Common use of Claims Data Clause in Contracts

Claims Data. Assumption: Aggregation of table data into claims records will be needed. Professional and pharmacy claims records 400 Pharmacy adjudicated claims are received weekly from VT Pharmacy Benefit Management (PBM) system and are paid in MMIS in the weekly financial cycle; receiving these from MMIS helps ensure linkage of PBM claims to financial reporting. Institutional & institutional crossover (Medicare) claims records 400 Dental claims records 150