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TABLE OF CONTENTS INFOH USER GUIDE

I. Introduction ------------------------------------------------------------- pages 3 - 4 II. General Rules for Submission of INFOH Case Counts ---------- page 5

III. General Rules for Submission of INFHO Data ----------------pages 5 – 7

a. Assignment of Patient Type -----page 6

IV. Logging into INFOH -------------------------------------------------------- page 8 V. Welcome to Data Services Screen ------------------------------------- page 9 VI. Submit Discharge Case Counts --------------------------------------- page 10 VII. Discharge Case Count Verification ---------------------------------- page 11

VIII. Submit Data Batches ----------------------------------------------------- page 12

IX. Batch Review Screen ----------------------------------------------------- page 13

X. Batch Detail Screen ------------------------------------------------------- page 14

XI. Edit Record Screen ------------------------------------------------------- page 15

XII. Correcting Edits --------------------------------------------------- pages 15 – 16

XIII. Data Verification ---------------------------------------------------------- page 17

XIV. Data Verification Report ------------------------------------------------ page 18

XV. Find a Patient Record --------------------------------------------------- page 19

XVI. Create Reports ------------------------------------------------------------ page 20

XVII. NPI Upload ----------------------------------------------------------------- page 21

XVIII. Support – Submitting Requests --------------------------------------- page 22

XIX. Email Examples ----------------------------------------------------------- page 23

3

INFOH SUBMISSION MANUAL

INTRODUCTION What is INFOH? INFOH stands for Information Network for Oregon Hospitals. This initiative was developed by Apprise Health Insights, the data subsidiary of the Oregon Association of Hospitals and Health Systems (OAHHS), in response to the need for hospital billing and discharge data that went beyond the Oregon state mandate requiring hospitals to submit quarterly inpatient and outpatient surgical data. INFOH expands hospital billing data collection to include emergency department and all other outpatient encounters. The expansion was approved by the full hospital membership in July of 2013. Why INFOH? Apprise will use the additional data, in coordination with OAHHS and the overall hospital membership, in order to better understand trends in hospital utilization and reimbursement, and to support its advocacy efforts on behalf of Oregon’s community hospitals. Likewise, hospitals need additional data to support their planning efforts in an environment where more care is being provided in an outpatient setting. Understanding the full spectrum of care provided will be crucial in the era of Coordinated Care Organizations (CCOs) and overall health care transformation that focuses on value versus volume. Data Submission Requirements The Office for Oregon Health Policy and Research (OHPR) is authorized under Oregon Revised Statute 442.120 to collect hospital inpatient and outpatient surgical claims data and free-standing ambulatory surgery center (ASC) claims data. Current reporting requirements began in 2008 and will continue. Per OHPR, data should conform to the Official UB-04 Data Specifications Manual (published and maintained by the National Uniform Billing Committee NUBC), for claim-specific codes were applicable. INFOH is a web-based data collection tool designed to effectively and efficiently collect inpatient discharge, outpatient surgical, emergency department, and all other outpatient encounter claims. Data will be required quarterly, but hospitals are strongly encouraged to submit data as frequently as possible to avoid last minute delays and allow for additional time for corrections. OAHHS recommends monthly data submission at a minimum as the volume of data being collected increases substantially with the addition of emergency department and all other outpatient encounters. Data can be submitted in either flat-file or 837i v5010 formats as specified in this manual. In addition to submitting actual claims records, facilities must also submit case counts by month for inpatient discharges, outpatient surgeries, emergency department visits, and total outpatient visits prior to the quarter close. These monthly counts are used to determine quarterly compliance with volume of error-free records submitted to INFOH.

