ASC X12 and APCD Council Collaborate on Development of Standardized Reporting Requirements

Falls Church, VA – October 13, 2011 – On October 6, 2011 the Accredited Standards Committee X12 (ASC X12), the All-Payer Claims Database Council (APCD Council) and the National Association of Health Data Organizations (NAHDO) hosted their inaugural meeting to discuss the strategy for developing the Uniform Medical Claims Payer Reporting Standard, at the ASC X12 Standing Meeting in Pittsburgh, PA.

New requirements that meet current state and federal health care reporting needs require changes to existing business models for reporting medical claims data. To meet these requirements, ASC X12 is facilitating the development of claim and enrollment transaction variations.

The meeting initiated a collaborative effort to determine the most efficient business model and develop related work products (e.g. Implementation Guide) to standardize reporting requirements for states that collect medical claims and to ease the burden for payers required to submit such data. The meeting also included an overview of other industry reporting needs related to claims for Medicaid, Medicare, and Patient Protection and Affordable Care Act (PPACA).

Members of the APCD Council presented a review of the past and present landscape of all-payer claims database implementation efforts, with a specific focus on standardization efforts. A copy of the presentation is available at http://apcdcouncil.org/sites/apcdcouncil.org/files/APCD%20X12.pdf.

Meeting attendees voted to pursue this effort as with ASC X12 projects. The meeting resulted in three project proposals to develop implementation guides to support the reporting of post-adjudicated claims data for institutional, professional and dental claims. In a session later that day, the ASC X12 Insurance (X12N) Subcommittee voted on and approved the project proposals. The work to develop the related Post-Adjudicated Claims Data Reporting guides will be coordinated by a special workgroup of X12N over the next 9 to 12 months.

“ASC X12 is pleased that so many attended this kick-off event in-person and virtually, to address the best way to increase the quality of the data and reduce the implementation costs for the health care industry,” said Margaret Weiker, Chair of the X12N Subcommittee.

“This collaboration between NAHDO, the APCD Council, and ASC X12 is very important, and we are pleased that X12 voted to approve these projects. We recognize that there are benefits for many different stakeholders, and we are excited about the potential impact of this project to advance the utility and efficiency of claims data collection,” said Patrick Miller, co-chair of APCD Council.

ASC X12 and ACPD members and organizations interested in participating in the workgroup involved in the development of the implementation guides should send an e-mail to info@x12.org.

About ASC X12
ASC X12, chartered by the American National Standards Institute more than 30 years ago, develops and maintains EDI and CICA standards along with XML schemas which drive business processes globally. The diverse membership of ASC X12 includes technologists and business process experts, encompassing health care, insurance, transportation, finance, government, supply chain and other industries. For additional information, visit www.x12.org or contact info@x12.org.

About APCD Council
The APCD Council is a federation of government, private, non-profit, and academic organizations focused on improving the development and deployment of state-based all payer claims databases (APCDs). The APCD Council is convened and coordinated by the Institute for Health Policy and Practice (IHPP) at the University of New Hampshire (UNH) and the National Association of Health Data Organizations (NAHDO). For additional information, visit www.apcdcouncil.org or contact ashley.peters@unh.edu.

About NAHDO
The National Association of Health Data Organizations (NAHDO) is a national membership and educational association dedicated to improving health care data collection and use. Standardizing how and what data are collected has been an ongoing priority of NAHDO for the past 25 years. The mutual understanding of the importance of data standards for state reporting systems made for a natural relationship between NAHDO and ASC X12N. For the past 15 years NAHDO has been an active member of ASC X12. With full cooperation of both organizations, an ASC X12-approved implementation guide was developed and continues to be maintained. This standard provides the data content and messaging standards that many states have written into their data collection rules and regulations. Because of the relationship with ASC X12N, these standards are also consistent with the standards used in other parts of the health care industry. The most notable is the consistency of the state reporting systems with the HIPAA mandated transactions. For more information, visit www.nahdo.org or contact dlove@nahdo.org.