An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov

Version:

3.40.0

ALL-42-001-1

Data Quality Measure
Last updated

Key Information

Measure Name % of providers identified as AFFILIATED-PROGRAM-TYPE = 6 in PRV00009 who are not reported as sub-capitated network providers on sub-capitation encounters in the claims files (SOURCE-LOCATION = 23)
File Type Multiple Files
Measure ID ALL-42-001-1
Measure Type Claims Percentage
Content area ALL

Validation

Validation Type Inferential

Measure Priority

Measure Priority N/A
Focus Area N/A
Category N/A

Claim Information

Claim Type Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp
Adjustment Type All Adjustment Types
Crossover Type All Indicators

Thresholds

Minimum TBD
Maximum TBD
TA Minimun
TA Maximum
Longitudinal Threshold N/A
For TA
(for including in compliance training)
For TA
(Longitudinal) 		No

Data Elements

DD Data Element BILLING-PROV-NUM • BILLING-PROV-NUM • BILLING-PROV-NUM • SOURCE-LOCATION • BILLING-PROV-NUM • SOURCE-LOCATION • TOT-OTHER-INSURANCE-AMT • AFFILIATED-PROGRAM-TYPE • SOURCE-LOCATION
DD Data Element Number CRX070 • COT112 • CLT130 • CLT056 • CIP179 • CIP104 • COT056 • PRV119 • CRX032

Annotation N/A
Specification N/A