Summary

Summary

FAQ (New)

  • What are the Find Care tool implications if we’re still using the 5 part keys after 03/15/2024?

    • –  Provider data will load into Kyruus Connect

      • warning errors will occur

      • errors will be on reports

    • –  Searches that use BPDKeys (used 5-part keys) will not work

      • Carve out rules

      • Blending

      • National provider searches

      • National cost searches (Axis/NCCT & CLNR)

  • Does Kyruus Health have a contingency plan if plans are unable to test and or complete testing by BCBSA date (01/31/2024)?

    • –  Kyruus Health is developing

    • –  Will share with plans as soon as available

      • Will share in email and or tickets

      • Will share prior to next cohort call

      • Will review in next cohort call

         

        • If a plan notices that their BPD Key match is the same as their previous 5 part key match, at what point does a plan determine that is as high of a match as they can expect to see?

        – This would be a business decision that each plan would need to determine

        • Is there a way to receive a list of the product codes Kyruus Health has access to in order to confirm if we are received them?

        – Kyruus Health has requested a list of product codes we are authorized to access from BCBSA

        • Is the product code include the Master ID?

          • –  The product code/ID is part of the BPDKEY

          • –  It is the second part of the BPDYKEY

          • –  It is separate from the Provider Master ID

        • Where should plans pull the Provider ID from (to populate the 3rd part of the BPDKEY in the ALTID file)?

        – This should be the ID that plans send to BCBSA

        FAQ (previously reviewed)

        • Does Kyruus Health know if the Demographic Retrieve Endpoint (used by plan) and the Quality Retrieve Endpoint that Kyruus Health is using contain the same data?

          • –  The two should match

          • –  If seeing discrepancies, plans need to work with BCBSA (submit ticket with BCBSA)

        • As we approach the 1/31 testing completion due date, will the turnaround time for issues be

          pulled in/escalated from the standard timeframe?

          • –  Kyruus Health’s goal is to review and resolve testing issues as quickly as possible

          • –  Submitted testing issues will be reviewed on a daily basis minimally.

          • –  If there is additional triage or work required, Kyruus Health will communicate this through

            the ticket as appropriate

        • If a client/Kyruus Health sees ongoing issues with match rate or their files, is it possible to set up a one off session to avoid the back and forth within the ticket?

          • –  The Kyruus Health team is working diligently to remain within the cohort structure as much as possible.

          • –  However if there is a situation that calls for a one off meeting or session, Kyruus Health will explore the options available at that time.

        • Has Kyruus Health experienced any issues with the BCBSA endpoints?

          • –  Plans have seen issues, including with reviews

          • –  Intermittent issues have been notices with CLNR v2

          • –  Kyruus Health will check with internal teams to see if this is occuring

          • On the Analysis report, the unmatched key parts in the unmatched column - Is this a sample or is it supposed to match the excel file provided?

            • –  No, Kyruus Health is working on making updates to better clarify the understanding on the results.

            • –  The counts at the bottom are looking at the raw data, the counts in the top are looking at processed data (which is what you will see in the UI).

            • –  The report is listing the number of unique provider IDs that have errors for each part

            • –  The goal is to assist in identifying where the matching issues may be.

            • –  Kyruus Health is building more tools to assist in researching issues better and more quickly

            • –  Sample count of unique IDs by part of key found in the report:

            Part Part Name Unmatched
            3rd ProviderID 654
            4th ProviderMasterID 425
            5th ProviderLocationID 316

             

            FAQ (previously reviewed) (con’t)

            • What endpoint is HSQ using to compare plan data to BCBSA data? – Quality Retrieve endpoint

            • Was this compared to a pull of data at a certain point in time?
            – The file names/dates are on the report. The BCBSA data is the latest on that date.

            • How do we know which of the provider files the invalid key was from? – The BPD Keys are in the AltId file

            • For the 5-part key with invalid keys can you research and advise if these are in the compare files with a different sequence?

              • –  Kyruus Health is not doing research into invalid 5 Part Keys since the focus is BPD.

              • –  Please review your current provider data error reports to compare 5-part key mismatches.

            • Which product codes are blocked from TCE tool for either BPD or 5 part keys?

              • –  This is something that the Association will be able to provide plans.

              • –  Kyruus Health does not have a list of potential product codes that could match.

            • When the product IDs cannot be matched, who needs to verify whether Kyruus Health

              should be authorized to receive these products? (Kyruus Health or plan)

            – Plans should work directly with BCBSA to determine this. • What is the expected value for the key?

            • –  This is something that the Association will be able to provide.

            • –  Kyruus Health does not have a list of potential plan codes or BPD Keys that could match.

            FAQ (previously reviewed) (con’t)

            • If plans send additional files for analysis what is the expected turnaround time?

              • –  Data processing can take up to 2 weeks

              • –  Kyruus Health is working to provide the analysis reports as quickly as possible and have been

                returning them in about 5 days on average (as of 12/21/2022)

              • –  When sending new files, please include the names and dates of the files in your corresponding

                Planning Action 1 ticket so that the Kyruus Health teams can be ready to kick off the internal

                processes to run your new data

            • If a plan will be changing or combing the plan codes with the PDT Solution, what needs to be done for Kyruus Health analysis?

              • –  Please submit data using the new plan codes in the BPD Key in the ALTID file for all providers

              • –  Plans need to provide the updated keys to match the keys BCBSA is using