06/19/2024 |
3.27.0 |
PRV-6-002-2 |
UPDATE |
Priority |
N/A |
Medium |
06/19/2024 |
3.27.0 |
PRV-6-002-2 |
UPDATE |
Category |
N/A |
Provider identifiers |
06/19/2024 |
3.27.0 |
PRV-6-002-2 |
UPDATE |
For ta comprehensive |
No |
TA- Inferential |
06/19/2024 |
3.27.0 |
PRV-6-002-2 |
UPDATE |
For ta inferential |
No |
Yes |
06/19/2024 |
3.27.0 |
PRV-6-002-2 |
UPDATE |
Ta min |
|
0 |
06/19/2024 |
3.27.0 |
PRV-6-002-2 |
UPDATE |
Ta max |
|
0.1 |
06/02/2023 |
3.8.0 |
PRV-6-002-2 |
UPDATE |
Specification |
STEP 1: Provider enrolled on the last day of DQ report monthDefine the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria:1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 2: Provider attributes are active on last day of DQ report monthOf the providers that meet the criteria from STEP 1, further refine the population using segment PROVIDER-ATTRIBUTES-MAIN- PRV00002 by keeping records that satisfy the following criteria:1. PROV-ATTRIBUTES-EFF-DATE <= last day of the reporting month2. PROV-ATTRIBUTES-END-DATE >= last day of the reporting month or missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 3: Provider is an individualOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 2, further refine the population by keeping records that satisfy the following criteria:1. FACILITY-GROUP-INDIVIDUAL-CODE = "03" STEP 4: Provider taxonomy is active on the last day of DQ report monthOf the providers that meet the criteria from STEP 3, further refine the population using segment PROVIDER-TAXONOMY-CLASSIFICATION-PRV00006 by keeping records that satisfy the following criteria:1a. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE <= last day of the reporting month2a. PROV-TAXONOMY-CLASSIFICATION-END-DATE >= last day of the reporting month OR missingOR1b. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE is missing2b. PROV-TAXONOMY-CLASSIFICATION-END-DATE is missingSTEP 5: Provider Classification Lookup Designation is "Facility or Group" or missingOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 4, further refine the population by keeping records that meet the following criteria:1a. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE match values in Provider Classification lookup tableAND1b. Provider Classification Lookup Designation = “Facility” or "Group"OR2. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE do not equal to values in Provider Classification lookup tableOR3. PROV-IDENTIFIER-TYPE is missingOR4. PROVIDER-CLASSIFICATION-CODE is missingSTEP 6: Calculate percentageDivide the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 5 by the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 3 |
STEP 1: Provider enrolled on the last day of DQ report monthDefine the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria:1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 2: Provider attributes are active on last day of DQ report monthOf the providers that meet the criteria from STEP 1, further refine the population using segment PROVIDER-ATTRIBUTES-MAIN- PRV00002 by keeping records that satisfy the following criteria:1. PROV-ATTRIBUTES-EFF-DATE <= last day of the reporting month2. PROV-ATTRIBUTES-END-DATE >= last day of the reporting month or missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 3: Provider is an individualOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 2, further refine the population by keeping records that satisfy the following criteria:1. FACILITY-GROUP-INDIVIDUAL-CODE = "03" STEP 4: Provider taxonomy is active on the last day of DQ report monthOf the providers that meet the criteria from STEP 3, further refine the population using segment PROVIDER-TAXONOMY-CLASSIFICATION-PRV00006 by keeping records that satisfy the following criteria:1a. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE <= last day of the reporting month2a. PROV-TAXONOMY-CLASSIFICATION-END-DATE >= last day of the reporting month OR missingOR1b. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE is missing2b. PROV-TAXONOMY-CLASSIFICATION-END-DATE is missingSTEP 5: Provider Classification Lookup Designation is "Facility or Group" or missingOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 4, further refine the population by keeping records that meet the following criteria:1a. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE match values in Provider Classification lookup tableAND1b. Provider Classification Lookup Designation is never “Individual"OR2. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE are never equal to values in Provider Classification lookup tableOR3. PROV-IDENTIFIER-TYPE is always missingOR4. PROVIDER-CLASSIFICATION-CODE is always missingSTEP 6: Calculate percentageDivide the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 5 by the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 3 |
