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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-7199

Data Quality Measure
Last updated

Key Information

Measure Name % of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period
File Type Multiple Files
Measure ID RULE-7199
Measure Type Claims Percentage
Content area ALL MCR MULTI

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Managed care
Category Program participation

Claim Information

Claim Type Medicaid,Enc or CHIP,Enc
Adjustment Type All Adjustment Types
Crossover Type All Indicators

Thresholds

Minimum 0
Maximum 0.02
TA Minimun 0
TA Maximum 0.02
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element BEGINNING-DATE-OF-SERVICE • MANAGED-CARE-CONTRACT-END-DATE • MANAGED-CARE-CONTRACT-EFF-DATE • PLAN-ID-NUMBER
DD Data Element Number CLT048 • MCR021 • MCR020 • CLT080

Annotation N/A
Specification RULE-7199