Encounter Data definition

Encounter Data. Any Contractor accessing payments for services through the Global Commitment to Health Waiver and Vermont Medicaid programs must provide encounter data to the Agency of Human Services and/or its departments and ensure that it can be linked to enrollee eligibility files maintained by the State.

Encounter Data. Any Grantee accessing payments for services through the Global Commitment to Health Waiver and Vermont Medicaid programs must provide encounter data to the Agency of Human Services and/or its departments and ensure that it can be linked to enrollee eligibility files maintained by the State.

Encounter Data means information reflecting a face-to-face meeting or other billable service furnished by a provider to a person served through the Iowa Plan. Medicaid encounter data must be submitted by the contractor to the department in an electronic format specified by the department.

Examples of Encounter Data in a sentence

• The MCP shall have the capability to report all elements in the Minimum Data Set as set forth in the ODM Encounter Data Specifications and shall submit a test file in the ODM-specified medium in the required formats prior to contracting or prior to an information systems replacement or update.

• Accuracy Encounter Data ODM also reviews the accuracy of the encounter data by reviewing the percentage of matched encounters between the ODM encounter data files and an MCP’s fully adjudicated claims files where a payment amount discrepancy is identified.

• The MCP must have the capability to report all elements in the Minimum Data Set as set forth in the ODM Encounter Data Specifications and must submit a test file in the ODM-specified medium in the required formats prior to contracting or prior to an information systems replacement or update.

More Definitions of Encounter Data

Encounter Data means encounter information, data and reports for Covered Services provided to a Member that meets the requirements for Clean Claims.

Encounter Data means information documenting a service to an Enrollee.

Encounter Data means the record submitted to CMS about an enrollee receiving any item(s) or service(s) provided through Medicaid or Medicare under a prepaid, capitated, or any other risk based payment methodology. Encounter Data records are maintained in the CMS Encounter Data System (EDS).

Encounter Data. MCPs indicated whether an encounter is sub-capitated and “shadow priced” at the detail and header level, depending on how the encounter was paid. In the payment arrangement field (‘CDE_PAY_ARR’), code ‘05’ indicates sub- capitated arrangements. This field was used to separate sub-capitated claims from the non-sub-capitated encounter data.

Encounter Data means the compilation of data elements, as specified by the Department in written notice to Contractor, identifying an Encounter that includes information similar to that required in a claim for Fee-For-Service payment under the HFS Medical Program.

Encounter Data means information, data, and/or reports about clinical encounters and Covered Services rendered and supported by documentation in the Covered Person’s medical record.

Encounter Data means the compiled data elements relating to the receipt of any item(s) or service(s) by an Enrollee under a contract between the Department and Contractor that is subject to the requirements of 42 CFR§438.242 and 42 CFR §438.818. Specific requirements for Encounter Data submissions are defined by the Department and include information similar to that required in a claim for FFS payment under the HFS Medical Program.