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Showing results for "claims".
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-150-fullreport.pdfFebruary 14, 2018 - Administrative data (e.g., claims data). … Analytic eXtract (MAX) for 11 States. • 2011 claims data from two MEDNET States. • 2012 claims data … from one MEDNET State. • 2009 claims data from 17 New York State Medicaid health plans. • 2013 claims … Although this measure has been developed and tested for claims data, it is likely highly feasible to … This measure has been specified and tested in claims data only.
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AHRQ SDOH Database Overview (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/sdoh/SDOH-overview-presentation.pdfJuly 01, 2022 - SDOH Database With Other Data Sources Data Type Examples of Data Sources Potential Linking Variables Claims … /Billing Data Research Identifiable Files • Medicare, Medicaid Limited Data Sets • All-Payer Claims Databases … management data Census tract ZIP Code County 23 SDOH Database: Examples of Linked Data Questions • Claims … data (Medicare claims) ► To what extent do changes in healthcare utilization for chronic illnesses -
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/gallagher-report.pdfAugust 01, 2014 - Claims/Compensation A key aim of the HealthPact project was to develop and evaluate a collaborative … Risk and claims managers received training in how to collect data for the evaluation via a webinar. … Risk and claims managers preferred to learn from initial experimentation by others. … • Risk managers’ and claims managers’ heavy workloads. … Claims/Compensation VII.Products and Publication
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www.ahrq.gov/challenges/health-data/how-to-enter.htmlMarch 01, 2023 - Agrees to assume any and all risks and waive claims against the Federal Government and its related entities … Agrees to indemnify the Federal Government against third-party claims for damages arising from or related
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Final Report: Modeling Risk and Reducing Liability through Better Communication and Teamwork (pdf file)
www.ahrq.gov/sites/default/files/2024-01/baker-report.pdfJanuary 01, 2024 - that team training improved team performance in labor and delivery (L&D) and reduced the number of claims … improving teamwork, another prevailing strategy for improving care quality and reducing liability claims … Research has shown that, when physicians disclose their mistakes, payouts for claims against the doctor … communication between providers and patients/families and, as a result, mitigate risk and reduce liability claims -
www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/highlight01.htmlMarch 01, 2019 - Outdated or underdeveloped claims systems, health information exchanges, and electronic health records … Strategies range from producing practice-level reports from claims data to helping practices calculate … In some cases, States were overly optimistic in their plans to link existing data systems, such as claims … Generally, claims and encounter data indicate which provider (and not which practice) a patient visited … Claims do not contain information about which providers work together, making it difficult to develop
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www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/cmsqualconf0615.htmlMarch 01, 2019 - Claims, Administrative, and Medical Home Data Comments? Questions? … Dailey Top of Page Slide 3 Today’s Comments Updates on data collection: site visits, claims … relationships between primary care physicians and patients, and others Top of Page Slide 8 Claims
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www.ahrq.gov/research/publications/search.html?page=7April 01, 2017 - Inventory and Prioritization of Measures To Support the Growing Effort in Transparency Using All-Payer Claims … Databases AHRQ funded the All-Payer Claims Databases (APCDs) project to learn more about how APCDs
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www.ahrq.gov/policymakers/chipra/chipra-publications.htmlJuly 01, 2015 - Identifying Sickle Cell Disease Cases Using Administrative Claims . … Using Medicaid and CHIP Claims Data to Support Pediatric Quality Measurement: Lessons From 3 Centers
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Develop Your Own (doc file)
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/chtoolbx/develop/develop.docJanuary 01, 2003 - Envelope—But Not Too Hard · Learn and Use the "Typical" Data Sources · Consider Using Encounter or Claims … Encounter and claims data are examples of administrative data. … Online Resource: For more information on these types of data, go to Consider Using Encounter or Claims … Data—Very Carefully Encounter and claims data are varieties of administrative data. … Some States have made significant investments in cleaning claims or encounter data to ensure accuracy -
www.ahrq.gov/ncepcr/reports/grants-transform/overview.htmlMarch 01, 2017 - Quantitative assessments included analysis of operational and administrative data (such as claims data … operational data; and assessed cost and utilization for individual patients through an analysis of claims … data from the Centers for Medicare & Medicaid Services and Utah’s All Payer Claims Database. 10 Return
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www.ahrq.gov/ncepcr/research-transform-primary-care/transform/synthesis-report/overview.htmlOctober 01, 2015 - Quantitative assessments included analysis of operational and administrative data (such as claims data … operational data; and assessed cost and utilization for individual patients through an analysis of claims … data from the Centers for Medicare & Medicaid Services and Utah’s All Payer Claims Database. 10
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www.ahrq.gov/patient-safety/settings/hospital/candor/modules/checklist4.htmlAugust 01, 2022 - Notify appropriate individuals of the event (e.g., claims management, legal counsel, any liability carrier … Determine if it is appropriate to continue to withhold some or all claims to third parties and bills
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www.ahrq.gov/research/findings/final-reports/prospectscare/prospects1a.htmlJuly 01, 2018 - obtained from an electronic or paper medical record, is generally not considered as robust as inpatient claims … the greatest accuracy in attributing patients to particular primary care providers when using both claims … Panelists commented that linking claims data with clinical data would provide a particularly rich picture … concerns as an ongoing challenge in linking data across sources, whether clinical data from EHRs or claims … Overall, panelists anticipated that comprehensive data sets linking clinical and claims data will become
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www.ahrq.gov/research/publications/search.html?page=2June 01, 2023 - Publication Number: 22(23)-0047-2-EF Developing and Assessing the Validity of Claims-based … used by healthcare providers to identify frail patients using validated EHR frailty indexes; however, claims
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Mod4-Event-Checklist (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module4/mod4-event-checklist.pdfApril 01, 2016 - ■ Notify appropriate individuals of the event (e.g., claims management, legal counsel, any liability … – Determine if it is appropriate to continue to withhold some or all claims to third parties and -
www.ahrq.gov/sites/default/files/wysiwyg/chsp/compendium/2018-chsp-tin-linkage-file-tech-doc.pdfJanuary 01, 2018 - xvii Invalid TINs appear in the data when a valid TIN was not reported on MA claims. … Medicare claims We used billing information in 2018 Medicare fee-for-service claims to create an analytic … used to create the MD-PPAS data, including only claims: 1. … A date of service can include more than one service and multiple Medicare claims. … Medicare claims 4. IQVIA OneKey database III. Methodology A.
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/lessons/lessons-using-pqms.pdfJanuary 01, 2016 - Instead of using the specified denominator (an enrolled health plan population based on claims data) … measures developed for use at the state or health plan level often rely on program administrative or claims … At the health system, hospital, or practice level, however, these claims data are often unavailable … significant number of self-paid visits—documented in electronic medical records (EMRs) but not in claims … One key informant – a state Medicaid medical director – noted that pharmacy claims, which are available
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www.ahrq.gov/professionals/clinicians-providers/resources/rice/ceproj.htmlOctober 01, 2014 - To what extent do they include economic models, which can incorporate claims not directly related to … To what extent do economic models incorporate claims not directly related to the approved indication?
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Final Report: Modeling Risk and Reducing Liability through Better Communication and Teamwork (pdf file)
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/baker-report.pdfApril 01, 2012 - that team training improved team performance in labor and delivery (L&D) and reduced the number of claims … improving teamwork, another prevailing strategy for improving care quality and reducing liability claims … Research has shown that, when physicians disclose their mistakes, payouts for claims against the doctor … communication between providers and patients/families and, as a result, mitigate risk and reduce liability claims
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