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Capturing Social Determinants of Health Using Z Codes

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DV Phase 1: Planning for DV Activities
StepResponsible PartyDV ActivitiesTimeline
1SOSelect appropriate DVC based on “Standards for Selecting a Data Validation Contractor”December - March
2DVC, SONotify CMS of DVC selection / Request access to Health Plan Management System (HPMS) Plan Reporting Data Validation Module (PRDVM)January - April
3DVC, SOComplete the web-based DV TrainingFebruary - March
4DVC, SOReview all DV documentsJanuary - March

Note: References to December refer to the calendar year before the DV review; all other references to months refer to the same calendar year as the DV review.

DV Phase 2: Performing DV Activities
StepResponsible PartyDV ActivitiesTimeline
5SOComplete Organizational Assessment Instrument (OAI) and provide appropriate documentation to selected reviewer per the OAI's documentation requestMarch 1 - April 1
6DVC, SOAnalyze OAI ResponsesMarch 1 or later
7DVC, SOPrepare for physical or virtual site visit (site visit agenda, resource needs, and logistics)Early April
8DVC, SOConduct on-site review (convene entrance conference, conduct interviews with SO staff, observe SO's reporting processes, and obtain census and/or sample files)Early April (allow for up to 1 week)
9DVCRequest additional documents following site visit (if applicable)Mid/late April
DV Phase 3: Analyzing Results and Submission of Findings
StepResponsible PartyDV ActivitiesTimeline
10DVCDetermine compliance with “Data Validation Standards” and record findings in Excel-version of the Findings Data Collection Form (FDCF)June
11DVC
Provide draft findings to SOJune
12DVC, SOReview draft findings and obtain additional documentation necessary to resolve issuesJune
13DVCSubmit DV review findings to CMS via HPMS PRDVM and receive DV scoresNo later than
June 30
DV Phase 4: Completing Post-DV Activities
StepResponsible PartyDV ActivitiesTimeline
14DVC, SOCompile archive of DV work papersJuly 31
15SO
Receive Pass or Not Pass threshold level and assess Pass or Not Pass determination based on final DV scoresSummer/Fall
16SOAppeal DV determination(s) (if applicable)Within 5 days of receiving threshold level from CMS

Select the Job Aid button to view the 2018 Data Validation (DV) Activities job aid featuring the DV program activity steps. You are encouraged to print this job aid for reference throughout DV process. It may also be accessed by selecting the Reference button at the top of each page.


Complete!

This lesson is complete.