June 23–24, 2016 Hyatt Regency Boston Harbor User Group Meeting and Conference CAQH and IntelliCred Lynne O’Connor, Sr. Director, Consulting & Advisory Service June 23–24, 2016 | Hyatt Regency Boston Harbor

June 23–24, 2016 Hyatt Regency Boston Harbor Let’s Discuss CAQH Data Files Saving the CAQH Files for use with the Import Process Setting Defaults for the CAQH Import Process Data Acceptance, What Comes In, What Does Not The CAQH Import Function What Tools Exist to Clean Up and Standardize the CAQH Imported Data What We Will Cover

June 23–24, 2016 Hyatt Regency Boston Harbor Why would you want to use the CAQH Import Function Who is able to access CAQH and take advantage of obtaining provider data files How do organizations obtain the CAQH data files Let’s Discuss CAQH Data Files The CAQH ProView Participating Organization User Guide provides instructions for Managing Extracts as well as Scheduling and Downloading Files. You must be an existing, Participating Organization with CAQH.

June 23–24, 2016 Hyatt Regency Boston Harbor The CAQH data files are delivered to you in a format called.xml Saving the CAQH Files for use with the Import Function Once you have these files, you must save them on your computer and in your IntelliCred folder. The proper path for saving is: C:\IntelliCred\caqh

June 23–24, 2016 Hyatt Regency Boston Harbor There are two methods available for setting some data defaults. These data defaults include: Parent/Payor Facility Checklist Template Verifying/Host Facility Appointment Type Affiliation Status Setting Defaults for the CAQH Import Function Method #1 1.From the Menu/Tool Bar, select CAQH XML Icon 2.Configure the Data Defaults Method #2 1.From the System Menu, select Utilities 2.In the Utilities Window, select CAQH Import Default Settings 3.Configure the Data Defaults

June 23–24, 2016 Hyatt Regency Boston Harbor New functionality related to the CAQH Import process gives you the ability to decide whether or not certain data from CAQH will be queued for you to audit before it comes in. Data Acceptance, What Comes In, What Does Not 1.From the Menu/Tool Bar, select CAQH XML 2.In the CAQH XML File Import Window, place a check in the Use Acceptance checkbox

June 23–24, 2016 Hyatt Regency Boston Harbor The CAQH Import Audit Log will populate with the data from the.xml files you have selected to import. This is the data that will be queued for your ability to decide whether to accept it or not. Data Acceptance, What Comes In, What Does Not

June 23–24, 2016 Hyatt Regency Boston Harbor The first step of the CAQH process is for you to Get or Load the.xml files you have obtained from CAQH. The CAQH Import Function 1.From the Menu/Tool Bar, select CAQH Import 2.In the CAQH XML File Import Window, click the Get Files button 3.Browse to this folder: C:\IntelliCred\caqh 4.Click to highlight the CAQH folder 5.Click the OK button

June 23–24, 2016 Hyatt Regency Boston Harbor Once you have loaded the.xml files into the CAQH XML File Import Window, they will be listed on the left. You are able to De-Select any of these.xml files and exclude them from the import process Only those files that remain highlighted will be included in the import process The About section lists the steps to follow for the import process The CAQH Import Function 1.Place a check in the Use Acceptance checkbox to insure data will be queued for you to audit 2.Make sure your Data Defaults are set 3.Check the additional boxes at the bottom to automatically set other data as desired 4.Click the Import button

June 23–24, 2016 Hyatt Regency Boston Harbor The CAQH Import Function While the import runs, you will see a number of import process indicators… When the import process is complete, you will see a Process Complete message

June 23–24, 2016 Hyatt Regency Boston Harbor Because we are using the Acceptance Option, we see those providers who have been added to the CAQH Import Audit Log. Using the Audit Log, you will be able to view each data field contained in the CAQH.xml file for each provider. The CAQH Import Function Check the box adjacent to the provider name in order to load all of the queued data to the lower portion of the screen

June 23–24, 2016 Hyatt Regency Boston Harbor With the provider data loaded into the bottom portion of the screen, a number of filters are available for use in determining the data to be allowed into IntelliCred. The CAQH Import Function

June 23–24, 2016 Hyatt Regency Boston Harbor The CAQH Import Function Select All and Deselect All buttons make it easy to quickly decide what comes in and what does not Screen Filter makes it easy to focus in on certain data you may not want to import…like Addresses

June 23–24, 2016 Hyatt Regency Boston Harbor Changes Filter Drop Down List Both : Audit log data will include all data, regardless of whether there are changes from a previous import Changes : Audit log data includes only the data that has changed based on a previous import No Changes : Audit log data includes only the data that has not changed based on a previous import Data Filters Radio Buttons To be Accepted : Includes data that has not previously been accepted in a previous import Previously Accepted : Will display data that has already been accepted in a previous import Previously Rejected : Will display data that was previously rejected in a previous import The CAQH Import Function

June 23–24, 2016 Hyatt Regency Boston Harbor Once you have selected the practitioners to include and/or exclude from the import process, there are two decisions to make: One at a time! Accept : Click the Accept button to import the selected data for the selected providers Reject : Click the Reject button to reject the selected data for the selected providers The CAQH Import Function

June 23–24, 2016 Hyatt Regency Boston Harbor The CAQH Import Function Once the import has been accepted, you will see a Process Complete message. Behind this message, you will see that the data previously queued in the log is gone. Click the OK button

June 23–24, 2016 Hyatt Regency Boston Harbor The CAQH Import Function Click the View XML File button in order to open a window allowing you to see the data file Once the file is opened, the button will now say Hide XML File Click the Hide XML File button to close the data file window Click the Run Report button in order to open a CAQH Audit Report window Set the applicable filters at the top of the window Click the Run button to run the report Reports can be printed or saved to other formats such as Excel

June 23–24, 2016 Hyatt Regency Boston Harbor What Tools Exist to Clean Up and Standardize the CAQH Imported Data You may notice after importing data from CAQH that you may need to add some data that IntelliCred expects but that was not contained in the CAQH.xml data file. You may also notice that some data will need to be modified in order to insure standardization with the rest of your IntelliCred provider demographic data.

June 23–24, 2016 Hyatt Regency Boston Harbor What Tools Exist to Clean Up and Standardize the CAQH Imported Data Here are some examples we can talk about. We will also talk about methods to add, modify and standardize. Basic Information: o Practitioner Category o Query NPDB o Query OIG Addresses: o All data fields Licensure: o License Type o Verifying Agency DEA: o Status Hospital Affiliation: o Start and End Dates o Hospitals added to the Lookup Table Be on the lookout… Required data fields in IntelliCred Data needed for verifications Data needed for correspondence Data from CAQH that got appended to important Lookups such as: o Specialty o Schools o Hospitals

June 23–24, 2016 Hyatt Regency Boston Harbor