Okay, I’m back from visiting the parental units and enjoying yet another show of how the Granddaughter Rules play out. My dad was always involved with us, but his involvement usually stopped at baths, balls, books, banks and trips to the airport. That was where the combination of his knowledge base and societal expectations of blue collar manliness met. This weekend I saw him (attempt to) braid a doll’s hair while we were waiting for a table at a restaurant and get a complete make-over. The Granddaughter rules.
The big health insurance news this weekend was the 10% error rate on the 834 files that the Feds are generating. Some of this seems to be systemic errors, which are extremely fixable. Most of the problems seem to be a combination of human errors and system design problems. Those are a bit tougher to fix but are also fixable:
Insurers have seen various types of errors in the 834 transmissions, including garbled or incorrect information, duplicate forms and, in some cases, missing forms.
A source familiar with the project blamed 834 problems on the use of poor software “rules,” essentially a system of programming routines that govern how the marketplace application responds to each piece of data consumers enter in a HealthCare.gov form. For example, if a consumer accidentally puts an ampersand in the address box in their form, rather than receive an error, they will be allowed to continue filling out their application online. However, the ampersand will prevent the 834 file from being generated. “Software rules intended to prevent certain errors weren’t put into place,” the source said. “People are calling up health plans, saying they have enrolled, and [insurers] have no record of them,” the source said.
Data integrity between multiple interfacing systems with varying formating rules is a pain in the ass. I’m currently working on a different project that is attempting to marry a location to a claim through externally maintained data structures. Most of the initial work has been merely making sure that my company’s Address 1 maps and parses correctly to the external data structure’s Address Location 1 field.
I’m not too worried that 834s are erroring out. My company has an entire department dedicated to cleaning up 834s because they are almost never perfect for any firm of more than 3 people and a single contract. I’m worried that some of the common rules were either not written into the interfacing layer of the data hubs OR a pre-exisiting off the shelf 834 validation system was not integrated into the build. Weird things will happen but the commonly strange things should be accounted for and cleaned out before they impact members or prospective members.