Common use of Rejected Encounters Clause in Contracts

Rejected Encounters. Encounters submitted to ODJFS that are incomplete or inaccurate are rejected and reported back to the MCPs on the Exception Report. If an MCP does not resubmit rejected encounters, ODJFS’ encounter data set will be incomplete.

Appears in 5 contracts

Sources: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Centene Corp), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)

Rejected Encounters. Encounters submitted to ODJFS that are incomplete or inaccurate are rejected and reported back to the MCPs on the Exception Report. If an MCP does not resubmit rejected encounters, ODJFS’ encounter data set will be incomplete. Measure 1: The percentage of encounters submitted to ODJFS that are rejected. The measure will be calculated per MCP.

Appears in 3 contracts

Sources: Provider Agreement (Molina Healthcare Inc), Provider Agreement (Wellcare Health Plans, Inc.), Provider Agreement (Molina Healthcare Inc)

Rejected Encounters. Encounters submitted to ODJFS that are incomplete or inaccurate are rejected and reported back to the MCPs on the Exception Report. If an MCP does not resubmit rejected encounters, ODJFS' encounter data set will be incomplete.

Appears in 1 contract

Sources: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)

Rejected Encounters. Encounters submitted to ODJFS that are incomplete or inaccurate are rejected and reported back to the MCPs on the Exception Report. If an MCP does not resubmit rejected encounters, ODJFS’ encounter data set will be incomplete. Measure 1 only applies to MCPs that have had Medicaid membership for more than one year.

Appears in 1 contract

Sources: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)

Rejected Encounters. Encounters submitted to ODJFS that are incomplete or inaccurate are rejected and reported back to the MCPs on the Exception Report. If an MCP does not resubmit rejected encounters, ODJFS' encounter data set will be incomplete. Measure 1: The percentage of encounters submitted to ODJFS that are rejected. The measure will be calculated per MCP (i.e., to include all counties serviced by the MCP).

Appears in 1 contract

Sources: Ohio Medical Assistance Provider Agreement for Managed Care Plan Abd Eligible Population (Wellcare Health Plans, Inc.)

Rejected Encounters. Encounters submitted to ODJFS that are incomplete or inaccurate are rejected and reported back to the MCPs on the Exception Report. If an MCP does not resubmit rejected encounters, ODJFS’ encounter data set will be incomplete. Measure 1: The percentage of encounters submitted to ODJFS that are rejected. The measure will be calculated per MCP (i.e., to include all counties serviced by the MCP).

Appears in 1 contract

Sources: Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)

Rejected Encounters. Encounters submitted to ODJFS that are incomplete or inaccurate are rejected and reported back to the MCPs on the Exception Report. If an MCP does not resubmit rejected encounters, ODJFS' encounter data set will be incomplete. Measure 1: The percentage of encounters submitted to ODJFS that are rejected. The measure will be calculated per MCP (i.e., to include all counties serviced by the MCP). Appendix L

Appears in 1 contract

Sources: Provider Agreement (Wellcare Health Plans, Inc.)