Plaintalk Blog: What’s a Data Submission Guide?

As Administrator of the Colorado All Payer Claims Database (CO APCD), one of CIVHC’s key responsibilities is ensuring the database is as complete and accurate as possible. One of the ways we work towards this goal is through annual updates to the Data Submission Guide (DSG) in collaboration with the health insurance payers (submitters) and the Colorado Department of Health Care Policy and Financing (HCPF).

Payers use the DSG as a guide to understand what fields must be submitted and in what format. The DSG is updated annually to re-define or modify current data elements, and to introduce new data elements that enables enhanced reporting and new insights from the CO APCD. CIVHC follows the Executive Director Rule Change Process outlined below for each annual update.

CIVHC begins working with HCPF and the payers far in advance of a new rule to make the process as smooth and collaborative as possible. The first step in the process is for CIVHC and HCPF to identify proposed DSG changes before discussing them with the payers. There are several reasons why new data elements may be proposed including:

1. New data elements are necessary to advance health care initiatives by stakeholders and/or support implementation of legislation
2. Changes need to be made to existing data fields to clarify the specifications and requirements, or standardize the way payers are pulling the data from their systems
3. New elements or adjustments need to occur to more closely align with the national Common Data Layout which eases reporting burden for payers

CIVHC discusses the proposed changes with the payers through multiple meetings to ensure there are no major concerns or changes needed to enable them to submit as proposed. After new elements are approved at the rule change hearing, CIVHC begins working closely with payers to clarify any outstanding questions. We then collect test files months in advance to identify submission elements that need clarification or re-working.

View the current version of the Data Submission Guide here.