encounter data

encounter data

information showing use of provider services by health plan enrollees that is used to develop cost profiles of a particular group of enrollees and then to guide decisions about or provide justification for the maintenance or adjustment of premiums.

encounter data

Lab medicine Pt-related data–EKGs, CXRs, H&P–generated at the time he/she is seen in a health care setting.
References in periodicals archive ?
The healthcare industry is more than 200 percent more likely to encounter data theft and experiences over 300% more security incidents and attacks than the average industry.
Amid such criticism, the Office of Inspector General, in its 2014 Work Plan vowed to review the extent to which CMS is verifying the accuracy of MA encounter data and risk adjustment reporting.
Conference Focus: How patient encounter data, including ER visit and hospital discharge reports are used by embedded case managers to target high-risk patients; Critical skills needed for embedded case managers, including the experience Caldwell seeks when recruiting for this role; Impact embedded case managers in Caldwell's primary care practices have had on its 30-day readmission rates; engaging physicians in work flow processes to support embedded case management, including details on how Caldwell maximizes transitional care management codes; and case load management strategies, protocols and outreach strategies employed by the embedded case managers.
For example, the exchange of encounter data with Palmetto, a CMS vendor for the One Care program, is currently under development and is expected to use this secure data network.
Although CIVHC has the data from managed behavioral health organizations (MBHOs), it's encounter data and not in the warehouse with other all payer claims, said Sonn.
141) Developments include engaging an External Quality Review Organization ("EQRO"), creating and reporting of Healthcare Effectiveness Data and Information Set ("HEDIS") measures and performance measures by MCOs, implementation of a performance improvement strategy, improving performance improvement projects ("PIPs") in coordination with the EQRO and within each MCO, creating a new fiscal agent system, and creating the Medicaid Encounter Data System.
On the top, basic encounter data, including links to more information about the attending physician
The system architecture is shaped to simplify the recording of all patient encounter data whether in Primary Care, Community Care or even as an Outpatient/Inpatient in Secondary (Hospital/Acute) Care environments.
While many organizations do not encounter data rates that lead to oversubscription, it is still an issue to consider when planning the use of aggregation taps or mirror/SPAN ports.
To the Editor: The global Military Health System maintains electronic inpatient (Standard Inpatient Data Record, SIDR) and outpatient (Standard Ambulatory Data Record, SADR) clinical diagnostic coded data generated by the Department of Defense Composite Health Care System (CHCS), an electronic system that tracks and stores administrative and other patient encounter data.
Your network organization will need to match claims data with clinical encounter data to answer these questions, but it should be able to do this analysis as part of its fee for standard results reporting.
Although we did not study NPPD costs, a general caution is in order: NPPD costs should not be added to costs in encounter data.