Results

Total Results: 144 records

Showing results for "claims".
Users also searched for: health literacy

1. Comparing MEPS Use and Expenditure Estimates for the Privately Insured to Truven MarketScan® and OptumLabs™ Claims Data, 2008-2013 (pdf file)
   meps.ahrq.gov/data_files/publications/workingpapers/wp_17001.pdf
   October 01, 2017 - databases, and 2008-2013 OLDW claims data. … claims; and (3) outpatient 9 claims, which are essentially all claims not categorized … Total spending for each MarketScan enrollee includes all inpatient claims, all prescription drug claims … claims. … Truven simply left these unmatched claims in the outpatient claims files—any inpatient professional

2. Working Paper #8004: Validating the Collection of Separately Billed Doctor Expenditures for Hospital Services: Results from the Medicare-MEPS Validation Study (pdf file)
   meps.ahrq.gov/data_files/publications/workingpapers/wp_08004.pdf
   March 01, 2008 - SBD claims are included in the Medicare Carrier file along with other Part B claims by non-institutional … There are no direct links between Carrier file claims and hospital facility claims in the inpatient … No effort was made to link these claims to Medicare claims in the IP and OP files for reimbursement … claim in the CMS IP and OP files.2 We did this by matching the SBD claims to hospital claims for … After the SBD claims were linked to individual claims for hospital care in the CMS files

3. Working Paper #9003: Validity of Household Reports of Medicare-covered Home Health Agency Use (pdf file)
   meps.ahrq.gov/data_files/publications/workingpapers/wp_09003.pdf
   August 01, 2009 - At the individual level, we found moderate concordance in reporting between the MEPS and Medicare claims … This difference in reports of any home health care use between the MEPS-HC and Medicare claims was … Table 2 presents additional comparisons between the MEPS-HC and Medicare claims in the intensity of … At the individual level, we found moderate agreement between the MEPS-HC and Medicare claims. … First, while we matched a large sample of Medicare beneficiaries in MEPS to claims data, our matched

4. Working Paper 12044: Evaluating an Alternative Data Source for Editing MEPS Drug Prices (pdf file)
   meps.ahrq.gov/data_files/publications/workingpapers/wp_12004.pdf
   July 01, 2012 - adjudicated drug claims for more than 16 million people. … For this analysis we selected a 10 percent sample of the outpatient pharmacy claims. … Medicare Claims CMS provided us claims data for a five percent random sample of Medicare beneficiaries … These claims files contain drug claims from all plans in the Medicare prescription drug program. … beneficiaries linked with Medicare claims.

5. Medicare-MEPS Validation Study: A Comparison of Hospital and Physician Expenditures (pdf file)
   meps.ahrq.gov/data_files/publications/workingpapers/wp_08003.pdf
   March 01, 2008 - The MMVS uses claims for a sample of Medicare beneficiaries in the MEPS as part of a comprehensive … Claims in the Inpatient and Outpatient SAFs have revenue center sub-claims for services provided at … Among all other outpatient claims, same-day sub-claims within or across claims records by a provider … CMS claims data are shown in the upper pane of the table; MEPS data are in the lower panel. … plus office-based physician expenditures), and 70 percent of the claims totals for SBDs.

6. Medical Expenditure Panel Survey Publication Details
   meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=855
   January 01, 2003 - Publication date:    March 14, 2008 Description:    The Medicare-MEPS Validation Study uses Medicare claims … We first compare CMS claims data to MEPS estimates of SBD expenditures in aggregate for all hospital … SBD expenditures are approximately 2-5 percent lower than the amounts reported on the Medicare Part B claims … facility and SBD expenditures for household-reported hospital events with an exact match to a CMS hospital claims … These matched pair analyses also show SBD expenditures lining up well between MEPS and the CMS claims

7. Evaluating Alternative Benchmarks to Improve Identification of Outlier Drug Prices for Medical Expenditure Panel Survey Prescribed Medicines Data Editing (pdf file)
   meps.ahrq.gov/data_files/publications/workingpapers/wp_22001.pdf
   September 30, 2022 - The MarketScan data contained private insurance claims data for about 16 million people in 2019. … The comparison data source was the 2019 IBM MarketScan Outpatient Pharmaceutical Claims data. … The administrative claims data were, however, a convenience sample. … Patent status for the drugs in these claims was obtained from the IBM Micromedex RED BOOKTM. … payment fills almost always had positive third-party payments in the claims data.

