Encounter Data definition

Encounter Data. Any Contractor accessing payments for services through the Global Commitment to Health Waiver and Vermont Medicaid programs must provide encounter data to the Agency of Human Services and/or its departments and ensure that it can be linked to enrollee eligibility files maintained by the State.

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Encounter Data means information reflecting a face-to-face meeting or other billable service furnished by a provider to a person served through the Iowa Plan. Medicaid encounter data must be submitted by the contractor to the department in an electronic format specified by the department.

Encounter Data means information documenting a service to an Enrollee.

Examples of Encounter Data in a sentence

HHSC will make non-risk payments within a reasonable amount of time after the Encounter reporting period, generally no later than 95 Contractor has processed the Encounter Data.
HHSC will establish base Capitation Rates for the Rate Periods following Rate Period 1 by analyzing historical Encounter Data and financial data.
For providing these drugs to Members, HHSC will make non-risk payments to the MCO based on Encounter Data Contractor during an encounter reporting period.
For drugs dispensed by a pharmacy, the first non-risk payment will cover pharmacy Encounter Data received from the date the drugs are added to the Medicaid and CHIP formularies through the end of that State Fiscal Quarter.
Encounter Data provided by MCO must conform to all HHSC requirements.

More Definitions of Encounter Data

Encounter Data means encounter information, data and reports for Covered Services provided to a Member that meets the requirements for Clean Claims.

Encounter Data means records of health care services submitted as electronic data files created by the Contractor’s system in the standard 837 format and the National Council for Prescription Drug Programs (NCPDP) Batch format.

Encounter Data means certain information required to be submitted to OHA under OAR 410-141-3570 and related to services that were provided to Members regardless of whether the services provided: (i) were Covered Services, non-covered services, or other Health-Related services; (ii) were not paid for; (iii) paid for on a Fee- For-Service or capitated basis; (iii) were performed by a Participating Provider, Non-Participating Provider, Subcontractor, or Contractor; and (iv) were performed pursuant to Subcontractor agreement, special arrangement with a facility or program, or other arrangement.

Encounter Data. MCPs indicated whether an encounter is sub-capitated and “shadow priced” at the detail and header level, depending on how the encounter was paid. In the payment arrangement field (‘CDE_PAY_ARR’), code ‘05’ indicates sub- capitated arrangements. This field was used to separate sub-capitated claims from the non-sub-capitated encounter data.

Encounter Data means the record submitted to CMS about an enrollee receiving any item(s) or service(s) provided through Medicaid or Medicare under a prepaid, capitated, or any other risk based payment methodology. Encounter Data records are maintained in the CMS Encounter Data System (EDS).

Encounter Data means the compilation of data elements, as specified by the Department in written notice to Contractor, identifying an Encounter that includes information similar to that required in a claim for Fee-For-Service payment under the HFS Medical Program.

Encounter Data means information, data, and/or reports about clinical encounters and Covered Services rendered and supported by documentation in the Covered Person’s medical record.

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