2007Q1 Compliance Report
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Quarterly Compliance and 45-Day Status Report for Pennsylvania Hospitals and Ambulatory Surgical Facilities 2006Q2 THROUGH 2007Q1 Pennsylvania Health Care Cost Containment Council September 2007 r and 45-Day Status Report for (Intentionally left blank) Quarterly Compliance and 45-Day Status Report Pennsylvania Health Care Cost Containment Council 225 Market Street, Suite 400 Harrisburg, PA 17101 Phone: (717) 232-6787 Fax: (717) 232-3821 http://www.phc4.org Marc P. Volavka Executive Director September 2007 (Intentionally left blank) Contents Definitions...............................................................................................................................................................................1 No Ambulatory/Outpatient UB92 Submission (First Quarter 2007).........................................................................................2 Ambulatory/Outpatient Facilities Recognized for UB92 Submission Excellence (First Quarter 2007)....................................3 No Inpatient UB92 Submission (First Quarter 2007) ..............................................................................................................4 Inpatient Facilities Recognized for UB92 Submission Excellence (First Quarter 2007)..........................................................5 Ambulatory/Outpatient Compliance and 45-Day Status Report (Second Quarter 2006 through First Quarter 2007) .............7 Change of Status Information for Ambulatory/Outpatient Facilities (First Quarter 2007).......................................................21 Inpatient Compliance and 45-Day Status Report (Second Quarter 2006 through First Quarter 2007)..................................23 Change of Status Information for Inpatient Facilities (First Quarter 2007).............................................................................33 NOTE: UB92 refers to the 1992 version of the modified Uniformed Claims and Billing Form adopted for use by the Council. This specifies data elements, definitions, and standard file format used by data sources for meeting regulatory requirements. (Intentionally left blank) Definitions A facility is deemed compliant when they have met the following criteria: The data submission is received on or Quarter Ends Submission Due Date before the original due dates as follows: March 31 June 30 June 30 September 30 September 30 December 31 December 31 March 31 Passed initial edit process for proper format and readability UB92 error rate is 15% or less Ninety Percent of the Atlas™-derived records were received and matched by the original due date All facilities are considered compliant for each quarter denoted with a checkmark ( ✓ ). The only exceptions are for those facilities that followed the Request for Exceptions policy under the Health Care Cost Containment (Act 14 of 2003) and had the request approved by the Council. ________________________________________________________________________________________________________________________________ The following are definitions used in the 45-day status sections of this report. No Data: The facility did not submit UB92 discharge data to PHC4. Failed: The facility submitted UB92 data to PHC4, but for some reason the media was not properly formatted or otherwise unreadable. E – XXX%: The facility submitted UB92 data to PHC4, but had an error rate that exceeded the allowable maximum of 15%. This rate is calculated by dividing the number of records with at least one error by the total number of records submitted. The error rate is displayed. E – NAIC: The facility submitted UB92 data to PHC4, but had an excessive percentage of blank NAIC Codes. XX Days Late: The facility submitted UB92 data to PHC4 after the original due date. Days late refers to the number of days between the original due date and the date of the acceptable submission. I – XX%: The facility did not submit or match the minimum number of Atlas™-derived records by the straggler date. The straggler date, which is approximately six weeks after the original due date, is intended to give facilities an opportunity to correct and/or add records to their original submission. The match rate is displayed. Late: The facility did not submit or match the minimum number of Atlas™-derived records by the original due date. Currently, the required number of Atlas™-derived records is defined as matching 90% of the UB92 data submission to the list of 35 diseases, procedures and medical conditions which can be found on the PHC4 Web site at http://www.phc4.org/dept/dc/list35.htm . 