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Access to the secure program may be obtained by contacting INFOH@apprisehealthinsights.com. System training will be required by Apprise before access is granted to a new user. Username and password information must not be shared. Due Dates INFOH specifies two different due dates. Initial data submissions are due 45 days after the end of the calendar quarter. Final due dates are 60 days after the end of the calendar quarter. Why two different due dates? Due to the volume of data submitted by hospitals, it is highly advised to comply with both due dates in order to provide the necessary time for corrections. Minimum compliance levels for quarterly data submission are as follows: Inpatient – 95% Outpatient Surgical – 95% Emergency Department – 95% All Other Outpatient – 75%* *It is anticipated that these compliance levels will be increased over time as hospitals gain experience with the error-correction capabilities provided by INFOH. Initial Due Dates (45 days after the end of the calendar quarter): Q1: January - March data is due May 15 Q2: April - June data is due August 15 Q3: July - September data is due November 15 Q4: October - December data is due February 15 Final Due Dates (60 days after the end of the calendar quarter): Q1: January - March data is due May 31 Q2: April - June data due is August 31 Q3: July - September data is due November 30 Q4: October - December data is due February 28 Use of this manual is effective for discharges of October 1, 2014 and after.

5

GENERAL RULES FOR SUBMISSION OF INFOH CASE COUNTS

Facilities are required to submit monthly Case Count information for: Inpatient Outpatient Surgery Emergency Department Total Outpatient.

NOTE: Inpatient and Total Outpatient discharges/visits are counted ONLY ONCE. Counts for Total Outpatient should include Outpatient Surgery and Emergency Department. Reference Appendix I – Definition of Inpatient and Outpatient Records to determine definition of categories. Specific instructions on how to submit case counts will be updated when ready.

GENERAL RULES FOR SUBMISSION INFOH DATA Facilities determine the submission format: Inpatient Flat, Outpatient Flat, or Apprise-specific 837i v5010. Inpatient Flat and Outpatient Flat formats are comma-delimited files with set fields lengths. There must be a line feed after position 2500 for every record. The Apprise-specific 837i v5010 format submission requires that these specifications be used as a companion guide to the corresponding ASC Health Care Claim: Institutional Consolidated Guide, version 005010X223A2. Reference the ASC X12 837i Technical Reports Type 3 (TR3) and modify specific data elements to create the Apprise-specific transaction for submission. Apprise does not provide the TR3 documents, but they are available from the Washington Publishing Company at www.wpc-edi.com. Modifications to the X12 837i v5010 are specified to ensure hospital compliance for submitting to INFOH through electronic administrative data. The modifications do not, however, contradict or otherwise modify the X12 837i v5010 in a manner that will make its use noncompliant. In addition, these changes are separate from and do not impact how claims are submitted for payment. General rules for batch compliance include but are not limited to:

Flat files have fields with specific start and stop positions. X12 837i v5010 general compliance needs to be adhered to including but not limited to:

o Inclusion of standard header (SE = beginning of transaction) and trailer (ST = end of transaction) sets.

o Batch size is limited to a maximum of 100,000 CLM segments. o ISA and IEA must have exact same control numbers. o Detail information on the claim is comprised of hierarchical structure in a series of

loops. Hierarchical level segments (HL) indicate the provider, subscriber and patient information.

o HL segments are numbered sequentially within a transaction set (ST to SE) with the sequential number found in HL01, the first data element in the HL segment. HL segments must be unique.

6

o HLs may contain multiple ‘child’ HLs which indicate an HL nested within the previous HL. ‘Parent’ HLs are required when a ‘child’ HL exists.

Batch failures include but are not limited to:

File is not in a compliant format. File is too large. File is missing required data elements (i.e. Facility NPI). More than 50% of batch contains duplicate records.

