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digital.ahrq.gov/principal-investigator/nanji-karen-c
January 01, 2023 - Through the Use of Clinical Decision Support
Ocular anesthesia-related closed claims … Ocular anesthesia-related closed claims from Ophthalmic Mutual Insurance Company 2008-2018.
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digital.ahrq.gov/principal-investigator/schillinger-dean
January 01, 2023 - adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims … adherence in a diverse population: a cross-sectional analysis of convergent validity with pharmacy claims
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digital.ahrq.gov/sites/default/files/docs/library/Medicaid_ACO_Issue_Brief_-_FINAL.pdf
February 01, 2010 - Patient-level claims data will enable
ACOs to more effectively evaluate the needs of their patient … programs, states may not have access
to robust encounter data and will be challenged to provide
complete claims-level … Processes will need to be
established for both the Medicaid agency and the MCOs to
share aggregate and claims-level … The Medicare-proposed ACO rule excludes FQHCs and
RHCs from serving as ACOs due to the lack of FFS claims … Most of the Medicare Shared Savings quality measures
cannot be captured using claims data.
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digital.ahrq.gov/sites/default/files/docs/page/McColmSuccessStory2009_0.pdf
December 01, 2009 - qualified EHR system, or claims coding. … data extraction of PQRI quality measures from the
organization’s EHR was developed and compared to claims … Also, CMH established and implemented a manual
claims-coding method for PQRI reporting to serve as a … Automated coding from the EHR was compared to manual claims
coding.
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digital.ahrq.gov/ahrq-funded-projects/improving-quality-through-decision-support-evidence-based-pharmacotherapy/annual-summary/2010
January 01, 2010 - The system is based on an emerging standard for decision support and uses routinely available claims … These rules are designed to function using routinely available claims and scheduling data in order to … paper, “ Improving Medication Adherence in a Regional Healthcare Information Exchange Using a Scalable, Claims
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digital.ahrq.gov/ahrq-funded-projects/standardization-and-automatic-extraction-quality-measures-ambulatory-electronic/annual-summary/2009
January 01, 2009 - During this phase, CMH established and implemented a claims-coding method to report to PQRI for comparison … During the comparison period, October 2008 through February 2009, providers and coders utilized the claims-coding … This result is qualified by a low compliance rate for manual claims coding of the quality measures.
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digital.ahrq.gov/sites/default/files/docs/activity/improving_quality_through_decision_support_for_evidence_based_pharmacotherapy_2010_pdf__2.pdf
January 01, 2010 - The system is based on an emerging standard for decision support and uses
routinely available claims … These rules are designed to function
using routinely available claims and scheduling data in order to … , “Improving Medication Adherence in a Regional Healthcare Information
Exchange Using a Scalable, Claims
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digital.ahrq.gov/sites/default/files/docs/activity/standardization_and_automatic_extraction_of_quality_measures_2009_pdf__2.pdf
January 01, 2009 - During this phase, CMH established and implemented a claims-coding
method to report to PQRI for comparison … During the comparison period, October 2008 through February
2009, providers and coders utilized the claims-coding … This result
is qualified by a low compliance rate for manual claims coding of the quality measures.
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digital.ahrq.gov/ahrq-funded-projects/hie-and-ambulatory-test-utilization/annual-summary/2011
January 01, 2011 - Therefore, a new algorithm for attributing an ordering provider to laboratory and radiology claims was … Because ManagedCare was the agency providing the project with claims data for the analysis, new business
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digital.ahrq.gov/sites/default/files/docs/library/33-45.pdf
February 01, 2012 - For each provider, a 24-month window of
pharmacy claims data was obtained—12 months prior to and
12 … Data
Data to determine the rate of DDIs were obtained from phar-
macy claims. … The total number
of pharmacy claims for medications ordered by each prescriber
for individuals in … Assessment of potential
drug-drug interactions with a prescription claims database. … Median (Range)
Number of Claims
Per Prescriber
Number of
Prescribers (%)
Total Number
of Claims
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digital.ahrq.gov/sites/default/files/docs/activity/2011_018749_nease_pdf_3.pdf
January 01, 2011 - Therefore, a new algorithm for attributing an ordering
provider to laboratory and radiology claims was … Because ManagedCare was the agency providing the project
with claims data for the analysis, new business
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digital.ahrq.gov/sites/default/files/docs/implementation/Lobach.ppt
August 12, 2005 - # of ED visits, billing diagnoses for visit, severity level of visit
Claims data with ICD9 and CPT Codes … State Medicaid claims data
Chart audits (electronic or manual)
Clinic encounter records
Claims data and … What claims data is available?
Is there a data dictionary for interpreting the data?
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digital.ahrq.gov/sites/default/files/docs/page/2006Lee_051711comp.pdf
May 01, 2006 - Demographic, administrative, claims, results, medication
histories, clinical summaries, images, or … Size/number of collaborator
small medium large
Type of information exchanged
demographic claims
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digital.ahrq.gov/funding-mechanism/novel-high-impact-studies-evaluating-health-system-and-healthcare-professional
January 01, 2023 - Description
This research, using data from the country’s largest telehealth provider and claims
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digital.ahrq.gov/sites/default/files/docs/biblio/ChunliuZhan.ppt
June 06, 2005 - , which is “supposedly” determined by the diagnoses at admission
Payment can be calculated based on claims … from 995 hospitals across 35 states, approximating 20% sample of acute hospitals
2.5 million Medicare claims … sepsis
Face validity, relative larger number of case
Method
Calculating Medicare PPS payment for claims
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digital.ahrq.gov/sites/default/files/docs/biblio/Chunliu%20Zhan.ppt
June 06, 2005 - , which is “supposedly” determined by the diagnoses at admission
Payment can be calculated based on claims … from 995 hospitals across 35 states, approximating 20% sample of acute hospitals
2.5 million Medicare claims … sepsis
Face validity, relative larger number of case
Method
Calculating Medicare PPS payment for claims
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digital.ahrq.gov/sites/default/files/docs/care-transitions-qas-092619.pdf
September 26, 2019 - QUESTION: Can you elaborate on the roles of the agencies in diving into claims for the roster of
patients … Did the HIE lead this process or did the FQHC review their own
claims? … In contrast, the analysis of health outcomes was completed using de-identified claims
from the NYS Medicaid … QUESTION: Can you elaborate on the roles of the agencies in diving into claims for the roster of patients … Did the HIE lead this process or did the FQHC review their own claims?
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digital.ahrq.gov/sites/default/files/docs/page/Utah%204-VI.ppt
June 13, 2006 - Medication History Settings
Utah Health Information Network
Evaluation Method Summary
AHRQ 2006
Jan Root, Ph.D.
Assistant Executive Director
UHIN Pilot
Submitter Receiver Message Format
Hospital Providers (clinical messages)
Payers (claim attachments) Discharge summaries, etc. HL7, pdf
Clinics Hospitals (clinic…
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digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/hunt-dl-et-al-1998
January 01, 1998 - As for other health care interventions, such claims should be based on careful trials that assess their
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digital.ahrq.gov/ahrq-funded-projects/e-prescribing-impact-patient-safety-use-and-cost
January 01, 2023 - Data on paid medical was used and pharmacy claims data coupled with data from the e-prescribing vendor