Encounter definition

Encounter means a record of a medically-related service rendered by an AHCCCS-registered provider to a member enrolled with a contractor on the date of service.

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Encounter means a Covered Service or group of Covered Services delivered by a Provider to a Member during a visit between the Member and Provider. This also includes Value-added Services. Encounter Data means data elements from Fee-for-Service claims or capitated services proxy claims that are submitted to HHSC by the HMO in accordance with HHSC’s required format for Medicaid and CHIP HMOs.

Encounter means the record of a service submitted to or by the Division and processed by AHCCCS that is rendered by a provider registered with AHCCCS to a member who is enrolled with the Division on the date of service for which the Division incurs a financial liability (A.A.C. R9-22-107.13).

Examples of Encounter in a sentence

• Monthly Capitation Per Encounter Turquoise Care 1115 Waiver Food as Medicine Meals for Pregnant Members July 1, 2025 Providers billing for Food as Medicine Meals for Pregnant Members services.

• Usage MUST follow the guidance of Concise Consolidated CDA: Deploying Encounter Summary CDA Documents with Clinical Notes section 2.6.3.2 Filtering by date/time range.

• Required Required 07/01/2024 Claims and Encounter Manager/Administrator The Claims and Encounter Manager/Administrator shall ensure prompt and accurate Provider Claims processing.

• Encounter or service records shall be maintained for a period of not less than five (5) years.

• The requirement to submit complete and accurate reports and data required under the Contract, including encounter data that complies with HCA Service Encounter Reporting Instructions (SERI) Guide, HCA Encounter Data Reporting Guide (EDRG), and Behavioral Health Supplemental Transactions that complies with the Behavioral Health Supplemental Transaction Data Guide, to the Contractor.

More Definitions of Encounter

Encounter means an instance of an individual presenting at the emergency center who satisfies the criteria in section R386-702-3(2); and

Encounter means an individual service or procedure provided to an Enrollee that would result in a claim if the service or procedure were to be reimbursed as Fee-For- Service under the HFS Medical Program.

Encounter means a Covered Service or group of Covered Services delivered by a Provider to a Member during a visit between the Member and Provider. This also includes Value-added Services. Encounter Data means data elements from Fee-for-Service claims or capitated services proxy claims that are submitted to HHSC by the MCO in accordance with HHSC’s required format for Medicaid and CHIP MCOs. Enrollment Report/Enrollment File means the daily or monthly list of Eligibles that are enrolled with an MCO as Members on the day or for the month the report is issued. EPSDT means the federally mandated Early and Periodic Screening, Diagnosis and Treatment program contained at 42 U.S.C. 1396d(r). The name has been changed to Texas Health Steps in the State of Texas. Exclusive Provider Organization (EPO) means an insurer with an Exclusive Provider Benefit Plan approved by TDI in accordance with 28 T.A.C. §3.9201-3.9212

Encounter means a record of a covered service rendered by a provider to a person enrolled with a capitated RBHA on the date of service.

Encounter means a single health care service or a period of examination or treatment.

Encounter means a face-to-face visit, which may include a visit using telemedicine, between a patient and a primary care provider during which primary care services are provided.

Encounter means a face to face contact between a health care professional and a CDIB cardan IHS eligible SoonerCare member for the provision of medically necessary Title XIX or Title XXI covered services through an IHS or Tribal 638 facility or an urban Indian clinic within a 24-hour period ending at midnight, as documented in the patient's record.