Encounter Data Submittal. A. Contractor shall implement policies and procedures for ensuring the complete, accurate, and timely submission of Encounter Data for all services for which Contractor has incurred any financial liability, whether directly or through Subcontracts or other arrangements.
B. Contractor shall require subcontractors and non-contracting providers to provide Encounter Data to Contractor, which allows Contractor to meet its administrative functions and the requirements set forth in this section. Contractor shall have in place mechanisms, including edits and reporting systems sufficient to assure Encounter Data is complete, timely, reasonable, and accurate prior to submission to DHCS.
C. Contractor shall submit complete, timely, reasonable, and accurate Encounter Data within six (6) business days of the end of each month following the month of payment, under this contract or as otherwise agreed upon by DHCS and in the format specified by DHCS.
D. DHCS will measure the quality of the Encounter Data for completeness, timeliness, reasonability, and accuracy.
E. If DHCS find deficiencies regarding Encounter Data or the quality of Encounter Data, DHCS may notify Contractor in writing of the deficiency and request correction and resubmission of the relevant Encounter Data. Contractor shall ensure that corrected Encounter Data is resubmitted within 15 calendar days of the date of DHCS' notice. Upon Contractor's written request, DHCS may grant an extension for submission of corrected Encounter Data.
Encounter Data Submittal. The Contractor will submit Encounter data to DHS on a monthly basis 90 days following the end of the reporting month in which the Encounter occurred as specified in the Managed Care Encounter Data Reporting Manual. Encounter data will include the data elements as outlined in Attachment 9.4-B, Managed Care Encounter Data Reporting Elements of the RFA.
Encounter Data Submittal. Contractor shall implement policies and procedures for ensuring the complete, accurate, and timely submission of Encounter-level data for all services for which Contractor has incurred any financial liability, whether directly or through Subcontracts or other arrangements. As a condition of payment, Contractor may require subcontractors and out-of-plan providers to provide Encounter-level data to Contractor that meets the same standards required for Contractor to comply with this section. Contractor shall submit Encounter-level data to DHS on a monthly basis, no later than ninety (90) days following the end of the reporting month in which the Encounter occurred, in the form and manner specified in DHS' most recent Managed Care Data Element Dictionary. Encounter-level data received and processed by Contractor too late to be submitted timely, shall be submitted to DHS with the next monthly submission. Encounter-level data shall include data elements specified in DHS' most recent Managed Care Data Element Dictionary. XXXXXX MEDICAL CENTERS, INC. 95-23637-A03
Encounter Data Submittal. Contractor shall implement policies and procedures for ensuring the complete, accurate, and timely submission of Encounter level data for all services which Contractor incurred any financial liability whether directly or through Subcontracts or other arrangements. Contractor shall submit Encounter-level data to DHS and to LHD on a monthly basis, no later than 90 calendar days following the end of the reporting month in which the Encounter occurred in the form and manner specified in the DHS’ most recent Managed Care Data Element Dictionary, hereby incorporated by reference. Encounter-level data shall include data elements as specified in DHS’ most recent Managed Care Data Manual Element Dictionary.
.1 MIS/Data Correspondence Upon written notice by DHS of any problems related to the submittal of data to DHS as required under this Contract, or upon written notice by DHS of concerns regarding any other changes or clarifications made by Contractor to its MIS system, Contractor shall submit Corrective Actions with measurable benchmarks within five working days from the date of DHS’ facsimile notice to Contractor. Within 30 days of DHS’ receipt of Contractor’s Corrective Action plan, DHS shall approve the Corrective Action plan or request revisions. Within 15 days after receipt of a request for revisions to the Corrective Action plan, Contractor shall submit a revised Corrective Action plan for DHS approval.
.2 Timely, Complete and Accurate Data Submission Contractor shall ensure that the Encounter-level data submitted to DHS are timely, complete and accurate and in compliance with the requirements of DHS’ most recent Managed Care Data Element Dictionary. Upon written notice by DHS that Encounter data is insufficient or inaccurate, Contractor shall ensure that corrected data is submitted within 15 calendar days.
Encounter Data Submittal. Contractor shall implement policies and procedures for ensuring the complete, accurate, and timely submission of encounter data for all services for which Contractor has incurred any financial liability, whether directly or through Subcontracts or other arrangements. Encounter data shall include data elements specified in CDHS’ most recent Managed Care Data Element Dictionary and all existing Policy Letters related to encounter data reporting. Contractor shall require subcontractors and non-contracting providers to provide encounter data to Contractor, which allows the Contractor to meet their administrative functions and the requirements set forth in this section. Contractor shall have in place mechanisms, including edits and reporting systems sufficient to assure encounter data is complete and accurate prior to submission to CDHS. Contractor shall submit encounter data to CDHS on a monthly basis in the form and manner specified in CDHS’ most recent Managed Care Data Element Dictionary and all existing Policy Letters related to encounter data reporting. Upon written notice by CDHS that the encounter data is insufficient or inaccurate, Contractor shall ensure that corrected data is resubmitted within 15 calendar days of receipt of CDHS’ notice. Upon Contractor’s written request, CDHS may provide a written extension for submission of corrected encounter data.
