On March 12, the Department of Health Care Services (DHCS) uploaded three new hospital-directed encounter files, available via the secure file transfer protocol site (the site is only intended for file transfers, and uploaded files will be deleted within 45 days).
The files include:
- Bridge Period 2019-20 Phase 1 (July 1 – Dec. 31, 2019 service dates): The name of the file will be HospitalName_BP1920P1.
- Bridge Period 2019-20 Phase 2 (January 1 – June 30, 2020 service dates): The name of the file will be HospitalName_BP1920P2.
- Bridge Period 2019-20 Phase 3 (July 1 – Dec. 31, 2020 service dates): The name of the file will be HospitalName_BP1920P3.
Please note, for the Bridge Period 2019-20 Phase 1 encounter file, DHCS is requiring the contract flagging status to be submitted to DHCS by Friday, April 16. DHCS expects hospitals to work with plans to address and attempt to resolve disagreements about contract status. As always, CHA encourages hospitals to reach out to their plan partners to understand the plan’s internal deadlines, as they will be earlier than the DHCS deadline noted above.
As shared previously in CHA News and reviewed thoroughly via webinar, effective July 1, 2019, the network provider requirements have changed pursuant to All Plan Letter (APL) 19-001 and Attachment A. DHCS has communicated to CHA that its program integrity reviews and sampling of contracts for Bridge Period 2019-20 Phase 1 (July 1 – Dec. 31, 2019) will include a more detailed review to verify the accurate network provider definition is being used. DHCS expects this work to begin in April and could include the sampling of contracts from both plans and providers.