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:

3.39.0

MCR-53-003-3

Data Quality Measure
Last updated

Key Information

Measure Name Total # of managed care encounters
File Type COT
Measure ID MCR-53-003-3
Measure Type Count
Content area MCR

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Managed care
Category Utilization

Claim Information

Claim Type N/A
Adjustment Type N/A
Crossover Type N/A

Thresholds

Minimum 1
Maximum N/A
TA Minimun 1
TA Maximum
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element STATE-PLAN-ID-NUM • MANAGED-CARE-PLAN-TYPE • TYPE-OF-SERVICE • PLAN-ID-NUMBER • MANAGED-CARE-PLAN-TYPE • MANAGED-CARE-PLAN-ID • PLAN-ID-NUMBER • PLAN-ID-NUMBER • PLAN-ID-NUMBER • OFFSET-TRANS-TYPE • PAYEE-MCR-PLAN-TYPE • PAYMENT-OR-RECOUPMENT-AMOUNT • PAYMENT-AMOUNT • PAYEE-ID-TYPE • MBESCBES-FORM-GROUP • PAYMENT-OR-RECOUPMENT-AMOUNT
DD Data Element Number MCR019 • ELG193 • COT186 • CLT080 • MCR024 • ELG192 • CIP130 • CRX056 • COT066 • FTX184 • FTX036 • FTX157 • FTX072 • FTX034 • FTX048 • FTX025

Annotation Sum total encounters for all plan ids in the EL-8-002-2 table, excluding those with plan types: 02, 03, 17, and 70
Specification STEP 1: Exclude Traditional PCCM, Enhanced PCCM, PACE, Health Home Plan Types

Of the Plan_Ids identified in EL-8-002-2, limit to Plan_Ids where:

1. Plan_Type_El is not equal to ("02","03", "17", or "70")



STEP 2: Total encounters

Of the non-missing Plan_Ids that meet the criteria in STEP 1, sum Encounters_Total