AHCCCS ICD10 Encounters Transaction Testing Overview

The following summarizes our procedures and expectations related to ICD10 Encounters transaction testing with our trading partners. If you have any questions, comments or suggestions please let us know.

Schedule:
Trading Partner End to End Testing with all Contractors: Beginning January 15th 2014 and running through September 30th 2015.
(837 Submissions – January 2014; Editing and Results Reporting - March 2014; Reports - June 2014; ICD10/DRG Integrated End to End June 2014)

Approach:
All test files will be in a dedicated test environment; refreshed with production Recipient, Provider and Reference data as of 10/04/2014.
Additional refreshes from production may occur each quarter thereafter (January 2015, April 2015, July 2015) and Contractors will be pre-notified before these refreshes occur.
AHCCCS will run according to a published testing schedule.
Encounter test files must be received by no later than 5:00 am on Thursdays.
Any file not received in time to process will be included in the following week’s processing.
Encounter processing will be run weekly on Thursday evening.
Test Cycles in UAT are run more frequently than in Production; ex. Encounter Cycle run weekly in UAT vs. twice monthly in Production.
Refer to the Testing Calendar for more information.
All Encounter test files will be validated through the AHCCCS Validator prior to acceptance by AHCCCS.
AHCCCS will attempt to process files as consistent with production procedures as permitted within the constraints of the dedicated test environment.
Encounter test files can have any file name under 30 characters in length with no spaces in the file name and placed in directory XXX/TEST/EDI-IN where XXX is your folder name (file names cannot end in .TMP).
Encounter Acknowledgement test files will be named as follows and will be placed in directory XXX/TEST/EDI-OUT: AZEF837_HPxxxxxx_ccyymmddhhmmssms_filename.ZZZ
F – form type – P (professional), I (institutional), D (dental)
xxxxxx - 6-digit AHCCCS Health Plan ID (first 6 bytes of the GS02)
ccyymmdd - process date
hhmmssms - process time
filename - original 837 filename as submitted by the trading partner
ZZZ - 277, 999, 824, or TA1 (TA1 will only be created if ISA14 is set ‘1’)
All test files must be identified as “T-test” rather than “P-production” in the ISA15 element.
All submitted test files will be validated, and if successful, processed through all editing and/or auditing processes on a weekly basis.

Submitters will be able to submit Encounters for any valid AHCCCS recipient, provider and service combinations as of the latest refresh; therefore Encounters may be production examples or test data. Be aware that test data submitted during a quarter will be lost when the next refresh is completed so plan testing cycles accordingly. (see first bullet point)
Although the effective dates for ICD10 processing in production will be outpatient dates of service or inpatient dates of discharge 10/1/2015, to facilitate testing the AHCCCS test environment will assume a 10/1/2014 effective date.

Testing Standards/Expectations:
Trading Partners should validate files for compliance using the Community Manager application. If you do not currently have a community manager account or are not currently a Trading Partner with AHCCCS send a request via email to: EDICustomerSupport@azahcccs.gov and they will assist you
in getting set up.
Recommended # of test files that a trading partner must successfully exchange to “pass” testing (see column 3 below) are the minimum. Trading Partners may elect to and are encouraged to exchange as many test files as desired.
Once a Trading Partner feels they have successfully completed all applicable end to end testing, an email should be submitted to us indicating your readiness to move forward with this transaction in the production environment: Lori.Petre@azahcccs.gov. We will follow-up to confirm the date this transition will occur.
All Trading Partner test completions will be tracked by AHCCCS.
Only applicable form types for each submitter must be tested.

Testing Expectations
Transaction	Who must test?	# of Receipts Recommended	# of Requests (Transactions)	Testing Requirements	
837 and NCPDP – Encounters	All current Contractors who wish to continue Encounter submissions must successfully complete testing, as well as all new submitters. Testing is open entry open exit, as ready	3 per applicable form type	Minimum of 25; Maximum of 100 per file	Validate files using Community Manager	
			At least one exchange should include Replacements/ Voids.	Ensure that files are accepted and can be processed appropriately from end to end.
Must test all applicable form types.		

Reporting Testing Problems & Questions:
All problem reports/issues/questions related to ICD10 testing other than the Community Manager (CM) application should be submitted to us via email at: ICD10Testing@azahcccs.gov. CM problems can be reported using the CM portal ‘ask AHCCCS’ button within the application.
For Problem reporting, please include the pertinent test data and as much detail of the issue as possible in your email. Testing related issues will be tracked and forwarded to the appropriate parties for review and response. *Do not include PHI data with your issue/question since the testing is
occurring with Production data and all PHI must be encrypted. If PHI data is needed to resolve the issue/question than we will contact you to arrange to have it sent thru an encrypted method.