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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-7643

Data Quality Measure
Last updated

Key Information

Measure Name % of claim headers with an MSIS ID not enrolled on Beginning Date of Service
File Type Multiple Files
Measure ID RULE-7643
Measure Type Claims percentage
Content area ELG MCR MULTI

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Managed care
Category File integrity

Claim Information

Claim Type Medicaid,Enc or CHIP,Enc
Adjustment Type Non-void
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 MSIS-IDENTIFICATION-NUM • BEGINNING-DATE-OF-SERVICE • MSIS-IDENTIFICATION-NUM • ENROLLMENT-EFF-DATE • ENROLLMENT-END-DATE
DD Data Element Number CLT022 • CLT048 • ELG251 • ELG253 • ELG254

Annotation N/A
Specification RULE-7643