Edit a Model Document

Based on your user authorization, you can edit some details of model documents.

Note: The model document must be currently checked out to you. Models checked out to you have a white background.

  1. Access the Model Document Edit page.
    • Select Go To > Contract Modeling > Model Document Management.
    • Click a link in the Model Document Name column. The Model Document Edit page opens. 
  2. Edit the model document data.
  3. Click Save.
  4. Optionally, you can perform the following actions:
    • Click Check In to make the current model document available for other users.
    • Click Cancel to abandon any entries or changes you made to the model document since the last save.
    • Click Request Execution to display options for requesting a model document execution. For more information, refer to Request a Model Document Execution.
    • Click Delete to remove the current model document.
    • Click Copy to copy the current model document to create a new one.
    • Click Audit Log to display the Model Audit Log wed dialog box for that model document.
    • Click  the link in the Scenario Claim column to view the scenario information. For more information, refer to Edit Model Scenarios.

    Note: The Request Execution button is disabled when the reporting scenario has an anchor date defined outside of the effective date / termination date range for a pre-defined Service Type Definition.

  1. Click the Scenario Name. The scenario information appears.
  2. Click Edit. The editable fields appear.
  3. Specify the details for the scenario.

Note: For information about adding a new scenario, refer to Add a Scenario to a Model Document.

  1. Optionally, select the DRG Version Override check box to group your claims by a specific version of the DRG grouper.
    • Once you select this check box, you can select the grouper version you want to use.
    • Once you select the group version, you can also select how ungroupable ICD codes are handled.
  2. Optionally, select the CDM Table Override check box to select a specific, imported CDM. For more information about CDM tables, refer to Manage Lookup Tables .
    • Once you select this check box, a list displays that allows you to select a specific CDM.
    • Select from the following matching options from the list to the right:
      • Match Revenue code or CPT code (this is the default selection)
      • Match Revenue code only
      • Match CPT only
      • Match Revenue code and CPT code
  3. Click Save.
  4. Optionally, click Cancel to abandon any entries or changes you made.

Note: You cannot save an edited model with an incorrect Anchor Date set in the report scenario. Click Cancel to exit the page.

The following table describes basic fields on the Model Document Edit page.

Field

Description

Activation Date

Date when the contract profile was available for processing

Active Status

Indicates the purpose and progress of the model

Adjust Charge Pct

Percentage by which the billed charges for all claims in the scenario are temporarily increased or decreased in order to adjust for prior rate changes or forecast the impact of future rate changes.

Note: Use whole numbers unless you want to view a fraction of a percentage. For example, type 50 to increase by 50%. Type -5 to decrease by 5%.

Anchor Date

Adjusts the first date of service for all claims in the scenario in order to reprice against a given table, based on the table’s effective date; typically used for future-dated fee schedules. Changing the anchor date does not change any actual claim data, for example, the length of stay on the claim remains the same when you use an anchor date.

CDM Override

Indicates whether this scenario uses an imported CDM that is different that your current production CDM.

  • Y – (Yes) indicates a CDM override was applied.
  • N– (No) indicates a CDM override was not applied.

CDM Table Override

Indicates the CDM table used for this scenario. In Edit mode, this field appears as a list that allows you to select the CDM table. In View mode, you can click View to review the selected CDM table.

Contract Profile Name

Name of the contact profile being modeled

DRG Version Override

Allows you to select a specific, typically newer, DRG grouper used to group the claims. For example, to modify 2005 data using the 2006 grouper.

  • Once you select this check box, you can select the grouper version you want to use.
  • Once you select the group version, you can also select how ungroupable ICD codes are handled.

For Reporting, use as Baseline

Indicates the scenario to use as a baseline for reporting comparisons. Only one scenario can be selected as the baseline in a model. If no scenario is selected, the first scenario in the model defaults as the baseline.

For Reporting, use TAC Section

Indicates which TAC section is reflected in the modeling reports

Global Patient List(s)

Name of the patient list assigned to all scenarios in the model document (for situations when you do not assign a patient list to each scenario individually)

Location

Facility in which the model documents were created

Model Document Name

Name of the model document

Notify E-Mail

E-mail address to which the system sends confirmation when the model document execution completes

Patient List Name

Applies the selected patient list to the scenario

Profile

Name and effective dates of the profile

Scenario Name

Name of the model scenario; typically the name of the contract proposal being modeled

Service Type Tables

Specifies which types of tables the scenario can access:

  • Predefined Tables Only – Only table(s) currently associated with the selected profile in the scenario.
  • Custom Tables Only – Only table(s) created in your facility that you select (even if they are not associated with the specified profile in the scenario).
  • Predefined and Custom Tables – Tables currently associated with the profile and tables you select. If the system finds duplicate service type names, the claim qualifies for the definition in the custom table.

STD Tables

Specifies which service type definition tables the scenario can access:

Ungroupable ICD Codes in DRG Override

Options for handling ungroupable ICD codes:

  • Regroup to Ungroupable DRG – Assigns DRG 470 for Version 24 or earlier and DRG 999 for Version 25 or later
  • Retain Original DRG – Retains the DRG that was originally billed
  • Exclude Accounts – Excludes accounts with ungroupable ICD codes from your model results

Note: This field is only available if you have selected a DRG override.

Use POA

Indicates if the Present on Admission (POA) indicator is used for this contract profile.

Note: Selecting Yes may cause errors for certain scenarios. Please select Both instead of Yes.

  • Yes – Allows the grouper to read the POA indicator on all Inpatient claims. See Note below.
  • No – Allows the grouper to ignore the POA indicator on the claim.
  • Both – Allows the grouper to read the POA indicator on all Inpatient claims. See Note below.

Note: This option is disabled for DRG grouper versions prior to 2008.

Click Model Document Management. The Model Document Management page opens. For more information, refer to Research Model Documents.

Click Add Model Document. The Model Document Add page opens. For more information, refer to Create a Model Document.