Encounter Data. Any Contractor accessing payments for services through the Global Commitment to Health Waiver and Vermont Medicaid programs must provide encounter data to the Agency of Human Services and/or its departments and ensure that it can be linked to enrollee eligibility files maintained by the State.
Encounter Data. Any Grantee accessing payments for services through the Global Commitment to Health Waiver and Vermont Medicaid programs must provide encounter data to the Agency of Human Services and/or its departments and ensure that it can be linked to enrollee eligibility files maintained by the State.
Encounter Data means information reflecting a face-to-face meeting or other billable service furnished by a provider to a person served through the Iowa Plan. Medicaid encounter data must be submitted by the contractor to the department in an electronic format specified by the department.
Examples of Encounter Data in a sentence
Encounter data must be accurate and include all services furnished to a Covered Person, including capitated provider’s data and rendering provider information.
Encounter data must be provided within the timeframes specified and in a form that meets United and State requirements.
Encounter data must be provided within the timeframes specified and in a form that meets Subcontractor, Health Plan and State requirements.
Encounter data must be accurate and include all services furnished to a Medicaid Managed Care Member, including capitated provider’s data and rendering provider information.
Encounter data must be provided within the timeframes specified and in a form that meets United requirements.
More Definitions of Encounter Data
Encounter Data means encounter information, data and reports for Covered Services provided to a Member that meets the requirements for Clean Claims.
Encounter Data means records of health care services submitted as electronic data files created by the Contractor’s system in the standard 837 format and the National Council for Prescription Drug Programs (NCPDP) Batch format.
Encounter Data. MCPs indicated whether an encounter is sub-capitated and “shadow priced” at the detail and header level, depending on how the encounter was paid. In the payment arrangement field (‘CDE_PAY_ARR’), code ‘05’ indicates sub-capitated arrangements. This field was used to separate sub-capitated encounter data from the non-sub-capitated encounter data. The MCPs provided additional information related to sub-capitated services through their CY 2018 MCP Survey submissions. These submissions provide insight into areas where a sub-capitated arrangement is present, yet the claims are not “shadow priced” in the submitted encounter data. We relied on this information for the purpose of properly identifying sub-capitated MCP encounter data.
Encounter Data means information documenting a service to an Enrollee.
Encounter Data means the record submitted to CMS about an enrollee receiving any item(s) or service(s) provided through Medicaid or Medicare under a prepaid, capitated, or any other risk based payment methodology. Encounter Data records are maintained in the CMS Encounter Data System (EDS).
Encounter Data. MCPs indicated whether an encounter is sub-capitated and “shadow priced” at the detail and header level, depending on how the encounter was paid. In the payment arrangement field (‘CDE_PAY_ARR’), code ‘05’ indicates sub- capitated arrangements. This field was used to separate sub-capitated claims from the non-sub-capitated encounter data.
Encounter Data means the compilation of data elements, as specified by the Department in written notice to Contractor, identifying an Encounter that includes information similar to that required in a claim for Fee-For-Service payment under the HFS Medical Program.