{"component": "definition", "props": {"groups": [{"samples": [{"hash": "9DHRV8Hzk1w", "uri": "/contracts/9DHRV8Hzk1w#encounter-data", "label": "Personal Services Agreement", "score": 36.0395278931, "published": true}, {"hash": "4NXFFLRHwnU", "uri": "/contracts/4NXFFLRHwnU#encounter-data", "label": "Contract for Personal Services", "score": 33.8574142456, "published": true}, {"hash": "anYfRk1TN82", "uri": "/contracts/anYfRk1TN82#encounter-data", "label": "Personal Services Contract", "score": 33.3619537354, "published": true}], "snippet_links": [{"key": "payments-for-services", "type": "clause", "offset": [25, 46]}, {"key": "global-commitment-to-health-waiver", "type": "definition", "offset": [59, 93]}, {"key": "vermont-medicaid", "type": "definition", "offset": [98, 114]}, {"key": "agency-of-human-services", "type": "clause", "offset": [159, 183]}, {"key": "eligibility-files", "type": "definition", "offset": [252, 269]}, {"key": "by-the-state", "type": "clause", "offset": [281, 293]}], "snippet": "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.", "size": 173, "hash": "f19769d82fae8ca09be49d9139a2534a", "id": 1}, {"samples": [{"hash": "gxVsU6TGbIp", "uri": "https://www.legis.iowa.gov/docs/ACO/GNAC/iacpdf(7-7-04)/iac/441iac/44188/44188pp2.pdf", "label": "www.legis.iowa.gov", "score": 18.7170162201, "published": false}, {"hash": "iY5Wxfisb44", "uri": "https://www.legis.iowa.gov/docs/ACO/GNAC/iacpdf(9-6-00)/iac/441iac/44188/44188952.pdf", "label": "www.legis.iowa.gov", "score": 11.0472278595, "published": false}, {"hash": "jY3RLtvhxXR", "uri": "https://www.legis.iowa.gov/DOCS/ACO/GNAC/iacpdf(3-8-00)/iac/441iac/44188/44188952.pdf", "label": "www.legis.iowa.gov", "score": 9.3921966553, "published": false}], "snippet_links": [{"key": "service-furnished", "type": "clause", "offset": [70, 87]}, {"key": "person-served", "type": "definition", "offset": [107, 120]}, {"key": "iowa-plan", "type": "definition", "offset": [133, 142]}, {"key": "contractor-to", "type": "clause", "offset": [193, 206]}, {"key": "electronic-format", "type": "definition", "offset": [228, 245]}, {"key": "by-the-department", "type": "clause", "offset": [256, 273]}], "snippet": "means information reflecting a face-to-face meeting or other billable service furnished by a provider to a person served through the Iowa Plan. 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(ii) were not paid for; (iii) paid for on a Fee- For-Service or capitated basis; (iii) were performed by a Participating Provider, Non-Participating Provider, Subcontractor, or Contractor; and (iv) were performed pursuant to Subcontractor agreement, special arrangement with a facility or program, or other arrangement.", "size": 8, "hash": "675366e9ccd8ad8ceb26e45513e1ec6a", "id": 6}, {"samples": [{"hash": "9LCgpkEAwnl", "uri": "/contracts/9LCgpkEAwnl#encounter-data", "label": "Provider Agreement", "score": 27.4519748688, "published": true}, {"hash": "bTBxByuiuY3", "uri": "/contracts/bTBxByuiuY3#encounter-data", "label": "Provider Agreement", "score": 25.119096756, "published": true}, {"hash": "hFQQY83lTHz", "uri": "/contracts/hFQQY83lTHz#encounter-data", "label": "Provider Agreement", "score": 24.9671459198, "published": true}], "snippet_links": [{"key": "depending-on-how", "type": "clause", "offset": [105, 121]}, {"key": "payment-arrangement", "type": "clause", "offset": [153, 172]}, {"key": "the-non", "type": "clause", "offset": [303, 310]}], "snippet": "MCPs indicated whether an encounter is sub-capitated and \u201cshadow priced\u201d at the detail and header level, depending on how the encounter was paid. In the payment arrangement field (\u2018CDE_PAY_ARR\u2019), code \u201805\u2019 indicates sub- capitated arrangements. This field was used to separate sub-capitated claims from the non-sub-capitated encounter data.", "size": 8, "hash": "78883ef33dbd84b7dccd0dba4a926b77", "id": 7}, {"samples": [{"hash": "43BySyjRGUN", "uri": "/contracts/43BySyjRGUN#encounter-data", "label": "Information Exchange Agreement", "score": 30.9513473511, "published": true}, {"hash": "iNCaFsV7zoj", "uri": "/contracts/iNCaFsV7zoj#encounter-data", "label": "Information Exchange Agreement", "score": 24.9767284393, "published": true}, {"hash": "dKtA6WRVmyL", "uri": "/contracts/dKtA6WRVmyL#encounter-data", "label": "Information Exchange Agreement", "score": 24.7960300446, "published": true}], "snippet_links": [{"key": "the-record", "type": "clause", "offset": [6, 16]}, {"key": "payment-methodology", "type": "definition", "offset": [178, 197]}, {"key": "data-records", "type": "definition", "offset": [209, 221]}, {"key": "the-cms", "type": "clause", "offset": [240, 247]}, {"key": "data-system", "type": "clause", "offset": [258, 269]}], "snippet": "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).", "size": 