Generic Provider Number Usage Sample Clauses
Generic Provider Number Usage. Measure: This measure is the percentage of non-pharmacy encounters with the generic provider number. Providers submitting claims which do not have an MMIS provider number must be submitted to ODJFS with the generic provider number 9111115. The measure will be calculated per MCP. All other encounters are required to have the MMIS provider number of the servicing provider. The report period for this measure is quarterly.
Generic Provider Number Usage. This measure is the percentage of institutional (UB-92) and professional (NSF) encounters with the generic provider number in the Medicaid Provider Number field. Providers submitting claims which do not have an MMIS provider number in the Medicaid Provider Number field must be submitted to ODJFS with the generic provider number (i.e. 9111115). The measure will be calculated per MCP. The report period for this measure is quarterly.
Generic Provider Number Usage. This measure is the percentage of non-pharmacy encounters with the generic provider number. Providers submitting claims which do not have an MMIS provider number must be submitted to ODJFS with the generic provider number 9111115. The measure will be calculated per MCP. All other encounters are required to have the MMIS provider number of the servicing provider. The report period for this measure is quarterly.
Generic Provider Number Usage. Measure: This measure is the percentage of non-pharmacy encounters with the generic provider number. Providers submitting claims which do not have an MMIS provider number must be submitted to OD.IFS with the generic provider number 9111115. The measure will be calculated per MCP (i.e., to include all counties serviced by the MCP). All other encounters are required to have the MMIS provider number of the servicing provider. The report period for this measure is quarterly. Report Period'. For the SFY 2007 contract period, performance will be evaluated using the following periods: January - March 2006; April - June 2006; July - September 2006: October -December 2006. For the SFY 2008 contract period, performance will be evaluated using the following periods: January - March 2007; April - June 2007; July - September 2007; October -December 2007. Data Quality Standard: A maximum generic provider usage rate of 10%. Penalty for noncompliance: The first time an MCP is noncompliant with a standard for this measure. ODJFS will issue a Sanction Advisory informing the MCP that any future noncompliance instances with the standard for this measure will result in ODJFS imposing a monetary sanction. Upon all subsequent measurements of performance, if an MCP is again determined to be noncompliant with the standard. ODJFS will impose a monetary sanction (see Section 6.) of three percent of the current month's premium payment. Once the MCP is performing at standard levels and violations/deficiencies are resolved to the satisfaction of ODJFS. the money will be refunded.
c. Timely Submission of Encounter Data