PDT Prerequisite Check-in & Data Submission

Summary

Summary

Prerequisite Action 2 - Confirm Data Files Contain Both Sets of Valid Keys

  • Data provided to HealthSparq for data analysis
    • 4 of 14 plans have provided data
  • HealthSparq actions triggered by this ticket:
    • Purpose of Confirming Data
      • Verify file format
      • Verify BPD format
      • Comparing the Plan BPD keys in the PROVALT_ID file to the data HealthSparq received from BCBSA via the new API
    • HealthSparq will
      • Document findings in the analysis report
      • Provide a listing of invalid keys

Overall Status for Planning - Action 1 - Confirm/Approve Provider PDT/BPD Data Analysis Report

  • Data analysis reports delivered
    • 4 of 14 plans
  • Purpose of this ticket:
    • Notifies plans that HealthSparq’s analysis of plan data has been completed
    • Data analysis finding are shared with the plans
      • High level report will be attached
      • A listing of invalid keys will be attached
    • Goal - Plans confirm the reported results are as expected
    • After files have completed analysis, please do not change formatting or do not update file(s) naming or location of file(s) without notifying HealthSparq
  • Action Required by each plan
    • Review the report & take one of the actions below, as appropriate:
      • Results are as Expected in Report: Comment no action needed and update status to ‘Resolve this issue’
      • Research Needed: Comment with the items that need research and update status to ‘waiting for support’.
      • New Files Provided: If files updated, please comment to include
        • The file name, date and timestamp that the new files have been submitted and
        • Update status to ‘waiting for support’ so that we know to trigger a new report for you.
    • Update the ticket status as appropriate based on action taken
  • Next Steps
    • Research needed or new files needed
      • Submit detailed questions in Planning - Action 1 ticket
      • Communication tracking
      • Data changes/new files submitted
      • Follow up Analysis Reports
    • Approval of report
      • HealthSparq updates plan specific intake configurations
      • HealthSparq updates plan specific carve out rules
      • HealthSparq will process provider files
      • Create a provider index with 5-part & BPD keys