Common use of Encounter Data Accuracy Clause in Contracts

Encounter Data Accuracy. Medical The PHP shall meet or exceed a ninety-eight percent (98%) approval acceptance rate for Medical claims. For purposes of this standard, medical encounters include 837-P encounters and 837-I encounters. A paid claim submitted as an encounter which passes all validation edits (SNIP level 1-7 and State specific validations) and is accepted by the Department. Monthly $25,000 per month

Encounter Data Accuracy. Medical The PHP shall meet or exceed a ninety-eight percent (98%) approval acceptance rate for Medical claims. For purposes of this standard, medical encounters include 837-P encounters and 837-I encounters. claims A paid claim submitted as an encounter which passes all validation edits (SNIP level 1-7 and State specific validations) and is accepted by the Department. Monthly $25,000 per month