WHAIC Announces Changes to Data Submission Format

January 06, 2017

Over the next year, the WHA Information Center will retire the current custom, text file data submission format used by hospitals and ambulatory surgery centers (ASCs) to submit data required by Chapter 153 of the Wisconsin Statutes. The current custom format will be replaced with a national, industry standard, HIPAA claim format known as the ANSI 837—a standard all hospitals and ASCs have used for years to submit claims to health insurers for payment.

The change is a result of feedback from hospitals and ASCs about the difficulty maintaining a non-standard format for their required data submissions—feedback that led to the development of the Data Modernization Act (2015 Wisconsin Act 287) which allows WHAIC to bring the data submission process in line with industry standards and to collect additional data that will support population health and quality initiatives.

Since the Data Modernization Act was enacted April 1, 2016, WHAIC has completed in-depth analysis and outreach on the data submission process. Data submitters were surveyed, EHR vendors were consulted, and focus group sessions were held across the state with hospitals and ASCs to gain a good understanding of the effort required to either maintain the current format or to switch to the 837 format. The result of WHAIC’s outreach and analysis was unanimous: while there will be upfront work to switch to an 837 format, using a standard format will greatly reduce the ongoing maintenance burden on data submitters and will greatly expand the uses of the data by hospitals, ASCs and others.

WHAIC will give data submitters over a year to make the changes needed to move to the 837 format. Specifications and training will be completed by WHAIC and made available the first quarter of 2017, giving data submitters as much time as possible to begin the technical work needed to make the change. Hospitals and ASCs will be required to begin submitting production data using the 837 format in May 2018, for dates of service starting January 1, 2018.

WHAIC will hold two short conference calls to discuss the timeline for the project and the resources available to help with the transition (details below). The first in-person training sessions on the transition will be held in March, 2017. Your facility is encouraged to take advantage of every opportunity to participate over the next year to help ensure a smooth and successful transition.

837 Transition Introductory Calls:

January 17, 2017: 10:00 a.m. – 11:00 a.m., or
January 26, 2017: 1:00 p.m. – 2:00 p.m.

Go to www.surveymonkey.com/r/837TransitionIntroWebinar to register for one of these calls.

This story originally appeared in the January 06, 2017 edition of WHA Newsletter