1 No Ambulatory/Outpatient UB92 Submission for First Quarter 2007 (Status 45-Days After Due Date) Facility Name Facility Type Brandywine Cosmetic Surgery Center Ambi-Surg Center Paoli Surgery Center Ambi-Surg Center Street Road Surgery Center Ambi-Surg Center Surgery Center of Central PA Ambi-Surg Center n=4 Facilities 2 Ambulatory/Outpatient Facilities Recognized for UB92 Submission Excellence for First Quarter 2007 Facility Name Facility Type Error Rate Facility Name Facility Type Error Rate Bethlehem Endoscopy Center Ambi-Surg Center 0.00% Heritage Valley Surgery Center Ambi-Surg Center 0.40% Center for Reproductive Surgery, LLC Ambi-Surg Center 0.00% UPMC South Surgery Center Ambi-Surg Center 0.41% Center for Spine Care at Lanc Neuro & Spine Ambi-Surg Center 0.00% UPMC St. Margaret Harmar Outpatient Center Ambi-Surg Center 0.47% Endoscopy Center of Central PA, LLC Ambi-Surg Center 0.00% Miners Medical Center General Acute 0.49% Gastroenterology Consultants, Inc Ambi-Surg Center 0.00% ACMH Hospital General Acute 0.53% HealthSouth Mt Pleasant Surgery Center Ambi-Surg Center 0.00% Four Seasons Endoscopy Center, Inc Ambi-Surg Center 0.55% Laurel Laser & Surgery Center Ambi-Surg Center 0.00% Endoscopy Center of Delaware County Ambi-Surg Center 0.56% Lawrence County Surgery Center, LLC Ambi-Surg Center 0.00% UPMC Braddock General Acute 0.57% Leonard Dzubow Ambulatory Surgical Center Ambi-Surg Center 0.00% Kingston Ophthalmology ASC, LLC Ambi-Surg Center 0.58% Mt. Lebanon Surgical Center Ambi-Surg Center 0.00% Berks Urologic Surgery Center Ambi-Surg Center 0.60% Surgery Center at Cranberry Ambi-Surg Center 0.00% York Endoscopy Center Ambi-Surg Center 0.60% Temple University Schl/Podiatric Medicine ASC Ambi-Surg Center 0.00% Mount Nittany Surgical Center Ambi-Surg Center 0.62% Valley Forge Surgical Center, L.P. Ambi-Surg Center 0.00% Ephrata Community Hospital General Acute 0.64% York Adams Pain Specialists, P.C. Ambi-Surg Center 0.00% Hanover Hospital, Inc General Acute 0.67% Scranton Endoscopy Center Ambi-Surg Center 0.09% UPMC St. Margaret General Acute 0.67% Southwestern Endoscopy Center Ambi-Surg Center 0.15% Einstein Surgery Center Ambi-Surg Center 0.69% Lewistown Hospital General Acute 0.17% Lee Ambulatory Surgical Center Ambi-Surg Center 0.71% Twin Rivers Endoscopy Center Ambi-Surg Center 0.17% Laurel Surgical Associates, LLC Ambi-Surg Center 0.75% Hazleton Endoscopy Center Ambi-Surg Center 0.21% Mid-Atlantic Gastrointestinal Center Ambi-Surg Center 0.76% Three Rivers Endoscopy Center Ambi-Surg Center 0.24% Robert Packer Hospital General Acute 0.80% 20/20 Surgery Center, LLC Ambi-Surg Center 0.27% Smarthealth Norwin Hills Outpatient Center Ambi-Surg Center 0.80% Corry Memorial Hospital General Acute 0.28% Westmoreland Regional Hospital General Acute 0.80% Lancaster Gastroenterology Procedure Ctr, LLC Ambi-Surg Center 0.29% Western Pennsylvania Hospital General Acute 0.81% College Heights Endoscopy Center, LLC Ambi-Surg Center 0.31% Uniontown Hospital General Acute 0.83% Allegheny Surgery Center, LLC Ambi-Surg Center 0.32% UPMC McKeesport General Acute 0.84% UPMC Monroeville Surgery Center Ambi-Surg Center 0.35% Conemaugh Valley Memorial Hospital General Acute 0.86% Waynesboro Hospital General Acute 0.35% Elk Regional Health Center General Acute 0.91% Valley View Surgical Center Ambi-Surg Center 0.37% Meadville Medical Center General Acute 0.91% Canonsburg General Hospital General Acute 0.39% SurgiCenter at Ligonier Ambi-Surg Center 0.93% n=58 Facilities Facilities on this list not only met all the compliance criteria, but were also in the top 20% of the lowest initial submission error rates. Additionally, these facilities met all the original due dates without needing any type of extension. 3 No Inpatient UB92 Submission for First Quarter 2007 (Status 45 Days After Due Date) PHC4 has received a readable Inpatient Data Submission from every facility required to submit data. We want to congratulate every facility on a job well done and hope this continues in the future. 4 Inpatient Facilities Recognized for UB92 Submission Excellence for First Quarter 2007 Facility Name Facility Type Error Rate Facility Name Facility Type Error Rate Bucktail Medical Center General Acute 0.00% Sunbury Community Hospital General Acute 0.59% Children's Home of Pittsburgh Specialty 0.00% UPMC St. Margaret General Acute 0.61% Crichton Rehabilitation Center Rehabilitation 0.00% UPMC Northwest General Acute 0.62% Meyersdale Community Hospital General Acute 0.00% Westmoreland Regional Hospital General Acute 0.63% Miners Medical Center General Acute 0.00% J. C. Blair Memorial Hospital General Acute 0.71% Select Specialty Hospital/Danville Long Term 0.00% Troy Community Hospital General Acute 0.71% Valley Forge Medical Center & Hospital Specialty 0.00% HealthSouth Harmarville Rehabilitation Rehabilitation 0.72% Windber Hospital General Acute 0.16% Clearfield Hospital General Acute 0.74% Frick Hospital General Acute 0.28% Mercy Jeannette Hospital