Data Requirements. • The data referred to in this document are encounter data – a record of health care services, health conditions and products delivered for Massachusetts Medicaid managed care beneficiaries. An encounter is defined as a visit with a unique set of services/procedures performed for an eligible recipient. Each service should be documented on a separate encounter claim detail line completed with all the data elements including date of service, revenue and/or procedure code and/or NDC number, units, and MCE payments/cost of care for a service or product. • All encounter claim information must be for the member identified on the claim by Medicaid ID. Claims must not be submitted with another member’s identification (e.g., xxxxxxx claims must not be submitted under the Mom’s ID). • All claims should reflect the final status of the claim on the date it is pulled from the MCE’s Data Warehouse. • For MassHealth, only the latest version of the claim line submitted to MassHealth is “active”. Previously submitted versions of claim lines get offset (no longer “active” with MassHealth) and payments are not netted. • An encounter is a fully adjudicated service (with all associated claim lines) where the MCE incurred the cost either through direct payment or sub-contracted payment. Generally, at least one line would be adjudicated as “paid”. All adjudicated claims must have a complete set of billing codes. There may also be fully adjudicated claims where the MCE did not incur a cost but would otherwise like to inform MassHealth of covered services provided to Enrollees/Members, such as for quality measure reporting (e.g., CPT category 2 codes for A1c lab tests and care/patient management). • All claim lines should be submitted for each Paid claim, including zero paid claim lines (e.g., bundled services paid at an encounter level and patient copays that exceeded the fee schedule). Denied lines should not be included in the Paid submission. Submit one encounter record/claim line for each service performed (i.e., if a claim consisted of five services or products, each service should have a separate encounter record). Pursuant to contract, an encounter record must be submitted for all covered services provided to all enrollees. Payment amounts must be greater than or equal to zero. There should not be negative payments, including on voided claim lines. • Records/services of the same encounter claim must be submitted with same claim number. There should not be more than one a...
Data Requirements. 1. Data, Data Dictionaries, and Data Flow Diagrams. The Engineer shall ensure that any State Data that it generates, manipulates, transmits, or stores, utilizes the TxDOT taxonomy, with documented data dictionaries, and data flow diagrams (including security protocols).
Data Requirements. The State owns all data associated with offenders under the custody or control of the State. Pursuant to Montana Code Annotated 44-4-1203 and at the direction of the State, Contractor will electronically enter all alcohol and drug testing data in OMIS. This data includes, but is not limited to the following:
Data Requirements a. Every single bale electronic warehouse receipt, whether negotiable or non-negotiable, issued for cotton stored in a licensed warehouse must, in addition to complying with the requirements of Section 11 of the Act and Section VI (A) and (B), (C)(1) and (2) of this Agreement, embody within its written or printed terms each of the following:
Data Requirements. The data exchange between the Recipient and the Airport, and any other necessary third parties as identified and required by the Airport, shall conform to the following formats: Name Format Description Samples uid <Driver ID + “:” + Trip ID> Driver ID concatenated with the Trip ID. <Recipient to provide samples and format> Alphanumeric and special characters tnc id Integer A unique number assigned to the TNC. <Recipient to provide samples > license_plate Seven-character string Seven-character or less, numerical and alphabetic, that represents the vehicle license plate. Accepts an empty String value if there hasn’t been a license plate assigned yet. “ ABC l 23”, “ ABC l 234” timestamp [YYYY]-[MM]- [DD]T[hh] :[mm]:[ss]Z The current time of the event or “ping” expressed in ISO 860 I combined date and time in UTC using 24-hour clock. httn://en.wikined ia.onr/wik i/IS O 860 I #UTC “2014-09- I 0Tl 4:12:05Z”
Data Requirements. For services not included in the CDS, the Network Provider will ensure the regular submission of data for system management using a Provider Log or entry of encounters into Region V Systems Compass (electronic management system). If Provider Logs are submitted, they will include the name of the service provided, the month, the consumer’s name, date of birth, and Social Security number. These Logs will be submitted along with monthly billing documents. This applies to the following children’s services: 1) Youth Assessment, and 2) Therapeutic Consultation.
Data Requirements. As a minimum, the following information shall be submitted by the Contractor with each VECP;
Data Requirements. The system shall capture, at a minimum, the enrollee, the reason of the complaint or grievance, the date the complaint or grievance was reported, the operator who talked to the enrollee, the explanation of the resolution, the date the complaint or grievance was resolved, the person who resolved the complaint or grievance, referrals to other departments, and comments including general information and/or observations. See Article 5.15.
Data Requirements. Seller agrees to furnish at no charge any data called for by this Agreement and data order separately which relates to the supplies or services ordered hereunder.
Data Requirements. Provider must provide to Subcontractor or Health Plan and/or the Department all information the Department requires under the applicable State Contract related to the performance of Provider’s responsibilities, including encounter data, as well as non- medical information for the purposes of research and evaluation, and any information the Department requires to comply with all applicable federal and State laws and regulations. Such data must include, but isn’t limited to, information pertaining to (a) substance use disorders, (b) births to Covered Persons, (c) clinical assessment and outcomes data, and (d) provider incentives. As applicable, Provider shall submit to Subcontractor or Health Plan all risk adjustment data as defined in 42 CFR 422.310(a). Provider shall send to Subcontractor or Health Plan all risk adjustment data and other Medicare Advantage program-related information as may be requested by Health Plan, within the timeframes specified and in a form that meets Medicare Advantage program requirements. By submitting data to Subcontractor or Health Plan, Provider represents, and upon Subcontractor’s request shall certify in writing, that the data is accurate, complete, and truthful, based on Provider’s best knowledge, information and belief.
