Common use of Health Information System Clause in Contracts

Health Information System. ‌ Insurer shall maintain a health information system that collects, analyzes, integrates and reports data, including utilization, claims, and Grievances and Appeals. At a minimum, Insurer’s health information system must: a. Comply with Section 6504(a) of the Affordable Care Act; b. Collect data on Enrollee and Provider characteristics; c. Collect data on all services provided to Enrollees through an encounter data system, including data sufficient to identify the Provider who delivers any item or service to Enrollees; d. Ensure that data received from Providers is accurate and complete by: i. Verifying the accuracy and timeliness of reported data, including data reported by Providers with a capitated payment arrangement; ii. Screening the data for completeness, logic and consistency; and iii. Collecting data from Providers in standardized formats to the extent feasible and appropriate. e. Make all collected data available to FHKC, AHCA and CMS, upon request.