Encounter Reporting the collection and reporting of encounter data to the Department of Health Services is submitted via the LTCare Information Exchange System (IES). Encounter data are detailed records of health care services or items that have been provided to MCO members. Encounter data are used for rate setting and program analysis.
Encounter Reporting the collection and reporting of encounter data to the Department of Health Services. Encounter data are detailed records of health care services or items that have been provided to MCO members. Encounter data are used for rate setting and program analysis.
Encounter Reporting the collection and reporting of encounter data to the Department of Health Services is submitted via the Long-Term Care Information Exchange System (IES). Encounter data are detailed records of services or items that have been provided to IRIS participants.
Encounter Reporting. For HMO Members for which PPG receives Capitation under this Agreement. PPG shall provide FHS encounter data in accordance with the Operations Manual, via magnetic media for all Contracted Services provided to HMO Members during a calendar month within thirty (30) days of the end of the month in which such services are rendered. PPG shall also promptly provide FHS with all corrections to and revisions of such encounter data. FHS and PPG shall work in good faith to eliminate hard copy reports and transition to Electronic Data Interface (EDI) exchange of information.
Encounter Reporting.
2.17.1 The Contractor must meet any diagnosis and/or encounter reporting requirements that are in place for Medicare Advantage plans, as may be updated from time to time. Furthermore, the Contractor’s Systems shall generate and transmit Encounter Data files to CMS according to additional specifications as shall be provided by CMS or the Department and updated from time to time. The Contractor shall maintain processes to ensure the validity, accuracy and completeness of the Encounter Data in accordance with the standards specified in this section. CMS and the Department will provide technical assistance to the Contractor for developing the capacity to meet encounter reporting requirements.
Encounter Reporting. Submission of encounters by a fiscal employer agent (FEA) to the Department, using the format and system specified by the Department.
Encounter Reporting. When applicable, Subcontractor is required to provide encounter and other related data in compliance with the ADHS/DBHS Provider Manual-Cenpatico Edition in a form acceptable to Cenpatico, ADHS, AHCCCS, and CMS (when applicable). This data shall include, but is not limited to, outcomes and performance data, within such timeframes specified therein. Subcontractor agrees that timely submission of such data shall be a prerequisite to Subcontractor’s right to compensation under the Agreement. If Subcontractor fails to provide the encounter data as required and such failure results in fines, penalties or other monetary damages being imposed on Cenpatico, Subcontractor is required to pay Cenpatico any and all such costs incurred by Cenpatico. Subcontractor agrees that subject to applicable law, in Cenpatico’s discretion, Cenpatico may utilize and disclose all data submitted by Subcontractor pursuant to this section. Subcontractor shall have the right, subject to applicable law and upon reasonable advance notice to Cenpatico, to inspect such data for Subcontractor and, upon notice to Cenpatico, to correct errors and omissions in such data.
Encounter Reporting. General The Contractor must meet any diagnosis and/or encounter reporting requirements that are in place for Medicare Advantage plans and Medicaid managed care organizations including the EOHHS Encounter Data Set Request, as may be updated from time to time. Furthermore, the Contractor’s Systems shall generate and transmit Encounter Data files according to additional specifications as may be provided by CMS or EOHHS and updated from time to time. The Contractor shall maintain processes to ensure the validity, accuracy and completeness of the Encounter Data in accordance with the standards specified in this section. CMS and EOHHS will provide technical assistance to the Contractor for developing the capacity to meet encounter reporting requirements.
Encounter Reporting. The Contractor must meet any diagnosis or encounter reporting requirements required by federal law or that may be determined necessary by EOHHS.
Encounter Reporting. For Members for which RPO receives Capitation Compensation under this Agreement, RPO shall provide Texas HealthSpring with the Member/RPO Provider encounter information, via personal computer diskette, magnetic tape or electronic transmission in a mutually agreed upon format for each encounter with a Member during a calendar month. Such electronic encounter information materials shall be complete, accurate and provided to Texas HealthSpring by the fifteenth (15th) day of the month following the month in which the encounter occurred. Additionally, RPO shall promptly provide Texas HealthSpring with all corrections to and revisions of such encounter data.
