Crosswalk

PRA Forms Revisions - Crosswalk_020121.csv

Collection of Encounter Data from MA Organizations, Section 1876 Cost HMOs/CMPs, MMPs, and PACE Organizations (CMS-10340)

Crosswalk

OMB: 0938-1152

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2016 (old version),2021 (new version),Type of Change,Reason for Change,Burden Change,
"CSSC Operations Submitter/Receiver ID Application Instruction - Connectivity Options
All submitters that submit data must establish a connection to the Front-End System through CMSNet provided by a CMS approved Network Service Vendor (NSV). CMSNet is the secure network linking all data processing entities. Small plans (contracts with enrollment less than 100,000) that elect to submit data may submit data to the secure CMS website.
","N/A
",Rev,Instructions are now included in the form eliminating the need for a separate instruction.,Yes,
"CSSC Operations Submitter/Receiver ID Application Form - Gentran/TIBCO (MFT)*:
Secure FTP.
Receipt of front-end response report within one business day.
Only for plans with less than 100,000 enrollees.
*Gentran/TIBCO (MFT) is not available to Third Party Submitters.
","CSSC Operations Submitter/Receiver ID Application Form - Instructions were included on the form. Removed redundancies. Added radio buttons, drop-down menus, installed a ""Submit"" button for electronic submission, and editing to ensure all required fields are completed.",Rev,The form was streamlined to offer better clarity to the end user making the form easier to use.,Yes,
"CSSC Operations Submitter Authorization Form - The following information must be completed by an authorized representative from the plan.  This form should not be completed by a PBM or Third Party submitter.  The completed form may be submitted online, printed and faxed to 1-803-935-0171 or scanned and sent via email to [email protected] for processing.  Please note that all required forms (i.e. EDI Agreement and Submitter Application) must be received by all entities involved in order to complete setup.",CSSC Operations Submitter Authorization Form - Removed the ability to fax the form. Separated the authorized submitter table into sections and added instructions for each section. Removed redundancies.,Rev,The form was simplified to offer better clarity to the end user making the form easier to use.,Yes,
"CSSC Operations RAPS Connect Direct Form - The following information must be completed by an authorized representative from the plan. This form will allow the plan to connect to the RAPS application via Connect Direct. The completed form may be submitted online, or scanned and sent via email to [email protected] for processing","CSSC Operations RAPS Connect Direct Form - Added content, instructions, and radio buttons throughout the form. Removed irrelevant content.",Rev,The form was restructured and simplified to offer better clarity to the end user making the form easier to use.,Yes,
"CSSC Operations Encounter Connect Direct Form - The following information must be completed by an authorized representative from the plan. This form will allow the plan to connect to the Encounter Data System  via Connect Direct. The completed form may be submitted online, or scanned and sent via email to [email protected] for processing","CSSC Operations Encounter Connect Direct Form -  Added content, instructions, and radio buttons throughout the form. Removed irrelevant content.",Rev,The form was restructured and simplified to offer better clarity to the end user making the form easier to use.,Yes,
"CSSC Operations PDE Connect Direct Form - The following information must be completed by an authorized representative from the plan. This form will allow the plan to connect to the PDE application via Connect Direct. The completed form may be submitted online, or scanned and sent via email to [email protected] for processing","CSSC Operations PDE Connect Direct Form - Added content, instructions, and radio buttons throughout the form. Removed irrelevant content.",Rev,The form was restructured and simplified to offer better clarity to the end user making the form easier to use.,Yes,
"CSSC Operations MMP Connect Direct Form - The following information must be completed by an authorized representative from the plan. This form will allow the plan to connect to the MMP application via Connect Direct. The completed form may be submitted online, or scanned and sent via email to [email protected] for processing","CSSC Operations MMP Connect Direct Form - Added content, instructions, and radio buttons throughout the form. Removed irrelevant content.",Rev,The form was restructured and simplified to offer better clarity to the end user making the form easier to use.,Yes,
"CSSC Operations Electronic Data Interchange (EDI) Agreement - The following information must be completed by an authorized representative from the plan. This form allows the plan to agree to submit data to CMS to the RAPS, Encounter Data, PDE, and MMP applications. ","N/A
",Rev,N/A - no changes were made.,Yes,
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