Common use of Encounter Data Reconciliation Clause in Contracts

Encounter Data Reconciliation. Pharmacy The encounters submitted by the PHP shall reconcile to at least ninety-eight percent (98%) of paid claims amounts reported on financial reports. The paid amounts on submitted individual encounter records compared to the paid claims amounts reported on financial reports submitted to the Department by the PHP. Daily $1,000 per day

Encounter Data Reconciliation. Pharmacy The encounters submitted by the PHP shall reconcile to at least ninety-ninety- eight percent (98%) of paid claims amounts reported on financial reportsreports within thirty (30) Calendar Days or at least ninety-nine percent (99.8%) of paid claim amounts reported on financial reports within sixty (60) Calendar Days. For purposes of this standard, pharmacy encounters only include NCPDP encounters. The paid amounts on submitted individual encounter records compared to the paid claims amounts reported on financial reports submitted to the Department by the PHP. Daily Monthly $1,000 100,000 per daymonth

Encounter Data Reconciliation. Pharmacy The encounters submitted by the PHP shall reconcile to at least ninety-eight percent (98%) of paid claims amounts reported on financial reportsreports within thirty (30) Calendar Days or at least ninety-nine point eight (99.8%) of paid claim amounts reported on financial reports within sixty (60) Calendar Days. The paid amounts on submitted individual encounter records compared to the paid claims amounts reported on financial reports submitted to the Department by the PHP. Daily Monthly $1,000 100,000 per daymonth