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Measure Name | % of claim headers with a Billing Provider Number that is not found on the provider file during the dates of service |
---|---|
File Type | Multiple Files |
Measure ID | RULE-1540 |
Measure Type | Claims percentage |
Content area | ALL MULTI PRO |
Validation Type | Inferential |
---|
Measure Priority | N/A |
---|---|
Focus Area | N/A |
Category | N/A |
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 |
Minimum | 0 |
---|---|
Maximum | 0.02 |
TA Minimun | |
TA Maximum | |
Longitudinal Threshold | N/A |
For TA
(for including in compliance training) |
No |
For TA
(Longitudinal) |
No |
DD Data Element | SUBMITTING-STATE-PROV-ID • BEGINNING-DATE-OF-SERVICE • PROV-IDENTIFIER • BILLING-PROV-NUM • ENDING-DATE-OF-SERVICE |
---|---|
DD Data Element Number | PRV019 • COT033 • PRV081 • COT112 • COT034 |
Annotation | N/A |
---|---|
Specification | N/A |