Operator Reporting Requirements. Ambulatory Care Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager, Incident Review Committee, AH, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Contract Manager Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility Infection Prevention and Control, Contract Manager Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule “D”, Appendix 2) Infection Prevention and Control, Contract Manager Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager and AH Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and Annually Facility Contract Manager follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Volume of Insured Services provided, by category Annually Facility Contract Manager Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility Contract Manager Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility Contract Manager Change of Ownership or Control Immediately Facility Contract Manager Conflicts of Interest Immediately Written Notification Contract Manager Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records Contract Manager Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA.
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Operator Reporting Requirements. Ambulatory Care Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager, Incident Review Committee, AH, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Contract Manager Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility Infection Prevention and Control, Contract Manager Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule “D”, Appendix 2) Infection Prevention and Control, Contract Manager Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager and AH Documented evidence of patient satisfaction program, including documented evidence of Client Annually Facility Contract Manager Concerns Resolution Process and Annually Facility Contract Manager follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Volume of Insured Services provided, by category Annually Facility Contract Manager Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility Contract Manager Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility Contract Manager Change of Ownership or Control Immediately Facility Contract Manager Conflicts of Interest Immediately Written Notification Contract Manager Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records Contract Manager Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA.
Appears in 1 contract
Samples: Agreement
Operator Reporting Requirements. Ambulatory Care Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager, Incident Review Committee, AH, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Contract Manager Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility Infection Prevention and Control, Contract Manager Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule “D”, Appendix 2) Infection Prevention and Control, Contract Manager Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager and AH Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and Annually Facility Contract Manager follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Volume of Insured Services provided, by category Annually Facility Contract Manager Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility Contract Manager Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility Contract Manager Change of Ownership or Control Immediately Facility Contract Manager Conflicts of Interest Immediately Written Notification Contract Manager Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records Contract Manager Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA. Schedule “D” Appendix 1 National Ambulatory Care Reporting System (NACRS) For Mandatory Reporting to Alberta Health Clinic Identifying Information • Delivery organization • Program number As defined by AHS Client Identifying Information • Client name Optional – Not Reported beyond AHS • AB Personal Health Number (PHN) 9 digit number • Unique Lifetime Identifier (ULI) Assigned by Alberta Health • Clinic chart number Unique identifier established by clinic • Postal code • Birth date YYYYMMDD • Gender Service Information • Service Visit Date • Mode of service Face-to face, telephone, etc. • Responsibility for payment Used to exclude federal govt., WCB, etc. • Main and secondary diagnoses ICD10-CA codes • Main and other interventions and attributes CCI procedure codes and attributes • Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) • Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) • Doctor name and identifier Physician specific information • Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance • Institution from and institution to Used when a Client is transferred from or to another acute care facility • Visit disposition Discharged, admitted, left without being seen, etc. Schedule “D” Appendix 2 Additional Elements Required for Data Management (XXX) Client Identifying Information • Province Client’s Home Province AB, BC, SK, MB, NL, PE, NS, NB, QC, ON, NT, YT, NU, US, OC (Other Country), NR (Unsp. Non-resident) Service Information • Facility Code AHS provided code that indicates service being provided. • Facility Fee Dollar value of service being provided • Alberta Health Physician Fee Billing Code Alberta Health Physician Service Fee code that further defines facility code Regional standard format and submission method remains as is via excel file and email. NOTE: Submission method may be adjusted in accordance with security standards of AHS. Schedule “D” Appendix 3
Appears in 1 contract
Samples: Agreement
Operator Reporting Requirements. Ambulatory Care Classification System and Billing Information Reporting Requirements are appended here as Appendix 1 Annual Reporting Requirements Template is appended here as Appendix 3 INFORMATION REPORTING FREQUENCY DATA SOURCE/ FORMAT REPORTING TO: Client / Procedure Information National Ambulatory Care Reporting System (NACRS) and Billing Information Requirements, as per Appendix 1 At a minimum of at least monthly within 15 days after month-end or with each invoice Submission method and standard format as defined by AHS Health Records (NACRS) Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager, Incident Review Committee, AH, CPSA Operators may be requested to submit a copy of each anesthetic record, operating room nursing record and recovery room record, during the Term. At request Facility Requestor authorized by Contract Manager Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Immediately Facility Infection Prevention and Control, Contract Manager Aggregate Info Complications (intra-operative and postoperative, including mortality rates and nosocomial infections, reported by procedure type) Annually Standard format provided by AHS (Schedule “D”, Appendix 2) Infection Prevention and Control, Contract Manager Reportable Incidents In accordance with timeframes set out in Schedule “D”, Appendix 4 In accordance with process described in Schedule “D”, Appendix 4 Contract Manager and AH Documented evidence of patient satisfaction program, including documented evidence of Client Concerns Resolution Process and Annually Facility Contract Manager follow-up; linked to AHS internal concerns resolution process; reports of patient satisfaction surveys Summary of Facility participation in AHS Research and Teaching Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Summary of Facility participation in AHS Quality Assurance and Monitoring Activities Annually Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Statement of Revenues from the sale of Enhanced Medical Goods or Services, or Non-Medical Goods or Services Within thirty (30) days of: the end of each Fiscal Year and the end of the Term Standard format provided by AHS (Schedule D, Appendix 2) Contract Manager Unplanned hospital admissions from Facility to AHS acute care facility Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Post operative hospital emergency department visits and/or admissions Immediate reporting of individual incident; annual reporting of aggregate data Standard format provided by AHS (Schedule “D”, Appendix 2) Contract Manager and AH Volume of Insured Services provided, by category Annually Facility Contract Manager Other Reports of CPSA Accreditation reviews, or changes to Accreditation status Immediately Facility Contract Manager Documented evidence of comprehensive general liability insurance, as per Agreement Annually Facility Contract Manager Change of Ownership or Control Immediately Facility Contract Manager Conflicts of Interest Immediately Written Notification Contract Manager Documented evidence of preventative maintenance program and equipment monitoring, including emergency equipment and laser equipment Annually Reports from external service technicians required; policy and performance records Contract Manager Regional standard format remains as is via Excel file. Submission method must be in accordance with the security standards of AHS and the HIA.. Schedule “D” Appendix 1 National Ambulatory Care Reporting System (NACRS) For Mandatory Reporting to Alberta Health Clinic Identifying Information • Delivery organization • Program number As defined by AHS Client Identifying Information • Client name Optional – Not Reported beyond AHS • AB Personal Health Number (PHN) 9 digit number • Unique Lifetime Identifier (ULI) Assigned by Alberta Health • Clinic chart number Unique identifier established by clinic • Postal code • Birth date YYYYMMDD • Gender
Appears in 1 contract
Samples: Agreement
