Encounter File definition

Encounter File means an electronically formatted record of multiple Encounters using data elements as established by the Department. Encounter Technical Workgroup means a workgroup composed of representatives from Contractor, the Department, the Fiscal Agent, and External Quality Review Organization (EQRO).
Encounter File means the codified output of one or more of the aforementioned services performed by such Provider to an Enrollee, resulting in claim transaction(s) to be processed.

Examples of Encounter File in a sentence

  • Threshold edits, those which will enable the Encounter File to be accepted, and informational editing, those which enable the Encounter to be processed, shall apply.

  • The Encounter File shall be received and processed by the Department’s Fiscal Agent and shall be stored in the existing MMIS.

  • Encounter File transmissions that exceed a five percent (5%) threshold error rate (total Claims/documents in error equal to or exceed five percent (5%) of Claims/documents records submitted) will be subject to penalties as provided in the Contract.

  • If Xxxxxx exercises his limited right to revoke, or if the release provisions of Section IV are held invalid for any reason whatsoever, Xxxxxx agrees to return any consideration received under the terms of this Agreement and that Company is released from any obligations under this Agreement.

  • An Encounter File that exceeds a five (5%) percent threshold error rate shall be assessed a per Encounter File error fee of $500.00.

  • Failure of the Contractor to submit the Encounter File within five (5) business days from the scheduled submission due date shall result in an assessment of $500.00 per day late fee.

  • An Encounter File is due on a weekly basis and shall be considered late if not received after five (5) business days from the weekly submission due date.

  • This Encounter File shall be completed according to the requirements provided by the Department, including use of specified EPSDT procedure codes and referral codes.

  • The following assumptions were made: A paid/accepted PROMISe encounter may be adjusted or voided by the BH-MCO. An adjustment is always Frequency Code 7. Successful adjustments are written to a Paid Encounter File.

  • All Encounter File Hold Requests must be received no later than 12:00 Noon one day prior to the scheduled PMMIS Encounter processing date.

Related to Encounter File

  • Master File has the meaning set forth in the CAISO Tariff.

  • 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.

  • Drug Master File or “DMF” is described in 21 C.F.R. Part 314.420. A DMF is a submission to the FDA that may be used to provide confidential detailed information about facilities, processes, or articles used in the manufacturing, processing, packaging, and storing of one or more human drugs.

  • Encounter means a record of a medically-related service rendered by an AHCCCS-registered provider to a member enrolled with a contractor on the date of service.

  • Data File means a single record or collection of data records that are logically related to each other, and are handled as a unit;

  • Death master file means the United States social security administration’s death master file or any other database or service that is at least as comprehensive as the United States social security administration’s death master file for determining that a person has died.

  • Servicer File means, collectively, all documents, records and copies pertaining to a Mortgage Loan which are required to be included in the related Servicer File pursuant to Section 3 thereof.

  • Batch means a specific quantity of Product that is intended to be of uniform character and quality, within specified limits, and is produced during the same cycle of Manufacture as defined by the applicable Batch Record.

  • HEPA filter means high-efficiency particulate air filters that are rated to achieve a minimum initial particle-removal efficiency of 99.97 per cent using ASTM F 1471– 93 or equivalent standard;

  • Adverse drug reaction means any undesirable or unexpected medication related event that requires discontinuing a medication or modifying the dose, requires or prolongs hospitalization, results in disability, requires supportive treatment, is life-threatening or results in death, results in congenital anomalies, or occurs following vaccination.

  • Batch Record means the production record pertaining to a Batch.

  • Database application form means the application form required by the Hibiscus Coast Municipality to be filled in by the successful tenderer, following the award of the contract, for inclusion on the HCM database before payment is made.

  • Review Package A package of documents consisting of a memorandum outlining the analysis and recommendation (in accordance with the Servicing Standard) of the Master Servicer or the Special Servicer, as the case may be, with respect to the matters that are the subject thereof, and copies of all relevant documentation.

  • Prescription drug order means an original or new order from a practitioner for drugs, drug-related devices or treatment for a human or animal, including orders issued through collaborative care agreements. Lawful prescriptions result from a valid practitioner-patient relationship, are intended to address a legitimate medical need, and fall within the prescribing practitioner's scope of professional practice;

  • Drug abuse means any pattern of pathological use of drugs that causes impairment in social or occupational functioning, or that produces physiological dependency evidenced by physical tolerance or by physical symptoms when it is withdrawn.

  • Case file means a record that is assembled and maintained for each application approved for state cost sharing.

  • Drug means (i) articles or substances recognized in the official United States Pharmacopoeia

  • DMF means a drug master file and all equivalents, and related proprietary dossiers, in any country or jurisdiction in the Territory (including any active substance master file in the EMA) for API submitted or to be submitted by a Party to Regulatory Authorities.

  • health and safety file means a file, or other record containing the information in writing required by these Regulations "health and safety plan" means a site, activity or project specific documented plan in accordance with the client's health and safety specification;

  • Death master file match means a search of the death master file that results in a match of the social security number or the name and date of birth of an insured, an annuity owner or a retained asset account holder.[PL 2017, c. 129, §1 (NEW).]

  • CMSA Loan Setup File means the report substantially in the form of, and containing the information called for in, the downloadable form of the "Loan Setup File" available as of the Closing Date on the CMSA Website, or such other form for the presentation of such information and containing such additional information as may from time to time be approved by the CMSA for commercial mortgage securities transactions generally.

  • Adverse Event means any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and that does not necessarily have a causal relationship with the treatment. An adverse event can therefore be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not related to the medicinal product.

  • Drug test means a test designed to detect the illegal use of a controlled substance.

  • HHSC means the Texas Health and Human Services Commission. “Health and Human Services” or “HHS” includes HHSC and DSHS.

  • Root Cause Analysis Report means a report addressing a problem or non-conformance, in order to get to the ‘root cause’ of the problem, which thereby assists in correcting or eliminating the cause, and prevent the problem from recurring.

  • CREFC® Special Servicer Property File format substantially in the form of and containing the information called for therein for the Mortgage Loans, or such other form for the presentation of such information as may be approved from time to time by the CREFC® for commercial mortgage securities transactions generally.