Encounter Reporting the collection and reporting of encounter data to the Department of Health Services is submitted via the LTCare Information Exchange System (IES). Encounter data are detailed records of health care services or items that have been provided to MCO members. Encounter data are used for rate setting and program analysis.
Encounter Reporting the collection and reporting of encounter data to the Department of Health Services. Encounter data are detailed records of health care services or items that have been provided to MCO members. Encounter data are used for rate setting and program analysis.
Encounter Reporting the collection and reporting of encounter data to the Department of Health Services is submitted via the Long-Term Care Information Exchange System (IES). Encounter data are detailed records of services or items that have been provided to IRIS participants.
Encounter Reporting. For HMO Members for which PPG receives Capitation under this Agreement. PPG shall provide FHS encounter data in accordance with the Operations Manual, via magnetic media for all Contracted Services provided to HMO Members during a calendar month within thirty (30) days of the end of the month in which such services are rendered. PPG shall also promptly provide FHS with all corrections to and revisions of such encounter data. FHS and PPG shall work in good faith to eliminate hard copy reports and transition to Electronic Data Interface (EDI) exchange of information.
Encounter Reporting. General The Contractor must meet any diagnosis and/or encounter reporting requirements that are in place for Medicare Advantage plans and Medicaid managed care organizations including the EOHHS Encounter Data Set Request, as may be updated from time to time. Furthermore, the Contractor‘s Systems shall generate and transmit Encounter Data files according to additional specifications as may be provided by CMS or EOHHS and updated from time to time. The Contractor shall maintain processes to ensure the validity, accuracy and completeness of the Encounter Data in accordance with the standards specified in this section. CMS and EOHHS will provide technical assistance to the Contractor for developing the capacity to meet encounter reporting requirements.
Encounter Reporting. 2.22.1. General
Encounter Reporting. 2.17.1 The Contractor must meet any diagnosis and/or encounter reporting requirements that are in place for Medicare Advantage plans, as may be updated from time to time. Furthermore, the Contractor’s Systems shall generate and transmit Encounter Data files to CMS according to additional specifications as shall be provided by CMS or the Department and updated from time to time. The Contractor shall maintain processes to ensure the validity, accuracy and completeness of the Encounter Data in accordance with the standards specified in this section. CMS and the Department will provide technical assistance to the Contractor for developing the capacity to meet encounter reporting requirements.
Encounter Reporting. 2.20.1. The Contractor must meet any diagnosis and encounter reporting requirements that are in place for Medicare Advantage plans and Medi-Cal managed care organizations. Furthermore, the Contractor’s systems shall generate and transmit Encounter Data files to CMS according to additional specifications as shall be provided by CMS and DHCS and updated from time to time. CMS and DHCS will provide technical assistance to the Contractor for developing the capacity to meet encounter reporting requirements.
Encounter Reporting. Each Physician (and any Resident under the supervision of a Physician, using the supervising Physician’s Practitioner Number) will submit Encounter Records to the Medical Services Plan/Health Insurance BC via Teleplan in accordance with the requirements, rules and procedures of the Medical Services Plan (MSP)/Health Insurance BC for the Services provided under this Contract and the Encounter Records will include the following information: MSP Payee Number (Clinic’s Payee Number XXXX), Practitioner Number, Patient’s/Client’s personal health number (PHN), Patient/Client Name, Date of services, Encounter code(s), ICD-9 diagnostic codes (1 code mandatory, 3 maximum), Location Code, Facility Number, Note, and Referring/Referred practitioner # (if the Physician is referring patient to or receiving a referral from another practitioner). With respect to f. above, each Physician will use those simplified encounter codes for GPs provided by the Medical Services Plan/Health Insurance BC, as amended from time to time. Each Physician will also submit a shift code fee item 97570 – Contracted Clinical Shift via Teleplan and in accordance with the requirements, rules and procedures of the Medical Services Plan (MSP)/Health Insurance BC for each period of time under which Contract Services are provided. The shift code record will include the following: MSP Payee Number (Clinic’s Payee Number XXXX), Practitioner Number, Patient’s personal health number (PHN) (a patient seen during the day) Patient Name (a patient seen during the day) Date of services Start time (for that day), End time (for that day), Time units (an estimate of the number of 15 minute time units spent providing Services under the contract – captured under the Billed Services field in Teleplan), ICD-9 diagnostic codes (1 code mandatory, 3 maximum) (general symptoms ICD-9 code). Location Code, and
Encounter Reporting. For Beneficiaries for which Provider ------------------- receives Capitation Compensation under this Agreement, Provider shall provide Foundation with the following information, via personal computer diskette, magnetic tape or electronic transmission in standard UB-92 (UB-82) form or its successor format, for each encounter (either at Provider's Facility, or any other facility at which a Beneficiary received approved Inpatient Services, and for which Provider has paid the claim) with a Beneficiary during a calendar month. Such electronic encounter information materials shall be complete, accurate and provided to Foundation by the 15th day of the month following the month in which the encounter occurred. Encounter reporting shall be in accordance with, but not limited to, the Health Plan Employer Data and Information Set (HEDIS), Version 2.0, or its successor. Additionally, Provider shall promptly provide Foundation with all corrections to and revisions of such encounter data.
