(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.
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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 |