Risk Adjustment for EDS and RAPS User Group - August 23, 2018


Risk Adjustment for EDS and RAPS User Group - August 23, 2018

Table of Contents

  • Slides 8-21 - Encounter Data Report Cards, Overview, Overview, examples
  • Slides 25-27 - EDPS Edits, System rejecting records incorrectly
  • Slides 30-32 - EDFES Edits, EDFES Edits Statistics, Total encounters rejected in 2017, 2018
  • Slides 33-38 - 999 Acknowledgement Report, 999 Edits, Includes Top 7 Edits in 2017 and 2018
  • Slides 39-44 - 277CA Acknowledgement Report, 277 Edits, Includes Top 7 Edits in 2017 and 2018
  • Slides 46-50 - EDPS Edits, Statistics
  • Slide 51 - EDPS Edits, Edit 98320
  • Slide 57 - FQHC and RAPS Submission, Type of Bill (TOB)
  • Slide 58 - Beneficiary Identifiers, MBI vs HICN, Using MBI or HICN to update or delete EDPS data
  • Slide 59 - MOR, Record Types, Which MOR reports will use new record types
  • Slide 60 - MOR, Beneficiary Identifiers, MORs will use HICNs until 12/31/2019 see HPMS Memo 12/22/2017
  • Slide 61 - MOR, Accessing MORs, Plans will access MORs through Gentran or TIBCO

Last Updated: 08/23/2018