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Measure Name | % of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period |
---|---|
File Type | Multiple Files |
Measure ID | RULE-7195 |
Measure Type | Claims Percentage |
Content area | ELG ALL MULTI |
Validation Type | Inferential |
---|
Measure Priority | High |
---|---|
Focus Area | Managed care |
Category | Program participation |
Claim Type | Medicaid,Enc or CHIP,Enc |
---|---|
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 | BEGINNING-DATE-OF-SERVICE • MANAGED-CARE-PLAN-ENROLLMENT-EFF-DATE • MANAGED-CARE-PLAN-ENROLLMENT-END-DATE • PLAN-ID-NUMBER |
---|---|
DD Data Element Number | CLT048 • ELG196 • ELG197 • CLT080 |
Annotation | N/A |
---|---|
Specification | RULE-7195 |