01/27/2023 |
3.2.0 |
PRV-6-002-2 |
UPDATE |
Specification |
STEP 1: Provider enrolled on the last day of DQ report monthDefine the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria:1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 2: Provider attributes are active on last day of DQ report monthOf the providers that meet the criteria from STEP 1, further refine the population using segment PROVIDER-ATTRIBUTES-MAIN- PRV00002 by keeping records that satisfy the following criteria:1. PROV-ATTRIBUTES-EFF-DATE <= last day of the reporting month2. PROV-ATTRIBUTES-END-DATE <= last day of the reporting month3. SUBMITTING-STATE-PROV-ID is not missingSTEP 3: Provider is an individualOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 2, further refine the population by keeping records that satisfy the following criteria:1. FACILITY-GROUP-INDIVIDUAL-CODE = "03" STEP 4: Provider taxonomy is active on the last day of DQ report monthOf the providers that meet the criteria from STEP 3, further refine the population using segment PROVIDER-TAXONOMY-CLASSIFICATION-PRV00006 by keeping records that satisfy the following criteria:1a. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE <= last day of the reporting month2a. PROV-TAXONOMY-CLASSIFICATION-END-DATE >= last day of the reporting month OR missingOR1b. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE is missing2b. PROV-TAXONOMY-CLASSIFICATION-END-DATE is missingSTEP 5: Provider Classification Lookup Designation is "Facility or Group" or missingOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 4, further refine the population by keeping records that meet the following criteria:1a. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE match values in Provider Classification lookup tableAND1b. Provider Classification Lookup Designation = “Facility” or "Group"OR2. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE do not equal to values in Provider Classification lookup tableOR3. PROV-IDENTIFIER-TYPE is missingOR4. PROVIDER-CLASSIFICATION-CODE is missingSTEP 6: Calculate percentageDivide the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 5 by the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 3 |
STEP 1: Provider enrolled on the last day of DQ report monthDefine the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria:1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 2: Provider attributes are active on last day of DQ report monthOf the providers that meet the criteria from STEP 1, further refine the population using segment PROVIDER-ATTRIBUTES-MAIN- PRV00002 by keeping records that satisfy the following criteria:1. PROV-ATTRIBUTES-EFF-DATE <= last day of the reporting month2. PROV-ATTRIBUTES-END-DATE >= last day of the reporting month or missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 3: Provider is an individualOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 2, further refine the population by keeping records that satisfy the following criteria:1. FACILITY-GROUP-INDIVIDUAL-CODE = "03" STEP 4: Provider taxonomy is active on the last day of DQ report monthOf the providers that meet the criteria from STEP 3, further refine the population using segment PROVIDER-TAXONOMY-CLASSIFICATION-PRV00006 by keeping records that satisfy the following criteria:1a. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE <= last day of the reporting month2a. PROV-TAXONOMY-CLASSIFICATION-END-DATE >= last day of the reporting month OR missingOR1b. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE is missing2b. PROV-TAXONOMY-CLASSIFICATION-END-DATE is missingSTEP 5: Provider Classification Lookup Designation is "Facility or Group" or missingOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 4, further refine the population by keeping records that meet the following criteria:1a. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE match values in Provider Classification lookup tableAND1b. Provider Classification Lookup Designation = “Facility” or "Group"OR2. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE do not equal to values in Provider Classification lookup tableOR3. PROV-IDENTIFIER-TYPE is missingOR4. PROVIDER-CLASSIFICATION-CODE is missingSTEP 6: Calculate percentageDivide the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 5 by the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 3 |
12/09/2022 |
3.0.6 |
PRV-6-002-2 |
UPDATE |
Priority |
Medium |
N/A |
12/09/2022 |
3.0.6 |
PRV-6-002-2 |
UPDATE |
Category |
Provider identifiers |
N/A |
12/09/2022 |
3.0.6 |
PRV-6-002-2 |
UPDATE |
For ta comprehensive |
TA- Inferential |
No |
12/09/2022 |
3.0.6 |