8, "hash": "d4b3b53284b8adeb7e1e6fbc4c4feac0", "id": 8}, {"samples": [{"hash": "9ZVlzyqOu8n", "uri": "/contracts/9ZVlzyqOu8n#encounter-data", "label": "Contract for Health Services", "score": 26.1704311371, "published": true}, {"hash": "1c0YAoxkyaf", "uri": "/contracts/1c0YAoxkyaf#encounter-data", "label": "Contract for Health Services", "score": 24.6434364319, "published": true}, {"hash": "9UE1dFtjSrB", "uri": "/contracts/9UE1dFtjSrB#encounter-data", "label": "Contract for Health Services", "score": 24.5665798187, "published": true}], "snippet_links": [{"key": "data-elements", "type": "definition", "offset": [25, 38]}, {"key": "as-specified", "type": "clause", "offset": [40, 52]}, {"key": "by-the-department", "type": "clause", "offset": [53, 70]}, {"key": "notice-to-contractor", "type": "clause", "offset": [82, 102]}, {"key": "similar-to", "type": "definition", "offset": [155, 165]}, {"key": "service-payment", "type": "clause", "offset": [203, 218]}, {"key": "hfs-medical-program", "type": "definition", "offset": [229, 248]}], "snippet": "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.", "size": 7, "hash": "c31d1f0cf113693dc6e631ecd0f80503", "id": 9}, {"samples": [{"hash": "iiwL1XM6mY6", "uri": "/contracts/iiwL1XM6mY6#encounter-data", "label": "Cin Participation Agreement", "score": 24.2744693756, "published": true}, {"hash": "5cSnSM9RptE", "uri": "/contracts/5cSnSM9RptE#encounter-data", "label": "Participant Agreement", "score": 22.9342918396, "published": true}, {"hash": "44wc53Dx3IP", "uri": "/contracts/44wc53Dx3IP#encounter-data", "label": "Entity Agreement", "score": 22.9342918396, "published": true}], "snippet_links": [{"key": "services-rendered", "type": "definition", "offset": [78, 95]}, {"key": "the-covered-person", "type": "definition", "offset": [130, 148]}, {"key": "medical-record", "type": "clause", "offset": [151, 165]}], "snippet": "means information, data, and/or reports about clinical encounters and Covered Services rendered and supported by documentation in the Covered Person\u2019s medical record.", "size": 7, "hash": "d80cf85e7ecc8c89893e8972ad37feb7", "id": 10}], "next_curs": "ClsSVWoVc35sYXdpbnNpZGVyY29udHJhY3RzcjcLEhpEZWZpbml0aW9uU25pcHBldEdyb3VwX3Y1NiIXZW5jb3VudGVyLWRhdGEjMDAwMDAwMGEMogECZW4YACAA", "definition": {"snippet": "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.", "title": "Encounter Data", "size": 351, "id": "encounter-data", "examples": ["HHSC will make non-risk payments within a reasonable amount of time after the Encounter reporting period, generally no later than 95 Contractor has processed the <strong>Encounter Data</strong>.", "HHSC will establish base Capitation Rates for the Rate Periods following Rate Period 1 by analyzing historical <strong>Encounter Data</strong> and financial data.", "For providing these drugs to Members, HHSC will make non-risk payments to the MCO based on <strong>Encounter Data</strong> Contractor during an encounter reporting period.", "For drugs dispensed by a pharmacy, the first non-risk payment will cover pharmacy <strong>Encounter Data</strong> received from the date the drugs are added to the Medicaid and CHIP formularies through the end of that State Fiscal Quarter.", "<strong>Encounter Data</strong> provided by MCO must conform to all HHSC requirements.", "HHSC will make non-risk payments within a reasonable amount of time after the encounter reporting period, generally no later than 95 Days after processed the <strong>Encounter Data</strong>.", "HHSC will reimburse for services provided to eligible Medicaid Members as documented in both the invoice and <strong>Encounter Data</strong> on a non-risk basis subject to the non-risk upper payment limit in 42 CFR \u00a7 447.362.", "<strong>Encounter Data</strong> containing non- compliant information, including inaccurate Member or Member identification numbers, inaccurate provider identification numbers, or diagnosis or procedures codes insufficient to adequately describe the diagnosis or medical procedure performed, will not be -setting purposes.", "<strong>Encounter Data</strong> containing non- compliant information, including inaccurate Member or Member identification numbers, inaccurate provider identification numbers, or diagnosis or procedures codes insufficient to adequately describe the diagnosis or medical procedure performed, will not be e for rate-setting purposes."], "related": [["encounter", "Encounter", "Encounter"], ["electronic-subcontracting-reporting-system-esrs", "Electronic Subcontracting Reporting System (eSRS)", "Electronic Subcontracting Reporting System (eSRS)"], ["input-data", "input data", "input data"], ["baseline-data", "Baseline data", "Baseline data"], ["system-data", "System Data", "System Data"]], "related_snippets": [], "updated": "2025-07-24T04:27:56+00:00"}, "json": true, "cursor": ""}}