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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-7706

Data Quality Measure
Last updated

Key Information

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-7706
Measure Type Claims Percentage
Content area ELG ALL MULTI

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Managed care
Category Program participation

Claim Information

Claim Type N/A
Adjustment Type Non-void
Crossover Type All Indicators

Thresholds

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

Data Elements

DD Data Element PLAN-ID-NUMBER • MANAGED-CARE-PLAN-ENROLLMENT-END-DATE • BEGINNING-DATE-OF-SERVICE • MANAGED-CARE-PLAN-ENROLLMENT-EFF-DATE
DD Data Element Number COT066 • ELG197 • COT033 • ELG196

Annotation N/A
Specification RULE-7706