Performing CARA Data Processing & Management Sample Clauses

Performing CARA Data Processing & Management. For each of the CARA Processes and for each Member Population, Inovalon will undertake the following CARA processing services based upon clinical best practices, designated cost-benefit thresholds, and in accordance with CMS HCC technical specifications (as may be revised by CMS from time to time): i. Providing assistance to designated Client personnel in the provision of Health Plan Data Sets to Inovalon via secure FTP portal (or alternate method as mutually agreed to between Inovalon and Client); ii. Coordinating and leading native data mapping conference calls with designated Client personnel to resolve data inconsistencies revealed during Inovalon data validation processes; iii. Implementing data mapping processes to facilitate import of Health Plan Data Sets; iv. Establishing historical and current rate factors for each Member based upon member demographics and relative HCCs known to Client as provided within Health Plan Data Sets; v. Establishing historical and current member capitation rates based upon member demographics and HCCs known to Client as provided within Health Plan Data Set; vi. Applying Inovalon’s CARA processes to Health Plan Data Sets pertaining to the respective Process DOS Period to identify candidate Target CEDIs; vii. Cross-referencing identified candidate Target CEDIs against each respective member’s known Member Disease State Profile to identify previously unsubstantiated disease states (the “Newly Identified CEDI Disease States”); viii. Filtering candidate Target CEDIs that have been found to represent Newly Identified CEDI Disease States against established Client CARA Thresholds to identify members eligible for follow-up medical record review investigation (the “Eligible Target CEDI Members” and their respective CEDIs, “Eligible Target CEDIs”); ix. Formulating CARA Medical Record Chase Data Sets consisting of relevant Eligible Target CEDI Members; x. Prioritize CARA Member Medical Records within CARA Medical Records Chase Data Sets via the application of Inovalon’s ChaseWise medical record chase order classification logic; xi. Coordinate CARA Medical Record Review (MRR) Data Exchanges & Integration as outlined within Section 4(c) below; xii. Providing comprehensive reporting of CEDI Members, associated medical record review findings, financial impact results, and information on coding improvement opportunities to Client; Statement of Work #4 –Capitation Risk Adjustment (CARA®) Scope of Services xiii. Generate and provide to C...
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Related to Performing CARA Data Processing & Management

  • Data Processing In this clause:

  • Data Processing Agreement The Data Processing Agreement, including the Approved Data Transfer Mechanisms (as defined in the Data Processing Agreement) that apply to your use of the Services and transfer of Personal Data, is incorporated into this Agreement by this reference. Each party will comply with the terms of the Data Processing Agreement and will train its employees on DP Law.

  • Verizon Operations Support Systems Verizon systems for pre- ordering, ordering, provisioning, maintenance and repair, and billing.

  • STATEWIDE CONTRACT MANAGEMENT SYSTEM If the maximum amount payable to Contractor under this Contract is $100,000 or greater, either on the Effective Date or at any time thereafter, this section shall apply. Contractor agrees to be governed by and comply with the provisions of §§00-000-000, 00-000-000, 00-000-000, and 00- 000-000, C.R.S. regarding the monitoring of vendor performance and the reporting of contract information in the State’s contract management system (“Contract Management System” or “CMS”). Contractor’s performance shall be subject to evaluation and review in accordance with the terms and conditions of this Contract, Colorado statutes governing CMS, and State Fiscal Rules and State Controller policies.

  • Processing operations The personal data transferred will be subject to the following basic processing activities (please specify):

  • Processing Grievances The Association Representative involved and the grieving supervisor shall not leave work or disrupt departmental routine to discuss grievances without first requesting permission from his/her immediate superior, which shall not be unreasonably withheld. The Association Representative and the grieving supervisor shall be allowed a reasonable amount of time during working hours while on the Appointing Authority's premises when a grievance is investigated or presented in Steps 1 and 2.

  • Customer Services Customer Relationship Management (CRM): All aspects of the CRM process, including planning, scheduling, and control activities involved with service delivery. The service components facilitate agencies’ requirements for managing and coordinating customer interactions across multiple communication channels and business lines. Customer Preferences: Customizing customer preferences relative to interface requirements and information delivery mechanisms (e.g., personalization, subscriptions, alerts and notifications).

  • Account Management 15.1 The Contractor is required to provide a dedicated Strategic Account Manager who will be the main point of contact for the Authority. The Strategic Account Manager will:  Attend quarterly, or as otherwise agreed, review meetings with the Authority, in person at the Authority’s premises or other locations as determined by the Authority  Attend regular catch-up meetings with the Authority, in person or by telephone/videoconference  Resolve any on-going operational issues which have not been resolved by the Contractor or Account Manager(s) and therefore require escalation  Ensure that the costs involved in delivering the Framework are as low as possible, whilst always meeting the required standards of service and quality. 15.2 The Contractor is also required to provide a dedicated Account Manager for every Framework Public Body using the Framework, if required by the Framework Public Body. The service to be provided will be agreed with each Framework Public Body and may include:  regular review meetings, which may be in person at the Framework Public Bodies’ premises, by video-conference, webinar or telephone  Regular catch-up meetings/telephone calls to discuss current and on-going issues  Work with the Framework Public Bodies Contract Manager to resolve any on-going operational issues  Work with the Framework Public Body ’s Contract Manager to pro-actively introduce initiatives to:  Create efficiencies in processes  Improve the environmental performance of the contract. 15.3 It is expected that end users will contact the Contractor in the first instance to resolve any operational issues. The Account Manager will act as a point of escalation to be contacted either by end users or by the Framework Public Body’s Contract Manager should there be issues that the Contractor needs to resolve. 15.4 Further details of the roles and responsibilities of the Contractor, Authority and Framework Public Bodies are provided in Schedule 4 – Management Arrangements

  • Configuration Management The Contractor shall maintain a configuration management program, which shall provide for the administrative and functional systems necessary for configuration identification, control, status accounting and reporting, to ensure configuration identity with the UCEU and associated cables produced by the Contractor. The Contractor shall maintain a Contractor approved Configuration Management Plan that complies with ANSI/EIA-649 2011. Notwithstanding ANSI/EIA-649 2011, the Contractor’s configuration management program shall comply with the VLS Configuration Management Plans, TL130-AD-PLN-010-VLS, and shall comply with the following:

  • Financial Management System Subrecipient shall establish and maintain a sound financial management system, based upon generally accepted accounting principles. Contractor’s system shall provide fiscal control and accounting procedures that will include the following: i. Information pertaining to tuition rates, payments, and educational assistance payments; and

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