Data Development. This section of the narrative describes the formation of the base data used to produce the databook and the following adjustments that were applied to produce the base data for rate development, which were applied after the release of the databook: • Removal of Non-State Plan Services; Copayment Adjustments. • Adjustment for Third Party Liability (TPL) and Fraud and Abuse (FA). • Disproportionate Share Hospital (DSH) Payments. • Graduate Medical Education (GME) Payments. • Addition for Certain Expenditures Not Included in the Encounter Data. • Completion for Additional Claims Run Out. • Application of Historical Program Changes.
Appears in 3 contracts
Samples: Provider Agreement, Provider Agreement, Provider Agreement
Data Development. This section of the narrative describes the formation of the base data used to produce the databook and the following adjustments that were applied to produce the base data for rate development, which were applied after the release of the databook: • Removal of Non-State Plan Services; Copayment Adjustments. • Adjustment for Third Party Liability (TPL) and Fraud Xxxxx and Abuse (FA). • Disproportionate Share Hospital (DSH) Payments. • Graduate Medical Education (GME) Payments. • Addition for Certain Expenditures Not Included in the Encounter Data. • Completion for Additional Claims Run Out. • Application of Historical Program Changes.
Appears in 2 contracts
Samples: Provider Agreement, Provider Agreement
