Ohio Hospital Association | Ohio Hospital Association



If you have any questions about the Tool that these instructions are not able to address, please do not hesitate to contact Andy.White@. Step 1: Select the hospital for which you are reporting Click the drop-down box.Select 1 hospital from the list.The hospital you select will link the entire spreadsheet to the appropriate base rate and cost coverage model for that hospital.If reporting for a system, the Tool works for one hospital at a time; please use a new spreadsheet for each hospital.Step 2: Enter individual inpatient claimsFor inpatient claims, the amount of CCA dollars received is dependent upon the individual patient. Therefore, hospitals are encouraged to enter claims at the individual patient level. Large volumes of claims data can be pasted in bulk as opposed to individually typing each row.The following data fields are included in the Tool, with certain fields required:Payment Rate for each MCP as Percent of FFSUnique Account IdentifierAdmit DateDischarge DatePrimary Medicaid PayerAdmit Source Code—specific codes that should be used in the Tool can be found hereAdmit Source Code DescriptionDischarge Code—specific codes that should be used in the Tool can be hereDischarge Code DescriptionAPR DRG—specific codes can be found in the ToolSeverity of Illness—specific codes can be found in the ToolThere are several things to consider when uploading data:Use claims for Medicaid Primary coverage onlyNo Medicaid Secondary or Crossover claimsIn-state Medicaid claims onlyCopy and paste data directly into the yellow columnsThe spreadsheet is locked down to prevent any formulas from being disruptedBe sure to enter the payment rate for each MCP as a percentage of FFS. The Tool currently defaults to 105%, but that can be changed by the user.Copy and paste your individual inpatient claims data, in bulk, directly into the yellow columns.Step 3: Enter total outpatient dataFor outpatient claims, the amount of CCA dollars received is a percentage of your Total Outpatient revenue minus Dental, Independently Billed Services revenue, Observation revenue, and Supplies and Pharmaceuticals revenue paid on a fee schedule (outside of EAPG). The CCA amounts differ between different 4 different date ranges. Therefore, hospitals are encouraged to separately enter aggregate revenue totals for each payer for discharges from 1/2/2020 through 6/30/2020, 7/1/2020 through 10/31/2020, 11/1/2020 through 12/31/2020, and 1/1/2021 through 6/30/2021. For the purposes of this tab, “revenue” refers to expected payments.The data structure is important here, so please enter your data following the structure in the spreadsheet:Once complete revenue data is entered, the Net revenue eligible for CCA payments will automatically calculate.There are several things to consider when uploading data:Use claims for Medicaid Primary and Secondary/CrossoverIn-state Medicaid claims onlyThe spreadsheet is locked down to prevent any formulas from being disruptedStep 4: View CCA CalculatorOnce all data has been entered, view the CCA Calculator. The spreadsheet should automatically update with your data (if not, manually refresh the pivot table). The top table will show your hospital’s CCA Total Projection, CCA Total Paid (i.e. CCA revenue received, per the inpatient and outpatient data entered into the Tool), and the Variance between the Model and CCA Revenue. The bottom table will show your hospital’s CCA Paid by Payer for both inpatient and outpatient claims.Step 5: Extract DataIf you would like to share your CCA Model variance data with OHA, the OHA Extract tab has 2 tables of aggregate information that can be copied and pasted into a separate spreadsheet and emailed to OHA. Please do not send OHA any PHI. ................
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