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Measure Name | % of claim headers with a Billing Provider Number that is not found on the provider file during the dates of service |
---|---|
File Type | Multiple Files |
Measure ID | RULE-689 |
Measure Type | Claims Percentage |
Content area | ALL MULTI PRO |
Validation Type | Inferential |
---|
Measure Priority | Medium |
---|---|
Focus Area | N/A |
Category | Provider information |
Claim Type | Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp |
---|---|
Adjustment Type | All Adjustment Types |
Crossover Type | All Indicators |
Minimum | 0 |
---|---|
Maximum | 0.02 |
TA Minimun | 0 |
TA Maximum | 0.02 |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
TA- Inferential |
For TA
(Longitudinal) |
No |
DD Data Element | BILLING-PROV-NUM • SUBMITTING-STATE-PROV-ID • PROV-IDENTIFIER • ADMISSION-DATE • DISCHARGE-DATE |
---|---|
DD Data Element Number | CIP179 • PRV019 • PRV081 • CIP094 • CIP096 |
Annotation | N/A |
---|---|
Specification | RULE-689 |