ASSIGNMENT OF PATIENT TYPE Each facility determines whether a record is inpatient or outpatient. Inpatient Place of Service is also determined by each facility. Bill Type will define the Patient Type and the inpatient Place of Service of submitted records. Extreme care is required to assign patient records to the service they receive. Inpatient Patient Type and Place of Service assignment must occur as follows. See Appendix II. * Place of Service 1 – Acute Inpatient – Bill Type 0111 * Place of Service 2 – Medical Rehab – Bill Type 0151 * Place of Service 3 – SNF/Swing Bed – Bill Types 0181 and 0211 * Place of Service 4 – Behavioral Health – Bill Type 0171 Any other Bill Type will identify a record as Outpatient. This includes records submitted with invalid Bill Types. Outpatient Place of Service is determined in a hierarchical fashion depending on the Revenue Codes on each claim. See Appendix II.

Apprise-specific format and field requirements include:

Bill Type – Bill Type will determine Patient Type (either Inpatient or Outpatient) AND inpatient Place of Service. See above.

Hospital Number – Each facility must coordinate with Apprise on a single organizational NPI for submitting required INFOH data.

Race – Required on all records. See Appendix V. Ethnicity – Required on all records. See Appendix VI. Primary Expected Source of Pay, Secondary Expected Source of Pay, and Tertiary Expected

Source of Pay need to be mapped to INFOH’s Expected Source of Pay codes. See Appendix VII.

Patient’s First/Last Name – Required on all records. Patient Address 1 – Required on all records. Where Patient Address 1 is not available, for any

reason, populate field with “No Address Reported.” Admission Date – Required on all records. Admission Hour – Required on all inpatient records. See Appendix VIII. Priority (Type) of Admission – Required on all records. See Appendix IX. Point of Origin/Source of Admission – Required on all records. See Appendix X. POA – Required only on Inpatient Place of Service = 1 (Acute Care) principal, E-code, and

other/additional diagnoses unless the ICD-9 code is exempt. See Appendix XII.

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Other reporting requirements: Records (inpatient and non-recurring outpatient) should be submitted into the quarter of the

Discharge Date. Recurring outpatient records should be submitted into the quarter matching the Dates of

Service for that record. Inpatient

o Service line information (revenue portion) should be summary level claim information where all the charges are summarized (rolled-up) by revenue code.

o Inpatient procedure information is reported using ICD-9/10 procedure codes. o For 837i v5010, repeat HI segments to report ALL inpatient ICD-9/10 diagnoses and

ALL inpatient ICD-9 procedures codes associated with each claim. Outpatient

o Service line information (revenue portion) should be detail level claim information where all revenue lines are submitted.

o Outpatient procedure information is reported using CPT and/or HCPCS. o For 837i v5010

Repeat HI segments to report ALL outpatient ICD-9/10 diagnoses associated with each claim.

Repeat SV2 segments to report ALL outpatient CPT/HCPCS procedure codes associated with each outpatient claim.

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DATA VERIFICATION REPORT VERIFICATION REPORT INCLUDES – Information automatically emailed upon initiation of the verification process OR by selecting Verification Report from the Create Report menu show:

Inpatient o Place of Service o Total Charges by Revenue Center o Patient Discharge Status o Gender o Priority (Type) of Admission o Point of Origin o Race o Ethnicity o Primary Payer o Secondary Payer o Condition Codes o Occurrence Codes o Occurrence Span Codes o Value Codes o Accident State o Birth Weight in Grams o Generic NPI o Diagnoses o Present on Admission o E-Codes o Procedures o Age o Length of Stay o Outlying Total Charges o MS-DRG o ZipCodes o State of Resident o Clinician (Attending and Operating)

Outpatient Surgery, Emergency Department and Total Outpatient o Place of Service o Total Charges by Revenue Center o Patient Discharge Status o Type of Bill o Gender o Priority (Type) of Admission (Outpatient Surgery only) o Race o Ethnicity o Primary Payer o Secondary Payer o Condition Codes o Occurrence Codes o Occurrence Span Codes o Value Codes

19

o Accident State o Generic NPI o Diagnoses o E-Codes o Age o Length of Stay o Outlying Total Charges o ZipCodes o State of Residence o Clinician (Attending and Operating for Outpatient Surgery and ED only)

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