>>Narrator: How to use the Data Integrity Tool
Did you know that CMS provides review tools that issuers and states can use to prepare
for the QHP Application process?
These review tools allow you to check for errors within your QHP Application that would
result in correction notices after submission.
Issuers are encouraged to use these tools to identify and correct data errors prior
to submitting application data, in order to reduce the number of required corrections
identified during CMS’s reviews.
States are encouraged to use these tools during their reviews to identify potential errors
in their issuers’ application data that would require issuers to make corrections.
The Data Integrity Tool checks for critical data errors and warns of potential issues
within your QHP Application.
This tool can run validation checks specific to a plan’s coverage type, market type,
or child-only offering status.
The tool will produce validation errors for an individual template that contains data
errors, as well as cross-validation errors for inconsistent data between two different
templates.
You can use the Data Integrity Tool to run reviews for plans offered on-Exchange, and
plans offered both on- and off-Exchange.
However, the Data Integrity Tool will not run reviews on plans that are only offered
off the Exchange.
CMS recommends that you use the Data Integrity Tool before using other review tools, to ensure
the validity of your data before reviewing for compliance errors.
To run any of the reviews within the Data Integrity Tool, you will need a completed
Plans & Benefits Template.
Additionally, you may also want to use the Data Integrity Tool to check data in:
the Service Area Template, the Prescription Drug Template,
the Network ID Template, the Business Rules Template,
the Rates Table Template, and the Unified Rate Review Template.
To download the Data Integrity Tool, visit www.qhpcertification.cms.gov, click on “Application
Materials,” then “Review Tools.”
Find and click on the tool’s link.
A .zip file will be downloaded to your computer.
Within this .zip file, you’ll see:
The Data Integrity Tool, The Data Integrity Tool Frequently Asked Questions
Sheet, The Data Integrity Tool Reference List, and
The Data Integrity Tool Tip Sheet.
Carefully read the FAQ Sheet and Tip Sheet before using the tool.
To begin using the Data Integrity Tool, open the spreadsheet in Excel, and enable macros.
Before beginning the import process, closely review the Overview, Instructions, and Reference
tabs to learn how the Data Integrity Tool works, and how it will be most beneficial
to you.
To begin importing template data, navigate to the Menu tab.
Remember you must import Plans & Benefits data
for the tool to run properly.
Return to the Menu tab and continue to import all other templates you want to check for
validity errors.
Once you’ve imported all data, click on the “Validate All Imported Templates”
button.
You will see the validation results in the Validation Errors tab.
Results are categorized as “errors” or “warnings” in the “Error Type” column.
An error represents something in the data that needs to be corrected before submitting
application data.
A warning identifies something that could potentially result in an error in the application,
and cautions users to review before submitting data.
If you receive an error or warning, you should review the information provided.
Issuers will need to make the necessary corrections to their templates.
Once the necessary changes have been made, and the updated templates have been validated
and saved, return to the Data Integrity Tool’s Menu tab and select “Clear Validation.”
Reimport the templates to which changes were made.
Note that reimporting a single template will override existing data for that template,
so you do not need to “Clear ALL Imported Template Data” if changes were not made
to every template.
Once you’ve reimported the updated templates, click on the “Validate All Imported Templates”
button.
If the templates have successfully been updated to be error- and warning-free, you will receive
a message that says, “No warnings or errors were found.”
If, however, any plans still contain data errors, you will need to go to the Validation
Errors tab and repeat the review process.
Once you’ve completed the validation review, return to the Menu tab and click on the “Cross
Validate All Imported Templates” button.
If there are any errors or warnings found in the cross validation review, you will see
these on the Cross Validation Errors tab.
Review the errors and determine the changes that need to be made, and the templates in
which they need to be made.
Repeat the same update and reimport process discussed earlier.
Once the updated templates are reimported, be sure to clear both the Validation and Cross
Validation results, and run both reviews again.
Continue following these steps until you receive a message that says, “No warnings or errors
were found” for both reviews, or you’ve reviewed and determined that the remaining
“Warnings” are not applicable and will not result in an error in the application.
Now let’s review examples of data error results in the tool and how issuers can resolve
them.
In our first example, after importing the relevant templates and running the validation
check, the “Validation Errors” tab displayed the following error: one of your plans has
a combined in-network individual deductible equal to $4,000 and a corresponding MOOP equal
to $3,850.
The deductible is greater than the corresponding MOOP.
Please confirm that you have accurately entered your deductible and MOOP values.
This error occurs when the deductible of a plan exceeds the MOOP of that plan.
This is a data error that needs to be corrected.
In the “Validation Errors” tab, you will also see additional fields that will help
you pinpoint where the data error occurred, and which template you need to correct in
order to address the error.
To review the error within the tool, click on the linked cell reference under “DIT
Cell Reference” in column K.
In this example, the tool navigates to the P&B tab, and places the cursor on cell DY8
to show the cell where the error occurs.
Then navigate back to the Validation Errors Tab and use the Template Filename, Template
Worksheet, Template Row Reference, and Field Name columns to determine which fields in
which template need to be corrected.
Open the appropriate template, navigate to the worksheet identified by the Data Integrity
Tool, and locate the data error.
In this case, you would need to determine whether the deductible was too high, or the
MOOP was too low, and make the correction accordingly.
Once the correction is made, save and validate the template, and reimport the corrected template
into the tool.
Click “Clear Validation” to remove old results, and click “Validate All Imported
Templates.”
The Validation Errors tab now shows a message indicating that no validation errors were
found, since the data error was corrected.
In our second example, after running the Cross-Validation review, the “CrossValidation Errors” tab
displays the following error: one of your plans has an EHB percent of total premium
0.996 in the Plans & Benefits template and an EHB percent of total premium 0.986 in the
Unified Rate Review Template.
Values for EHB percent of total premiums between the Plans & Benefits template and Unified
Rate Review Template must match when rounded to three decimal places.
This error occurs when the EHB percent of total premium values in the Plans & Benefits
Template and URRT differ when rounded to three decimal places.
Similar to the Validation Errors tab, you can use the Template Filename, Template Worksheet,
and Template Field Name columns in the CrossValidation Errors tab to identify where the error occurred,
and the appropriate template you need to correct in order to address the error.
This example asks you to correct the EHB percent of total premium value in either the Plans
& Benefits Template or the URRT.
In this case, we identified the error to be in the URRT instead of the Plans & Benefits
Template.
Open the URRT, navigate to the worksheet identified by the Data Integrity Tool, and locate and
correct the appropriate cell.
Save and validate the template, and reimport it into the Data Integrity Tool.
Click the “Clear Cross” button to remove old results, and click the “Cross Validate
All Imported Templates” button to rerun the review.
The CrossValidation Errors tab now shows a message indicating no validation errors were
found, since the data error was corrected.
The Data Integrity Tool can help ensure issuers’ plans meet QHP certification requirements,
and help improve the review process for both issuers and states.
If you have questions regarding the QHP Certification Review Tools, please contact the Exchange
Operations Support Center (XOSC) Help Desk at CMS_FEPS@cms.hhs.gov, or 855-CMS-1515.
For more information about the QHP Certification Process, visit www.qhpcertification.cms.gov.
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