Issuers and their third-party administrators (TPA) were all working towards meeting the Dec. 19, 2014, deadline for the data production data submission to the Centers for Medicare and Medicaid Services (CMS). On the evening of Dec. 19, 2014, CMS officially notified all issuers that the deadline for the first preliminary run had been extended to Dec. 28, 2014, to ensure that most issuers are able to meet the requirement for the data-submission deadline to the EDGE server.
During the data preparation, validation and submission process, the Inovalon team gained valuable insights into the EDGE server that will allow for better planning in the months ahead and for the final Apr. 30, 2015, data-submission deadline. Examples of insights include file-processing limitations (the EDGE server accepts only one file at a time with a maximum record size of 100 thousand records per file), inconsistent responsiveness of the EDGE server, and cycle time for file processing (each file could potentially take up to 8 hours to get processed). Throughout the process, it was essential for Inovalon to continually monitor and administer the EDGE servers for issues including, but not limited to, disk storage inadequacy and server downtime.
Inovalon successfully submitted production data (enrollment, medical and pharmacy) to the EDGE server on behalf of our client regardless of these issues and the subsequent deadline extension. In addition, Inovalon also received all the outbound EDGE server reports including the reports that indicate processing completion: Risk Score Summary Report (RSSR) and Risk Score Detailed Report (RSDR), for all submissions.
The first production submission was a great learning experience for the Inovalon team working on this solution. Inovalon recommends all issuers working through this process of data submission to carefully monitor the performance and utilization of the Inovalon installed EDGE servers to account for the growing scale of data and EDGE server instances, as well as address the need for additional compute capabilities.