Results

Total Results: 1,772 records

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

21. Introduction | Agency for Healthcare Research and Quality
    www.ahrq.gov/data/apcd/backgroundrpt/intro.html
    April 01, 2017 - Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Databases Introduction Reviewing the Landscape of All-Payer Claims Databases Measure Inventory … All-payer claims databases (APCDs) incorporate utilization and cost across the health care system and … APCDs are large datasets that aggregate medical, facility, pharmacy, and sometimes dental claims, as

22. Reviewing the Landscape of All-Payer Claims Databases | Agency for Healthcare Research and Quality
    www.ahrq.gov/data/apcd/backgroundrpt/review.html
    July 01, 2022 - Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Databases Reviewing the Landscape of All-Payer Claims Databases Previous Page Next Page … databases, or other claims databases (Medicare or Medicaid). … They create twice-yearly cost reports based on claims from four major insurers. … Lastly, several organizations contribute discrete groups of claims-based measures.

23. Using Claims Data to Perform Surveillance for Surgical Site Infection: The Devil Is in the Details | Agency for Healthcare Research and Quality
    www.ahrq.gov/es/hai/patient-safety-resources/advances-in-hai/hai-article13.html
    June 01, 2014 - Medical claims were restricted to paid claims. … Claims data algorithm for classification of hernia repair Problem Claims We created an algorithm … to identify "problem claims." … claims on the same date, were also classified as problem claims. … We used these supplemental claims, which included anesthesia and pathology, along with claims for surgical

24. Using Claims Data to Perform Surveillance for Surgical Site Infection: The Devil Is in the Details | Agency for Healthcare Research and Quality
    www.ahrq.gov/hai/patient-safety-resources/advances-in-hai/hai-article13.html
    June 01, 2014 - Medical claims were restricted to paid claims. … Claims data algorithm for classification of hernia repair Problem Claims We created an algorithm … to identify "problem claims." … claims on the same date, were also classified as problem claims. … We used these supplemental claims, which included anesthesia and pathology, along with claims for surgical

25. Physician and Physician Practice Research Database Physician Practice Directory Codebook (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Physician-Practice-Directory-PUF-Codebook.pdf
    March 01, 2023 - Variable Name: SING_SPEC_TYPE Input Data Sources: 3P-RD Physician file, APCD Claims, CMS Claims … Number of Claims per Month Medicaid (MCO): Average Number of Claims per Month Medicare Advantage: … Number of Claims per Month Any Payer within the APCD: Average Number of Claims per Month Medicaid … (FFS & MCO): Maximum Number of Claims per Month Medicaid (FFS): Maximum Number of Claims per Month … Medicaid (MCO): Maximum Number of Claims per Month Medicare Advantage: Maximum Number of Claims per

26. Physician and Physician Practice Research Database, Geographic Physician Practice Public Use File Codebook (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Geographic-Physician-Practice-PUF-Codebook.pdf
    February 01, 2023 - Name: AVG_PRVDR_SBMT_CLMS_MCAIDFFS Input Data Sources: APCD/CMS Claims, 3P-RD Physician … Name: AVG_PRVDR_SBMT_CLMS_MCAIDMCO Input Data Sources: APCD/CMS Claims, 3P-RD Physician … Name: AVG_PRVDR_SBMT_CLMS_CMRCL Input Data Sources: APCD/CMS Claims, 3P-RD Physician Type: … Average physician submitting Medicaid (FFS) claims Average physician submitting Medicaid (MCO) claims … Average physician submitting Medicare Advantage claims Average physician submitting Commercial claims

27. Physician and Physician Practice Research Database, Geographic Physician Public Use File Codebook (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-geographic-physician-puf-codebook.pdf
    February 01, 2023 - Number of Claims per Month Medicaid (MCO): Average Number of Claims per Month Medicare Advantage: … Number of Claims per Month Any Payer within the APCD: Average Number of Claims per Month Medicaid … (FFS & MCO): Maximum Number of Claims per Month Medicaid (FFS): Maximum Number of Claims per Month … Medicaid (MCO): Maximum Number of Claims per Month Medicare Advantage: Maximum Number of Claims per … the APCD: Minimum Number of Claims per Patients Medicaid (FFS & MCO): Maximum Number of Claims per

28. 3P-Rd-Data-Dictionary-Geographic-Level (xls file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Data-Dictionary-Geographic-Level.xlsx
    February 02, 2023 - State APCD/CMS Claims ZIP_CD X X X X X X X X X X X X X X X STATE 2-Digit alpha state code Char $2. … physicians Char 2 XXXXX: Minimum Patient Age APCD/CMS Claims XXXXX_MIN_AGE X X B, F, G A, G A, G … per Month APCD/CMS Claims XXXXX_MIN_CLMS_PERMONTH X X B, F, G A, G A, G B, C, D, E, F, G A, G A, G … per month across all 3P-RD physicians Num 8 XXXXX: Average Number of Claims per Month APCD/CMS Claims … per month across all 3P-RD physicians Num 8 XXXXX: Maximum Number of Claims per Month APCD/CMS Claims

