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Administrative (UTRANSEND) System Service Level Specification v2.0

 

Approved

 

UHIN STANDARD COMMITTEE

Utah Health Information Network

Administrative (UTRANSEND) System Service Level Specification (SLA)

 

Version 2.0

UHIN Specification “UHIN System Service Level Specificationis compatible with all HIPAA and HI-TECH requirements.

 

Purpose:  This Service Level Specification sets forth the service level definitions, measurements thereof, and related service standards that will be provided by UHIN, to the UHIN Member receiving Administrative Services (clearinghouse).

 

Applicability:  All UHIN members participating with the Administrative Services.

 

Detail: The following outlines the basic service level that is provided to the UHIN member and any responsibilities of the UHIN member.

1.                      Service Availability

1.1.              Definition

Service Availability” or “Available” is defined as the amount of time that the Service (a) is available for UHIN Members in connection with UHIN’s Administrative Services (the “Services”), for its intended purpose in exchange of administrative transactions, and is capable of receiving and accurately transforming data and (b) meets the performance benchmarks, including without limitation UHIN’s Technical Standards and Specifications (http://www.uhin.org/pages/standards-specifications.php) or otherwise defined in writing by the parties, but specifically excludes hardware issues, not owned or controlled by UHIN, telecommunications failures in the connection from UHIN member to the administrative system: UTRANSEND, internet issues (including but not limited to periods of high latency, DNS issues, denial of service attacks, ISP failures and similar types of internet related issues) and problems in the data format caused by changes made by the member not agreed to in advance by UHIN (collectively, the “Exclusions”).  

 

UHIN Services covered in this Service Level Agreement Include the following:

  • Transformation of Electronic Data Interchange (EDI) transactions
  • Receipt of Batch EDI transactions
  • Receipt of Real-Time EDI transactions
  • Transfer of Batch EDI transactions
  • Transfer of Real-Time EDI transactions

 

1.2.              Measurement

The measurement for Service Availability for a given week is calculated by dividing the total number of minutes the Services were actually available during the Hours of Operation for such week by the total number of minutes in the Hours of Operation for such week and multiplying the result by 100.  The number of minutes in a given month will be calculated based on the number of days in such week.  “Hours of Operation” shall mean 24 hours multiplied by the number of days in the particular week. See UHIN ECA section 1.1and Phase I CORE 157: Eligibility and Benefits System Availability Rule for uptime details at http://www.caqh.org/pdf/CLEAN5010/157-v5010.pdf. 

 

1.3.              Minimum Service Level Requirement for Service Availability

While the Operating Rule requirement for real-time and batch transactions is 86% uptime per calendar week which UHIN complies with, UHIN has adopted for its members a minimum Service Availability for the Services (scheduled or unscheduled) of 99.9% measured on a running average calculated over a 90 day period. UHIN will immediately report any unscheduled System down time of which it becomes aware, to the UHIN members, through e-mail communication.

 

2.                      Scheduled Down Time

 

2.1.              Definition. 

There may be a scheduled down time period for performance of system maintenance, backup and upgrade functions for the Services (the “Scheduled Down Time Period).  The alerts process for notification of UHIN down-time will follow the Payer, Provider, Vendor and Network Requirements Specification schedule created agreed upon by the UHIN membership. This Specification can be found on the Standards page of the UHIN website at: http://www.uhin.org/system/files/documents/Payer%20Provider%20and%20Vendor%20Network%20Requirements%20Specification%20v2.6%20Approved.pdf

 

Scheduled downtime is also published in the UHIN Connectivity Companion Guide, available at http://www.uhin.org/system/files/documents/Connectivity%20Companion%20Guide%2020130715_0.pdf

 

 

2.2.              Measurement and Reporting Requirements.

The measurement for scheduled down time for the Services is the time elapsed from the time that the Services are not Available to fully perform operations to when the Services become Available to fully perform operations.  UHIN shall maintain and retain for no less than eighteen (18) months daily system logs setting forth scheduled system down time and tracking unscheduled downtime and other outages.  If requested by the member, UHIN shall provide copies of these logs to the member or its designee.

