Common Contracts

1 similar Healthcare Claims Data Base Data Submission and Use Agreement contracts

Frequently Asked Questions Data Submission Guide
Healthcare Claims Data Base Data Submission and Use Agreement • March 13th, 2018

Frequently Asked Questions for the Data Submission Guide # Question Answer 1. Where can I find the HCCD rule at DE ADC 1103.2.0 which shall supersede the definitions in this document? On the State of Delaware website: http://regulations.delaware.gov/register/j uly2017/proposed/21%20DE%20Reg%209%2007-01-17.htm 2. Do the mandatory payers report data based on covered lives in the contract or based on covered lives that are Delaware residents within thepayer contracts? Delaware residents’ data. Please see the Insurance Type table that describes contract types. Claims data from aDelaware resident would be included. 3. Are the claims data based on paid claims or incurred claims? Paid claims, those adjudicated and paid. 4. What is the consequence if a mandatory payer were to violate this regulation, 16 Del.C. Ch. 103? ? 5. Can we submit files prior to the due dates in the DSG? ? 6. Are submitted claims dates based on Claim date or Date of Service date? ?

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