Encounter Data Elements. Encounter data elements are based on the Medicaid-Medicare Common Data Initiative (McData Set) which is a minimum core data set for states and MCOs developed by CMS and HSD for use in managed care. Subject to the provisions of Section 4.2 of this Agreement, HSD may increase or reduce or make mandatory or optional, data elements as it deems necessary.
Encounter Data Elements. Encounter data elements are a combination of those elements required by HIPAA-compliant transaction formats, which comprise a minimum core data set for states and managed care organizations, and those 148 required by CMS or the State for use in managed care. The State may increase or reduce or make mandatory or optional, data elements, as it deems necessary. The CONTRACTOR will be held harmless in conversion to HIPAA coded encounter data when delays are the result of HIPAA implementation issues. The transition to HIPAA codes and requirements does not relieve the CONTRACTOR of timely submission of encounter data. The State will approve necessary default values for paper claim encounters that must pass the State’s required HIPAA format edits. The CONTRACTOR shall submit encounter data to the State using the 837 and NCPDP formats. The State will work with the CONTRACTOR and HSD/MAD’s claims processing contractor to provide the CONTRACTOR with an electronic disposition of each submitted encounter. Financial Reporting
Encounter Data Elements. Encounter data elements are a combination of those elements required by HIPAA-compliant transaction formats, which comprise a minimum core data set for states and managed care organizations, and those required by CMS or HSD/MAD for use in managed care. . Subject to the provisions of Section 4.2 of this Agreement, HSD/MAD may increase or reduce or make mandatory or optional, data elements, as it deems necessary. The CONTRACTOR will be held harmless in conversion to HIPAA coded encounter data when delays are the result of HIPAA implementation issues at HSD/MAD. The transition to HIPAA codes and requirements does not relieve the CONTRACTOR of timely submission of encounter data. HSD/MAD will approve necessary default values for paper claim encounters that must pass HSD/MAD required HIPAA format edits.
Encounter Data Elements. Encounter data elements are based on the Medicaid-Medicare Common Data Initiative (McData Set), which is a minimum core data set for states and MCOs developed by CMS and HSD for use in managed care. Subject to the provisions of Section 4.2 of this Agreement, HSD may increase or reduce or make mandatory or optional, data elements as it deems necessary. The CONTRACTOR will be held harmless in conversion to HIPAA coded encounter data when delays are the result of HIPAA implementation issues at HSD. The transition to HIPAA codes and requirements does not relieve the CONTRACTOR of timely submission of encounter data.