 

  • Scheduled Downtime: UHIN publishes the scheduled downtime via the UHIN applications and email alerts to properly communicate to providers and payer’s the UHIN system availability. UHIN’s maintenance window is every Tuesday between 6:00pm – and 12:00am (MST). Specifics regarding the type and duration of the maintenance will be provided through the routine downtime notification process.

 

  • Non-Routine Downtime: In the event that UHIN determines that maintenance work is required to be performed outside of the Scheduled Down Time Period, UHIN shall provide written notice for Non-Routine Downtime by email at least one week in advance.

 

  • Unscheduled Downtime: For unscheduled and emergency downtime, UHIN must provide an update within one hour of realizing downtime will be needed.

 

  • No Response Required: No response from UHIN member is required during scheduled downtime(s).

 

  • Holiday Schedule: UHIN technical support is available 24/7/365 at 877-693-3071.

 

The alerts process and work flow is described in the Payer, Provider, and Vendor Network Requirements Specification.

 

3.                      Problem Resolution Procedures

UHIN’s technical support team shall prioritize and respond to problems and requests according to the severity levels (“Severity Level(s)“) set forth below.

 

3.1.              Severity Level 1 Problems

A “Severity Level 1 Problem” is defined as an event (but specifically excluding any Exclusions) that halts or has a significant impact on use of the Services, by UHIN Members including without limitation, the following:

  • Any event that significantly disrupts or threatens to disrupt Service Availability to a UHIN Member.
  • Any online application outage that significantly impacts the Service Availability.
  • Consistent degradation of performance (response time or function) of the system that significantly impairs service to UHIN Members or any repeating, unresolved incidents that have significant impact on the Service Availability.

 

3.2.              Severity Level 2 Problems

A “Severity Level 2 Problem” is defined as a situation where Services have lost some level of functionality such as the transformation, receipt or transfer of EDI transactions, but are still accessible by UHIN Members. The lost functionality does not significantly impact the use of the System or the Services (including its UHIN Members), and a workaround does not exist.

 

3.3.              Severity Level 3 Problems

A “Severity Level 3 Problem” is defined as a situation where the System has lost some level of functionality such as the transformation, receipt or transfer of EDI transactions, but is still accessible by UHIN Members, and the lost functionality does not significantly impact the use of the System or the Services (including its UHIN Members), and a workaround exists.

 

3.4.              Severity Level 4 Problems

A “Severity Level 4 Problem” is defined as a situation where the System has functionality including the transformation, receipt and transfer of EDI transactions and these Services are still accessible by UHIN Members, but an abnormality exists.

 

3.5.              Response Time Calculation

Response Time” is the total amount of time it takes UHIN to respond to a request, calculated from the earlier of (a) the time a request arrives at UHIN via telephone call or email regarding the problem or (b) the time UHIN discovers the problem on its own, until: 1) the appropriate technician or administrator begins to address the request, and 2) contact is made to the requesting party with a status update if the problem was not addressed on the initial call.

 

3.6.              Problem Resolution Response Effort

Severity Level 1 problems take precedence and are handled first. UHIN shall prepare and provide to UHIN members an escalation document (“Escalation Contact Document”) that provides specific UHIN contact numbers for each step of the escalation procedures identified below.  Problems will be continually monitored and UHIN shall notify UHIN members of any existing problem and update members pursuant to the following Problem Resolution Response Table:

 

Problem Severity Level

 

Notification

Minimum Update Frequency and Method of Update

1: Complete service interruption

within 1 hour after discovery by UHIN

 

Every two hours by email, telephone or posted to the UHIN Website

2: Complete service interruption for one UHIN member end point effecting other trading partners

within 4 hours after discovery by UHIN

Every four hours by email

3: Partial service interruption for more than one UHIN member end point

by next business day after discovery by UHIN

Send initial nonfiction within 24 hours with weekly updates

4: Partial service interruption for one UHIN member end point effecting other trading partners

by next business day after discovery by UHIN

Send initial nonfiction within 24 hours with monthly updates

 

Severity Level 1 Action: UHIN will assign sufficient resources to resolve the problems as quickly as possible with the goal of maintaining the service levels agreed to herein. For Severity Level 1 problems, UHIN will use continuous effort to resolve the problem until an official fix is; installed, tested and the System and Services are back to normal operations.  Severity Level 1 problems will be continually monitored and affected members will be kept informed through frequent contact, with minimum contact as set forth in the Problem Resolution Response Table set forth above.  UHIN will escalate any Severity Level 1 Problems that remain unresolved after 4 hours to the next level of UHIN’s organization identified on the Escalation Contact Document, and will continue to escalate ongoing problems every four hours thereafter. Problems identified as a Severity Level 1 have no workaround solutions.