29. Introduction to Synthetic Healthcare Database for Research (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Introduction-2023Dec.pdf
    December 01, 2023 - SyH-DR includes person files, inpatient and outpatient claims files, pharmacy claims files, and provider … For example, only the approved final action claims were retained in the source files. … Therefore, the claims in SyH-DR are the original claims with some data elements partially or fully replaced … Attending Specialty AT_Spclty Claims No Full No Claim Type Code Clm_Type_Cd Claims No No No CPT Procedure … No No No Type of Bill Code TOB_Cd Claims No No No Total Charged Amount Tot_Chrg_Amt Claims, RX No

30. Lessons Learned From Implementation Challenges | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/hospital/candor/demo-program/grants/lessons.html
    August 01, 2022 - new clinical or policy interventions for patient safety that will impact meaningfully on malpractice claims … resources are poorly aligned to support future PSML initiatives, particularly so on the malpractice claims … PSML projects. 1 Perhaps the most important of these for national evaluations is the fact that NDPB claims … to track locally and are not dependent on these national data pipelines to collect (e.g., numbers of claims … and/or time to resolution of claims in the context of a DRP intervention).

31. 3P_RD_AHRQ_PUF_Data_Dictionary (xls file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Data-Dictionary.xlsx
    March 16, 2023 - SECTION IV: Source Claims Files Indicates data element names and availability in claims files for APCD … Organizational NPI APCD/ CMS Claims X X X X X X ORG_NPI Organizational NPI CHAR 10 $10. … Number of 3P-RD physicians associated with the physician practice site X APCD/ CMS Claims X X X X X … X 3P-RD Physician APCD/ CMS Claims X X X X X X SING_SPEC_TYPE If Single Specialty, Which? … State X APCD/ CMS Claims X X X X X X STATE State CHAR 7 $2.

32. | Agency for Healthcare Research and Quality
    www.ahrq.gov/topics/index.html?page=0
    October 01, 2008 - Pagination 1 2 next › ›› last » Last » All-Payer Claims … AHRQ activities focus on developing an effective, feasible approach for using all-payer claims databases

33. | Agency for Healthcare Research and Quality
    www.ahrq.gov/topics/index.html
    October 01, 2008 - Pagination 1 2 next › ›› last » Last » All-Payer Claims … AHRQ activities focus on developing an effective, feasible approach for using all-payer claims databases

34. Final Progress Report: Malpractice Insurers’ Medical Error Surveillance and Prevention Study (MIMESPS) (pdf file)
    www.ahrq.gov/sites/default/files/2024-09/studdert-report.pdf
    January 01, 2024 - One site contributed obstetric claims only; another site had claims in all clinical categories except … ), obstetrics (obstetric claims), and internal medicine (diagnosis and medication claims). … Representativeness of malpractice claims. … of the misclassified claims. 6. … • Value of malpractice claims in patient safety research.

35. Disabilities | Agency for Healthcare Research and Quality
    www.ahrq.gov/topics/disabilities.html
    January 01, 2014 - of Preventive Services to People with Disabilities Developing and Assessing the Validity of Claims-based

36. Asthma 1 Measure Calculation Steps (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/flow-diagrams.pdf
    March 11, 2021 - Asthma 1 Measure Calculation Steps Medicaid/APCD claims data Eligibility Table (summary of continuous … (all medical claims during time frame) Pharmacy Claims Data HEDIS ASM-C/MMA-A NDC Lists2 … Import into SAS data format Medical Claims Data (long format medical claims during time frame with … Data Medical Claims Data (long format medical claims during time frame) Asthma_Meds: Evaluation … DEC_IDENT_CE 10 4 Comorbidity Claims (all medical claims during time frame) PMCA v3 Algorithm

37. Sampling, Weighting, and Synthetization Methodologies (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-%20Methods-2023Dec.pdf
    December 01, 2023 - Therefore, the claims in SyH-DR are the original claims with some data elements partially or fully replaced … Multiple claims might be observed for each person, and diagnosis codes might recur across claims—for … , 1,200 most frequent for outpatient claims, and 300 most frequent for ED claims. … Pharmacy Claims Files Generic Drug Name The source pharmacy claims files contain National Drug Codes … and pharmacy claims.

38. Sampling, Weighting, and Synthetization Methodologies (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/SyH-DR-Sampling-Weighting-Synthetization-Methodologies.pdf
    December 01, 2023 - Therefore, the claims in SyH-DR are the original claims with some data elements partially or fully replaced … Multiple claims might be observed for each person, and diagnosis codes might recur across claims—for … , 1,200 most frequent for outpatient claims, and 300 most frequent for ED claims. … Pharmacy Claims Files Generic Drug Name The source pharmacy claims files contain National Drug Codes … and pharmacy claims.

39. Apcd-Inventory (xls file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/apcd/apcd-inventory.xlsx
    October 01, 2015 - pharmacy claims. … Does not include claims processed under the pharmacy benefit. … term=22533526 Adult Yes Reimbursement Patient-level across IMS claims dataset IMS PharMetrics claims … 5% sample of Medicare claims files Lit review 53 None. … NQF 453 Appears to be doable with claims alone.

40. Improvement Data | Agency for Healthcare Research and Quality
    www.ahrq.gov/pqmp/implementation-qi/toolkit/tcd/improvement-data.html
    July 01, 2021 - Measure performance rates for all levels were calculated using state Medicaid administrative claims … York Department of Health provided measure performance rates using their own Medicaid administrative claims … One difficulty with using state administrative claims is the delay in data availability. … Michigan Medicaid claims data become available approximately 6 months following the end of the year.