to view in one excel file all the self-pay cases that will be sent to DHS. To return to the Main Menu use the back button on your browser. (This is the only area of the application you should use the back button).

CONFIRMATION When you have finished reconciling the hospitals’ records you must click on the Confirmation button. You will be prompted to confirm the type of review you performed by selecting one of the two options listed below. Even if you determine that your facility did not have any self-pay records, please verify this by selecting one of the options. This will serve as verification that you have in fact reviewed your data. Once you have chosen one of the options click on the Submit Data for Processing button to complete the process. Please note that the Web application will be disabled after you complete this step. IMPORTANT: You must click on the Submit Data for Processing button or your changes will not be submitted to DHS.

View Records The following screen will appear to indicate that you successfully completed the process. At this point you can click View all records to view your complete submission, which include new selfpay cases, no longer self-pay cases, and remained self-pay cases. Or you have the option to click View changed records to view only the records you changed during the reconciliation.

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When you choose the records you want displayed, the following screen will appear. We suggest you click the Print button to keep a copy for your records before logging out.

Please do not hesitate to contact JoAnne Z. Nelson at 717 / 232 – 6787 or [email protected] with any questions, comments or concerns.

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