Silver State Health Insurance Exchange Monthly Meeting of Nevadas - - PowerPoint PPT Presentation

Silver State Health Insurance Exchange

April 09, 2019

Monthly Meeting of Nevada’s On-Exchange Insurance Carriers

Slide 2

Introductions - SSHIX

Heather Korbulic – Executive Director

hkorbulic@exchange.nv.gov

Ryan High – Chief Operations Officer

rhigh@exchange.nv.gov

Russell Cook – Information Systems Manager

rwcook@exchange.nv.gov

Eric Watt – Project Manager

w.eric.watt@exchange.nv.gov

Jamie Sawyer – Plan Certification Manager

jlsawyer@exchange.nv.gov

Slide 3

Introductions - CMS

Lindsay Canterbury – CMS/Consumer Information and Insurance Oversight (CCIIO) Julie Thomas – CMS/Consumer Information and Insurance Oversight (CCIIO)

Slide 4

Agenda

• Progress Since Last Meeting
• Revised EDI/Recon Guides
• Upcoming GetInsured EDI & Reconciliation Presentation
• CMS Presentation on Accounting During Transition Period
• Q&A

Slide 5

Progress Since Last Meeting

• SSHIX has been working with Carriers to address the EDI,

Reconciliation, and Transition-related questions that were submitted during February-March. Please submit any additional questions to Eric Watt, transition project manager, at w.eric.watt@exchange.nv.gov.

• SSHIX has received the first in a series of test files related

to our Consumer Data Migration. This puts us on track to confirm the feasibility of CMS’ data format and transfer methodology by the end of April.

Slide 6

Revised EDI/Reconciliation Guides

• GetInsured has prepared on updated version of their 834

Companion Guide to address the questions/concerns raised by carriers during February-March.

• GetInsured has also updated their Reconciliation Guide.

This document was referenced in the previous version of the 834 Companion Guide, but has not yet been distributed.

• Both documents will be distributed this week by Friday, 4/12

at the latest.

Slide 7

Upcoming GetInsured EDI/ Reconciliation Presentation

• GetInsured has prepared a detailed presentation describing

the evolution of their 834 implementation (including the rationale for the additional data elements), their implementation of the RCNI file, and the monthly reconciliation methodology.

• This presentation will be delivered on Tuesday, 4/16, from

10am-11am PST. The presentation will be recorded for those unable to attend.

• An invitation for the presentation will be sent out following

today’s Monthly Carrier Meeting.

Slide 8

CMS Presentation on Accounting During the Transition Period

Slide 9

Questions and Answers

Please submit written questions to Eric Watt, Project Manager: w.eric.watt@exchange.nv.gov