Results

Total Results: 1,772 records

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

61. Asthma 1: Emergency Room Visits for Children between 3 and 21 with identifiable asthma (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/sas-code.pdf
    October 31, 2018 - Claims will be filtered by time, diagnosis code, and age at service but can be pre-filtered to cut … Table: All (unfiltered) medical claims for at least the patients in the measure cohort. … These claims are in wide form and have 1 record per claim. … The Process: 1) 'Claims' dataset: claims are read in. 2) The program identifies whether … with that body system indicated (sum across claims). */ *indicator y/n; *sum across claims; if

62. AHRQ Physician and Physician Practice Research Database (3P-RD) (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/AHRQ-Physician-and-Physician-Practice-Research-Database-3P-RD-FINAL.pdf
    February 08, 2023 - Databases (APCD and other claims sources) ► State Medical Boards (SMB) • Nine (9) other data sources … 13 3P-RD States ► Name, date, and full address clean-up • Develop Physician characteristics from claims … NPI-Servicing Zip Code ► Not all APCD had TIN • Develop Physician Practice characteristics from claims … Variables • All variables standardized across all states regardless of claims data source • All … per month (total and by payor) • Patients per month (total and by payor) • Claims per patient per

63. Appendix A. Detailed Literature Search Methodology | Agency for Healthcare Research and Quality
    www.ahrq.gov/data/apcd/envscan/app-a.html
    June 01, 2017 - All-Payer Claims Databases Measurement of Care: Systematic Review and Environmental Scan of Current Practices … Literature Search Methodology Previous Page Next Page Table of Contents All-Payer Claims … The search included articles since January 2008, when the first all-payer claims databases (APCDs) were … data” OR “claims data.” … data (e.g., survey data or clinical data not available in the claims database).

64. United States Health Information Knowledgebase | Agency for Healthcare Research and Quality
    www.ahrq.gov/data/ushik.html
    July 01, 2022 - artifacts for Centers for Medicare & Medicaid Services (CMS) Quality Reporting Programs, State all-payer claims … The All-Payer Claims Databases portal contained APCD File Submission Specifications from 14 states. … APCDs are large-scale databases that systematically collect healthcare claims data from a variety of … , pharmacy claims, eligibility files, provider (physician and facility) files, and dental claims from … leveraging data from within the insurance claims and reimbursement system.

65. 1b.4_Input_File_Specifications_508 (xls file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/input-file-specifications.xlsx
    January 01, 2014 - Medical Claims Reference Name Concept Description Variable Type Note claim_header_id Claim level … unique identifier text or numeric Can be derived, just need a way to uniquely identify claims. … unique identifier text or numeric Can be derived, just need a way to uniquely identify claims. … Note: Comorbidity source table is in wide form, unlike the medical claims source table DX2 The ICD9 … End of Table Pharmacy Claims Pharmacy Claims Reference Name Concept Description Required Variable

66. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Tables 13 & 14 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables13-14.pdf
    October 17, 2019 - Min 25th Percentile Median 75th Percentile Max Subset following claims … $66,899 $29,432 $24,260 $44,612 59,082 $82,679 $191,200 Subset following claims … ZIP code or missing census data, yielding n=546 (98.0%). **** Among the subset of children following claims … code or missing census data, yielding n=426 (98.2%). ***** Among the subset of children following claims … 94.1 100 100 Subset who had an MRI (n=546)*** 77.6 33.2 0 68.5 95.4 100 100 Subset following claims

67. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Tables 11 & 12 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables11-12.pdf
    October 17, 2019 - 546)*** 0.4 (0.4) 5.6 (8.6) 8.0 (11.8) 0.1 (0.2) 79.7 (16.8) 2.6 (1.5) 3.7 (6.1) Subset following claims … (8.2) 8.1 (12.3) 0.1 (0.5) 79.3 (16.9) 2.7 (2.1) 4.1 (6.2) Subset following claims … missing or unmatched ZIP code, yielding n=546 (98.0%). **** Among the subset of children following claims … missing or unmatched ZIP code, yielding n=426 (98.2%). ***** Among the subset of children following claims … CT exclusions (n=426)**** 10.8 (14.9) Subset following claims MRI exclusions (n=489)***** 9.6 (13.4

68. Appendix A. Grantee Profiles | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/reports/candor-demo-program/plan-grants/appa.html
    August 01, 2022 - First, an actuarial review of claims concluded that the use of an ACEx2 system might stabilize claims … inflation and reduce costs through an accelerated claims process. … The RMCM was modeled after the University of Michigan Claims Management Model. … During this time period, 41 claims had sufficient data for analysis. … Claims were categorized by six unique claim types that ranged from grievances to formal claims against

69. Physician and Physician Practice Research Database Feasibility Report (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Feasibility-Report.pdf
    February 01, 2024 - Claims files derived from CMS sources as well as state all-payer claims database (APCD) data, where … We then identified APCD or CMS claims (claims) data elements as sources to enhance the core 3P-RD data … files, although access to claims data can be challenging. … Claims data (APCD data And additional claims data [e.g., Medicare FFS, T-MSIS]) • Claims data … information and claims information to be more closely aligned