8. Medical Expenditure Panel Survey Publication Details
   meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=923
   January 01, 2003 - 2008) of a sample of Medicare beneficiaries in the 2001-2003 MEPS who were matched to their Medicare claims … utilization of and spending on Medicare-covered home health agency services between MEPS and Medicare claims … At the individual level, we found moderate concordance in reporting between the MEPS and Medicare claims

9. Medical Expenditure Panel Survey Publication Details
   meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=1068
   June 30, 2012 - alternative benchmark: median retail unit prices (RUPs) calculated from the MarketScan's database of private claims … Using MarketScan and Medicare Part D claims data, we showed graphically the similarity of the distributions … the AWUP and median RUP using a sample of MEPS pharmacy data validated by matching to Medicare Part D claims

10. Medical Expenditure Panel Survey Publication Details
    meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=1221
    August 01, 2013 - MEPS Use and Expenditure Estimates for the Privately Insured to Truven MarketScan® and OptumLabs TM Claims … This study compares the 2008-2013 MEPS to private insurance claims data in the MarketScan database and

11. Comparison of Retail Drug Prices in the MEPS and MarketScan: Implications for MEPS Editing Rules (pdf file)
    meps.ahrq.gov/data_files/publications/workingpapers/wp_10001.pdf
    February 01, 2010 - Specifically, the 2006 MEPS PMED data are compared with prescription medicine claims for those with … Our comparison data source is the 2006 MarketScan Outpatient Pharmaceutical Claims data. … The 2006 data contain 120 million adjudicated drug claims for 16 million people. … The MarketScan databases capture from private insurance claims records person specific information … For this analysis we selected a 10% sample of the outpatient pharmacy claims.

12. Medical Expenditure Panel Survey Publication Details
    meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=944
    February 25, 2010 - drugs in the Medical Expenditure Panel Survey Pharmacy Component and the MarketScan Outpatient Drug Claims

13. Statistical Brief #412: Changes in Self-Insured Coverage for Employer-Sponsored Health Insurance: Private Sector, by Firm Size, 2001-2011 (pdf file)
    meps.ahrq.gov/data_files/publications/st412/stat412.pdf
    June 01, 2013 - plan is one for which the employer has chosen to assume the financial risk for the enrollees' medical claims … Some self-insured employers contract with an insurance company or third party administrator for claims … as a health insurance company or HMO—to assume financial responsibility for the enrollees' medical claims

14. Medical Expenditure Panel Survey Publication Details
    meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=854
    January 01, 2003 - component:    Household Component Publication date:    March 14, 2008 Description:    Medicare claims

15. STATISTICAL BRIEF #412: Changes in Self-Insured Coverage for Employer-Sponsored Health Insurance: Private Sector, by Firm Size, 2001-2011
    meps.ahrq.gov/data_files/publications/st412/stat412.shtml
    June 01, 2013 - plan is one for which the employer has chosen to assume the financial risk for the enrollees' medical claims … Some self-insured employers contract with an insurance company or third party administrator for claims … as a health insurance company or HMO—to assume financial responsibility for the enrollees' medical claims

16. Medical Expenditure Panel Survey Publication Details
    meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Working+Paper&opt=2&id=777
    September 22, 2006 - Unlike private prescription drug claims data sets, these data are representative of the entire non-institutionalized

17. MEPS Insurance Component Glossary of Health Insurance Terms
    meps.ahrq.gov/survey_comp/ic_ques_glossary.shtml
    January 01, 2019 - The premium equivalent is equal to the per-capita amount of claims, administration, and stop-loss premiums … ) - A health plan is considered purchased when the financial risk for the enrollee's medical claims … TPA) / ADMINISTRATIVE SERVICES ONLY (ASO) - An individual or firm hired by an employer to handle claims … where the employer and the insurer agree that the employer will be responsible for paying all claims … The insurer usually is also responsible for processing claims and administrative

18. Meps10S (pdf file)
    meps.ahrq.gov/survey_comp/ic_survey/1996/meps10s.pdf
    January 01, 1996 - who assumes the risk for enrollees’ medical expenses. 1 105 Self-insured – Your company pays the claims … Include: claims paid, administrative costs, and stop-loss coverage (if any).

19. Ic Ques Glossary (pdf file)
    meps.ahrq.gov/survey_comp/ic_ques_glossary.pdf
    January 01, 2017 - The premium equivalent is equal to the per-capita amount of claims, administration, and stop-loss premiums … plan) - A health plan is considered purchased when the financial risk for the enrollee’s medical claims … (TPA) / ADMINISTRATIVE SERVICES ONLY (ASO) - An individual or firm hired by an employer to handle claims … plan where the employer and the insurer agree that the employer will be responsible for paying all claims … The insurer usually is also responsible for processing claims and administrative services.

20. Statistical Brief #339: Self-Insured Coverage in Employer-Sponsored Health Insurance for the Private Sector, 2000 and 2010 (pdf file)
    meps.ahrq.gov/data_files/publications/st339/stat339.pdf
    September 01, 2011 - Self-insured plan A plan offered by employers where the financial risk for the enrollee's medical claims … Some self-insured employers contract with an insurance company or third party administrator for claims