Skip NIR for MHCP-Vaccination Submissions

Steps

If the above checklist is not matched it will cause a error when selecting Payment.

Error will be as follows:

1.Go to Patient registry ->Actions> Update Visit Details

This will be open in any active status’s.

2. Select Skip NIR Submission.

Once skipped you can close case. Then Proceed to submit manually

1. MHCP Claim
2. Update NIR

Why do you need to Skip it?

CMS has a MHCP integration which allows for some vaccinations to be provided to patient with a subsidiary. If ,

1. The Dose is incorrect or not eligible
2. The vaccines are not allowed under coverage

CMS will throw a general error. This error will not allow for submission/closure of the visit/case.

If the clinic has clarified and confirmed that MHCP requested a submission then the clinic will like to skip the automation so they can close the case.

What is the manual process in place ?

CMS team currently having issues closing the case manually.

But CS will submit to MHCP manually

Doctor will update NIR manually.

Effects of Skipping the submission?

1. CS will need to submit the claim manually to MHCP
2. Doctor will have to update NIR manually

Check list for submissions

1. Check if correct plan is attached
2. Check if correct vaccines is being dispensed.
3. Check if Dose is eligible as per Registration remark
4. Check if Doctor has selected the vaccination & CDS information.
5. Check if correct does is selected in dispensing line
6. If eligible dose is wrong- check if NIR is updated correctly with the value- or choose to do manual submission

If MHCP says not eligible – check if MCHP and confirm that a submission can be made