PRV-6-002-2 |
UPDATE |
For ta inferential |
Yes |
No |
12/09/2022 |
3.0.6 |
PRV-6-002-2 |
UPDATE |
Ta min |
0 |
|
12/09/2022 |
3.0.6 |
PRV-6-002-2 |
UPDATE |
Ta max |
0.1 |
|
12/09/2022 |
3.0.6 |
PRV-6-002-2 |
UPDATE |
Specification |
STEP 1: Provider enrolled on the last day of DQ report monthDefine the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria:1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 2: Provider attributes are active on last day of DQ report monthOf the providers that meet the criteria from STEP 1, further refine the population using segment PROVIDER-ATTRIBUTES-MAIN- PRV00002 by keeping records that satisfy the following criteria:1. PROV-ATTRIBUTES-EFF-DATE <= last day of the reporting month2. PROV-ATTRIBUTES-END-DATE <= last day of the reporting month3. SUBMITTING-STATE-PROV-ID is not missingSTEP 3: Provider is an individualOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 2, further refine the population by keeping records that satisfy the following criteria:1. FACILITY-GROUP-INDIVIDUAL-CODE = "03" STEP 4: Provider taxonomy is active on the last day of DQ report monthOf the providers that meet the criteria from STEP 3, further refine the population using segment PROVIDER-TAXONOMY-CLASSIFICATION-PRV00006 by keeping records that satisfy the following criteria:1a. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE <= last day of the reporting month2a. PROV-TAXONOMY-CLASSIFICATION-END-DATE >= last day of the reporting month OR missingOR1b. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE is missing2b. PROV-TAXONOMY-CLASSIFICATION-END-DATE is missingSTEP 5: Provider Classification Lookup Designation is "Facility or Group" or missingOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 4, further refine the population by keeping records that meet the following criteria:1a. PROV-CLASSIFICATION-TYPE and PROVIDER-CLASSIFICATION-CODE match values in Provider Classification lookup tableAND1b. Provider Classification Lookup Designation = “Facility” or "Group"OR2. PROV-CLASSIFICATION-TYPE and PROVIDER-CLASSIFICATION-CODE do not equal to values in Provider Classification lookup tableOR3. PROV-CLASSIFICATION-TYPE is missingOR4. PROVIDER-CLASSIFICATION-CODE is missingSTEP 6: Calculate percentageDivide the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 5 by the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 3 |
STEP 1: Provider enrolled on the last day of DQ report monthDefine the provider population from segment PROV-MEDICAID-ENROLLMENT-PRV00007 by keeping active records that satisfy the following criteria:1. PROV-MEDICAID-EFF-DATE <= last day of the reporting month2. PROV-MEDICAID-END-DATE >= last day of the reporting month OR missing3. SUBMITTING-STATE-PROV-ID is not missingSTEP 2: Provider attributes are active on last day of DQ report monthOf the providers that meet the criteria from STEP 1, further refine the population using segment PROVIDER-ATTRIBUTES-MAIN- PRV00002 by keeping records that satisfy the following criteria:1. PROV-ATTRIBUTES-EFF-DATE <= last day of the reporting month2. PROV-ATTRIBUTES-END-DATE <= last day of the reporting month3. SUBMITTING-STATE-PROV-ID is not missingSTEP 3: Provider is an individualOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 2, further refine the population by keeping records that satisfy the following criteria:1. FACILITY-GROUP-INDIVIDUAL-CODE = "03" STEP 4: Provider taxonomy is active on the last day of DQ report monthOf the providers that meet the criteria from STEP 3, further refine the population using segment PROVIDER-TAXONOMY-CLASSIFICATION-PRV00006 by keeping records that satisfy the following criteria:1a. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE <= last day of the reporting month2a. PROV-TAXONOMY-CLASSIFICATION-END-DATE >= last day of the reporting month OR missingOR1b. PROV-TAXONOMY-CLASSIFICATION-EFF-DATE is missing2b. PROV-TAXONOMY-CLASSIFICATION-END-DATE is missingSTEP 5: Provider Classification Lookup Designation is "Facility or Group" or missingOf the SUBMITTING-STATE-PROV-IDs that meet the criteria from STEP 4, further refine the population by keeping records that meet the following criteria:1a. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE match values in Provider Classification lookup tableAND1b. Provider Classification Lookup Designation = “Facility” or "Group"OR2. PROV-IDENTIFIER-TYPE and PROVIDER-CLASSIFICATION-CODE do not equal to values in Provider Classification lookup tableOR3. PROV-IDENTIFIER-TYPE is missingOR4. PROVIDER-CLASSIFICATION-CODE is missingSTEP 6: Calculate percentageDivide the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 5 by the count of unique SUBMITTING-STATE-PROVIDER-IDENTIFIER values from STEP 3 |