 

Severity Level 2 Action: UHIN will assign sufficient resources required to fix the problem in the target resolution timeframe. Severity Level 2 problems will have a target resolution of 23 hours dependent on the corrective actions required to return the System and Services to normal operations. These corrective actions and resolution timeframes will be communicated to the membership by UHIN. After 2 days, UHIN will escalate the problem in accordance with Severity Level 1 escalation procedures highlighted above   Problems identified as a Severity Level 2 have no workaround solutions.

 

 

Severity Level 3 Action: During the business hours of 8 a.m. to 5 p.m., UHIN will assign sufficient resources to fix the problem based on a mutually agreed upon target resolution timeframe. Severity Level 3 problems will have a target resolution of 5 to 10 business days dependent on the corrective actions required to return the System to normal operations.  After 5 days, UHIN will escalate the problem to the next level of UHIN’s organization as identified on the Escalation Contact Document. Problems with Severity Level 3 must have a workaround solution.

 

 

Severity Level 4 Action:  The target resolution timeframe for Severity Level 4 Problems will be determined separately for each problem by the member(s) and UHIN representatives. Problems with Severity Level 4 must have a workaround solution.

 

3.7.              Compliance Monitoring and Audit

UHIN shall monitor its compliance with the service level requirements specified in this document, and the member shall have a right to review UHIN’s audit compliance therewith upon two (2) weeks written notice, during UHIN’s normal business hours.  UHIN members may request and UHIN shall provide a report of service level compliance no more frequently than monthly and UHIN shall provide such report with sufficient detail such that can effectively determine UHIN’s compliance with the Service Level Agreement.

 

4.                      SYSTEM Response Time

 

4.1.              Definition

System Response Time” is defined as either (a) the amount of time from the receipt of a transaction from a UHIN Member, for UHIN to forward the transaction to the receiver; or (b) the amount of time from the receipt of transaction, reformatting the data and successfully delivery such to the recipient.

 

4.2.              Measurement

The measurement for System Response Time for a given period of time is calculated for the different type of transactions on a quarterly basis.

 

5.                      ROOT CAUSE ANALYSIS AND DISASTER RECOVERY PLAN

 

5.1.              Service Commitment

Should Service Availability, Problem Resolution Response Efforts or any other UHIN service level commitment under this Specification (each referred to as a “Service Commitment“) fall below the minimum service level requirement for a given month set forth in this specification, UHIN shall perform a root cause analysis to determine the cause of such Service Commitment failure(s), develop a written proposed corrective action plan (“CA Plan”) and schedule a meeting with the member to discuss such proposed CA Plan.  UHIN shall obtain the member’s approval of the final CA Plan and shall implement the final CA Plan to avoid recurrence of the Service Commitment failure(s).

 

5.2.              UHIN Disaster Recovery Plan

UHIN will develop, test and maintain at all times an appropriate plan of action including necessary procedures and reconciliation provisions, and the necessary software, data storage and computer equipment, either directly or through a third party disaster recovery service company to enable UHIN to resume full Service Availability to UHIN members within 23 hours from the onset of a major disruption in normal operations (“Disaster Recovery Plan”).  Upon the reasonable notice, UHIN will allow members to review all applicable portions of UHIN’s official Disaster Recovery Plan for the sole purpose of assuring compliance with this Section 5.2.

 

Implementation Date:

 

History: (MM/DD/YY)

 

V1.0

V2.0

2*1

ORIGINATION DATE

9/7/2012

10/31/2013

 

APPROVAL DATE

1/9/2013

4/9/2014

 

EFFECTIVE DATE

2/6/2013

5/28/2014

 

 

 

 

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