Wednesday, March 23, 2011

Looking for Links to CMS 5010 Edits?

You can find them in the menu to the right of this post, titled: Full Encounter Data Links.  In addition to the front end edits, you will see a link to TARSC, where information regarding the ongoing CMS/Health Plan calls.

If you have questions, or comments, please post a comment or send them to us at

Monday, March 21, 2011

Do You Have Questions about CMS Full Encounter Data?

On Wednesday, we're having a Full Encounter Data webinar, to discuss the changes needed due to the CMS requirement that Health Plans begin submitted a full 837 v 5010 transaction for all encounter data, beginning 1/1/2012.

Do you have questions you'd like us to answer during the webinar?  If so, please send an email to with your question, or leave us a comment. We can't guarantee we'll have an answer, but we'll do everything we can to get the answers from CMS in the ongoing Health Plan/CMS meetings.

We have more information on our website at Full Encounter Data.

Tuesday, March 15, 2011

SCAN Hosts Full Encounter Data Webinar for our Provider Partners

Guest Blog Posting By Marc Carren, Encounter Data Manager

As you know,  on Friday, October 29,  2010, CMS held a Medicare Advantage industry-wide national meeting and formally announced their decision to transition from the current Risk Adjustment Processing System (RAPS) to a Full Encounter Data Collection model and a new CMS Encounter Data Processing System (EDPS).  This EDPS encounter data will be used to feed into CMS’ existing Risk Adjustment Processing System.  We sent an announcement to all of our provider partners, and asked that the announcement be shared with individuals within their organizations charged with:
¨       Supervision/management of claims and encounter data 
¨       The hands-on tasks of collecting the  encounter data from your service providers or sub-contracted providers ,
¨       The hands-on tasks of upgrading systems, operations, and work flow, and
¨       The responsibility for working with SCAN to ensure your organization can be in compliance with these high-impact CMS requirements by 1/2/2012.

On Wednesday, March 23, from 10a.m. to 11 a.m., SCAN will hold a Kickoff webinar conference to formally announce this initiative, our plan, and discuss any issues you expect with this transition.  If you know of anyone within your organization that needs to be involved in this webinar, and did not receive an invitation, please send an email to, and we'll  have someone contact you with Webinar information.

Following the kickoff webinar, SCAN will begin an assessment and survey effort via conference calls with all our Provider Partners.  The results of this assessment will inform our project plan and alert us to any possible assistance, guidance, or consultation various partners may require.  This initiative will be covered in more detail in the Kickoff webinar.
We thank you in advance for your attention, participation, and effort.
Marc Carren
Encounter Data Manager
SCAN Health Plan

Wednesday, March 2, 2011

Next CMS Fee-for-Service 5010 Conference Call: March 30, 2011

On March 30, 2011, CMS will host the next conference call in their series on the transition to the ANSI 837 5010 transactions.  The topic of this call is Provider Testing and Readiness.

CMS will be posting additional information regarding the call on the CMS Website at:

You should check the CMS website two to three weeks before the call for Webinar and call in information.