Encounter File definition

Encounter File means an electronically formatted record of multiple Encounters using data elements as established by the Department. Encounter Technical Workgroup means a workgroup composed of representatives from Contractor, the Department, the Fiscal Agent, and External Quality Review Organization (EQRO).
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Encounter File means the codified output of one or more of the aforementioned services performed by such Provider to an Enrollee, resulting in claim transaction(s) to be processed.
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Examples of Encounter File in a sentence

  • Threshold edits, those which will enable the Encounter File to be accepted, and informational editing, those which enable the Encounter to be processed, shall apply.

  • Encounter File transmissions that exceed a five percent (5%) threshold error rate (total Claims/documents in error equal to or exceed five percent (5%) of Claims/documents records submitted) will be subject to penalties as provided in the Contract.

  • Encounter File transmissions with a threshold error rate not exceeding five percent (5%) will be accepted and processed by the Department.

  • The Encounter File shall be received and processed by the Department’s Fiscal Agent and shall be stored in the existing MMIS.

  • This Encounter File shall be completed according to the requirements provided by the Department, including use of specified EPSDT procedure codes and referral codes.

  • Failure of the Contractor to submit the Encounter File within five (5) business days from the scheduled submission due date shall result in an assessment of $500.00 per day late fee.

  • An Encounter File that exceeds a five (5%) percent threshold error rate shall be assessed a per Encounter File error fee of $500.00.

  • An Encounter File is due on a weekly basis and shall be considered late if not received after five (5) business days from the weekly submission due date.

  • Encounter File transmissions with a thresho ld error rate not exceeding five percent (5%) will be accepted and processed by the Department.

Related to Encounter File

  • Master File has the meaning set forth in the CAISO Tariff.

  • 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.

  • Drug Master File or “DMF” is described in 21 C.F.R. Part 314.420. A DMF is a submission to the FDA that may be used to provide confidential detailed information about facilities, processes, or articles used in the manufacturing, processing, packaging, and storing of one or more human drugs.

  • Encounter means a record of a medically-related service rendered by an AHCCCS-registered provider to a member enrolled with a contractor on the date of service.

  • Data File means a single record or collection of data records that are logically related to each other, and are handled as a unit;