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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 421HEALTH CARE INFORMATION
SUBCHAPTER DCOLLECTION AND RELEASE OF OUTPATIENT SURGICAL AND RADIOLOGICAL PROCEDURES AT HOSPITALS AND AMBULATORY SURGICAL CENTERS
RULE §421.65Acceptance of Event Files and Correction of Data Content Errors

(a) Upon receipt of an event file, DSHS shall establish a process to determine if it satisfies minimum criteria for processing. If it does not, DSHS shall establish a process to provide a report to be returned to the submitter regarding the invalid event file in a format and media that is approved for that provider and states the deficiencies. The facility shall submit a corrected event file within 10 calendar days of notification by DSHS or DSHS' agent. An event file does not meet minimum standards for processing if the file structure does not conform to the specifications in §421.67 of this title (relating to Event Files--Records, Data Fields and Codes).

(b) Correction of Data Content Errors.

  (1) DSHS shall establish an audit process for all event files accepted for processing. DSHS shall notify the facility identified from the event file in detail of all errors detected in an event file which was received in an acceptable format as provided in §421.67 of this title.

  (2) Within 30 calendar days of receiving initial notice of errors in an event file, the facility shall correct all event claims containing errors, add any event claims determined to be missing from the initial event file and resubmit the corrected and/or previously missing event claims. If the facility disagrees with any identified error, the facility may indicate that the event claim is as accurate as it can be or cannot be corrected. Each facility shall submit such modified and/or additional event claims as may be required to allow the chief executive officer or the chief executive officer's designated agent to certify the quarterly event file as required by §421.66 of this title (relating to Certification of Compiled Event Data). Corrections to an event file shall be submitted on approved media and formats as specified in §421.64 of this title (relating to Instructions for Filing Event Files) and §421.67 of this title unless DSHS approves another medium or format.

  (3) Within 10 calendar days of receiving corrections to an event file from a facility, DSHS shall notify the facility of any remaining errors. The facility shall have 10 calendar days from receipt of this notice to correct the errors noted or indicate why the data should be deemed acceptable and complete. This process may be repeated until the data is substantially accurate and the facility is able to certify the event file as required by §421.66 of this title or the deadline for submitting corrections prior to certification is reached. Corrected data is required to be submitted on or before the following dates for the respective quarter's discharges: Quarter 1 - August 1; Quarter 2 - November 1; Quarter 3 - February 1; Quarter 4 - May 1. DSHS may grant an extension to all facilities when deemed necessary.

  (4) Event claims that have not been previously submitted shall be submitted prior to the deadline for the following quarter's data. Correction and certification of these previously missing or additional event claims for the prior calendar quarter shall be made according to the deadlines established for following quarter in which the data that is scheduled to be processed as specified in §421.63(a) of this title (relating to the Schedule for Filing Event Files), paragraph (3) of this subsection concerning the acceptance of event files and correction of data content errors), and §421.66(b) and (d) of this title. Corrections to event claims previously submitted or that have a statement date prior to calendar quarter immediately before the calendar quarter being processed scheduled will not be processed.

(c) DSHS will document format acceptance criteria for event files. DSHS shall make this information available to submitters and facilities.


Source Note: The provisions of this §421.65 adopted to be effective August 29, 2004, 29 TexReg 8123; transferred effective September 1, 2004, as published in the Texas Register September 10, 2004, 29 TexReg 8842; amended to be effective February 26, 2009, 33 TexReg 9694; amended to be effective January 30, 2019, 44 TexReg 429

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