Common use of Encounter Data Reconciliation Clause in Contracts

Encounter Data Reconciliation. Medical The encounters submitted by the PHP shall reconcile to at least ninety-eight percent (98%) of paid claims amounts reported on financial reports within sixty (60) Calendar Days or at least ninety-nine point eight (99.8%) of paid claim amounts reported on financial reports within one hundred twenty (120) Calendar Days. The paid amounts on submitted individual encounter records compared to the paid claims amounts reported on financial reports submitted to the Department by the PHP. Monthly $10,000 per month

Encounter Data Reconciliation. Medical The encounters submitted by the PHP shall reconcile to at least ninety-eight percent (98%) of paid claims amounts reported on financial reports within sixty (60) Calendar Days or at least ninety-ninety- nine point eight percent (99.899%) of paid claim amounts reported on financial reports within one hundred twenty (120) Calendar Days. For purposes of this standard, medical encounters only include 837-P encounters and 837-I encounters. The paid amounts on submitted individual encounter records compared to the paid claims amounts reported on financial reports submitted to the Department by the PHP. Monthly $10,000 per month

Encounter Data Reconciliation. Medical The encounters submitted by the PHP shall reconcile to at least ninety-eight percent (98%) of paid claims amounts reported on financial reports within sixty (60) Calendar Days or at least ninety-nine point eight (99.8%) of paid claim amounts reported on financial reports within one hundred twenty (120) Calendar Daysreports. The paid amounts on submitted individual encounter records compared to the paid claims amounts reported on financial reports submitted to the Department by the PHP. Monthly Daily $10,000 1,000 per monthday