Data Quality Standard a. For Level 1. An omission encounter rate and a surplus encounter rate of no more than 10% at the line-level records.
b. For Level 2. A payment error rate of no more than 4% for each claim type based on how encounters are processed—i.e., either paid at the detail level or at the header level.
Data Quality Standard. An omission encounter rate and a surplus encounter rate of no more than 10% at the line-level records.
Data Quality Standard a. For Level 1. An omission encounter rate and a surplus encounter rate of no more than 10% at the line-level records.
b. For Level 2. A payment error rate of no more than 4% for each claim type based on how encounters are processed—i.e., either paid at the detail level or at the header level. Information concerning the proper submission of electronic data interchange (EDI) Post Adjudicated Claim Data Reporting (PACDR) encounter transactions may be obtained from the Ohio Department of Medicaid (ODM) website. The website contains PACDR Encounter Data Companion Guides for the Managed Care 837 dental, professional and institutional transactions. Additional Companion Guides for EDI transactions that should be used in conjunction with encounters include the 277CA Claim Acknowledgement and the 824 Application Advice. The PACDR Encounter Data Companion Guides shall be used in conjunction with the X12 Implementation Guides for EDI transactions. PACDR Encounters will be submitted to the Ohio Medicaid Enterprise System (OMES).
Data Quality Standard