70. Transcranial Doppler (TCD) Ultrasonography Screening for Children with SCD; and Appropriate Antibiotic Prophylaxis (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra-1416-p007-2-ef.pdf
    November 01, 2015 - Claims data. … Claims data. … (MAX) administrative claims data from six States with a moderate to high prevalence of SCD … ● This measure was also tested using administrative claims acquired directly from the respective … Caveats These measures are based on administrative claims; incomplete reporting of claims or SCD diagnosis

71. CHIPRA 235: Section 6, Table 5. Reasons for Variance (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-235-section-6-table-5.pdf
    January 01, 2013 - code was added/updated after Analyst 1 data extraction 1 Data update: Specialty-related visit claims … code was added/updated after Analyst 1 data extraction 2 Data update: Specialty-related visit claims … code was added/updated after Analyst 1 data extraction 2 Data update: Specialty-related visit claims … code was added/updated after Analyst 1 data extraction 1 Data update: Specialty-related visit claims … taxonomy record was added after Analyst 1 data extraction 1 Data update: Specialty-related visit claims

72. Conclusion and Future Directions | Agency for Healthcare Research and Quality
    www.ahrq.gov/data/apcd/backgroundrpt/conclusion.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 … Data Evaluation of All-Payer Claims Databases Discussion Conclusion and Future Directions References … This will require building a dataset by removing potential duplicates or claims that have been replaced

73. Chipra-141-Section-2-Tech-Specs (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-141-section-2-tech-specs.pdf
    December 01, 2012 - Algorithm to identify children with complex and non-complex chronic conditions using Medicaid claims … file that includes all claims (inpatient, outpatient, managed care encounter data) and has at … The Process: 1) 'Claims' dataset: claims are read in and the decimals are stripped from the … ICD-9 codes with or without decimals are thus accommodated. 2) Claims are sorted by person … <---- 1) SET LOCATION OF CLAIMS DATA TO BE USED; %let icdnum=25;

74. Section 8.A, Data Availability (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-153-section-8a.pdf
    January 01, 2011 - Some states do not report enrollment data, and none reports claims for their state funded (S-CHIP) … Additionally, while some states usually provide managed care claims, others do not (Byrd and Verdier … Testing managed care claims data quality in each state Managed care claims data is sometimes absent … States highlighted in Gray did not meet criteria to be utilized for studying appendectomy claims. … All claims data in these states is reported via FFS or PCCM, wherein claims are billed as FFS.

75. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Table 7 - 10 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables7-10.pdf
    January 01, 2006 - days after the date of evaluation for atraumatic seizure, was calculated using 5 consecutive years of claims … data drawn from Medicaid Analytic eXtract (MAX) administrative claims data provided by the Centers … range) 0.98 (0.81-0.99) Table 9: Contingency Table for Presence of Exclusions in Administrative Claims … Measurement Year Exclusion Documented in Charts Present Absent Total Exclusion present based on claims … 97 Total 13 91 104 Table 10: Contingency Table for Presence of Exclusions in Administrative Claims

76. Tables 7-10 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-196-section-6.pdf
    January 01, 2006 - after the date of evaluation for atraumatic headache, was calculated using 5 consecutive years of claims … data drawn from Medicaid Analytic eXtract (MAX) administrative claims data provided by the Centers … range) 0.99 (0.90-1.00) Table 9: Contingency Table for Presence of Exclusions in Administrative Claims … Measurement Year Exclusion Documented in Charts Present Absent Total Exclusion present based on claims … 62 Total 18 48 66 Table 10: Contingency Table for Presence of Exclusions in Administrative Claims

77. Findings | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/reports/candor-demo-program/plan-grants/findings.html
    August 01, 2022 - Of the 230 claims examined, 13 (5.7%) were determined to involve a potential transition of care event … was instituted in 2008 based on the successful University of Michigan Claims Management Model. … In the first part of the study, researchers surveyed patients and medical staff involved in 41 claims … In the second part of the study, researchers compared the same 41 claims closed under the new system … and (2) a safe harbor rule could have altered the course or outcome of medical liability claims; and

78. Appendix A. Grantee Profiles | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/hospital/candor/demo-program/grants/appa.html
    August 01, 2022 - Malpractice claims. … claims, 59 settlements), 2006–2007 (142 claims, 24 settlements), 2009–2010 (100 claims, 17 settlements … Claims. … Claims. … Findings Claims.

79. Section 6.A, Figures 1 to 4 and Table 5 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0138-section-6a.pdf
    December 01, 2013 - tested using a sample drawn from 5 consecutive years of Medicaid Analytic eXtract (MAX) administrative claims … tested using a sample drawn from 5 consecutive years of Medicaid Analytic eXtract (MAX) administrative claims …                                                       Figure 3: Michigan Medicaid Claims … CHAMPS) compared with a corresponding sample drawn from Medicaid Analytic eXtract (MAX) administrative claims … Figure 4: Michigan Medicaid Claims Results Compared with MAX data for 350‐Day Rate 0% 5% 10%

80. Discussion | Agency for Healthcare Research and Quality
    www.ahrq.gov/data/apcd/backgroundrpt/discuss.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 … Data Evaluation of All-Payer Claims Databases Discussion Conclusion and Future Directions References … Although claims data have been tagged a source of health care price transparency, when cost data are