This article will help you to:
- Understand the vendor solutions data requirements for Sandata Agency Management
Data Requirements - V1.2
Saturday, January 15, 2022
1:28 AM
SAM Data Requirement Guide
Introduction
Below is a list of data points that are required in SAM that will allow a record qualify to be sent from SAM to Sandata's Aggregator, eMedNY, and Tellus. The requirements are based on the SAM Stored Procedure uspGetScheduleToUploadAltEVV that is current as of 1/15/2022 SAM 6.10.19
Client Data Requirements
- Client must have at least one address record
- Client must have an address entry that has the 'Address' field on the 'Personal' page with some value that is not blank
- Client's admission must have the 'Santrax Enabled' checkbox checked on the admission 'General' page
- Client's admission must have a rank 1 payer record that is Aggregator enabled
- Client's admission must have a rank 1 payer assigned that is tied to a payer that has a 'Number' value entered in the "Provider Numbers" section for the specific location that the client's admission is associated with. This 'Number' value must match the Aggregator setup for this customer.
- Client's admission must have an authorization (requirement for Ohio)
- Client's authorization must align with billing rate with matching service and event code configured on the client's associated rate plan (requirement for Ohio)
- Client's admission must have a rank 1 payer with a customer number value entered that is not blank
- Client's admission must have a rank 1 payer that has the payer setting 'Hold Visit Verification with no Customer Number' (found on EDI Settings tab) not enabled Client's admission must have a rank 1 payer with a 'Medicaid ID' value that is greater than or equal to 5 characters in length
- Client's admission has to have an attribute that has the Newborn flag set (requirement for Ohio)
- Client admission must have an entry in the stxClientUploadDetails table (Tier 3 or Dev has to verify)
- Client must have Services which correctly correlate to the AltServiceCodes between SAM/Agg (requirement if MMT's ProcedureCode is set to AltServiceCode)
- Client must have schedule in '02-Confirmed', '03-In-Process', or '04-Closed' status OR an Admission Service record that is not ended with a date prior to the current date.
Staff Data Requirements
- Staff must have a SSN value that is not blank
- Staff must have an 'Agency ID' value that is not blank
- Staff must have a schedule that meets the "Visit Data Requirements"
- Staff must have a record in the SQL view called 'viewStaff' (Tier 3 or Dev has to verify)
- Staff must have an entry in the stxStaffUploadDetails table
Visit Data Requirements
- Schedule must have a client assigned
- Schedule must have a service assigned (unscheduled events are disqualified)
- Schedule must have a client participant item
- Schedule must have a client participant item associated to a billing rate
- If MMT is configured for AltServiceCode, this value must be configured on the billing rate
- Schedule must have a client that has a location assigned
- Schedule must have a client that has a 'Other ID' populated (requirement for Ohio)
- Schedule must have a client that has a rank 1 payer record
- Schedule must have a client whose rank 1 payer has a location entry on the payer 'General' tab with a 'Number' value
- Schedule must have a client that has a rank 1 payer record that is Aggregator enabled
- Schedule must have a client that is Santrax enabled (found on client general page)
- Schedule must have a client where the rank 1 payer is Santrax enabled (found on payor santrax settings page)
- Schedule must have a staff assigned
- Schedule must have a staff participant item
- Schedule must have a staff that has an 'Agency ID' value that is not blank
- Schedule must have a staff that has a 'Santrax ID' value that is not blank or zero
- Schedule must have a schedule date that is greater than or equal to the 'Aggregator Effective Date'
- Schedule must have an entry in the SantraxScheduleUploadDetails table (Tier 3 or Dev has to verify)
- Schedule must have a service that does not have the 'Do not Send Alert' enabled
Visit Task Requirements
- Schedule that meets the "Visit Data Requirements" has to have a task entered that aligns with a task previously sent from EVV Account Manager setup
Definitions
- Contract - A single value that is entered on the payer record on the tab called 'Santrax Settings' in the field called 'Contract Identifier'
- Program - A single value that is entered on the admit type record on the tab called 'General' in the field called 'Third Party Payer Program'
Last Updated: January 2022, JLO Last Reviewed: January 2022, JLO