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TMSIS Dataguide Medicaid.gov

Version:

3.40.0

RULE-8737

Data Quality Measure
Last updated

Key Information

Measure Name % of non-void sub-capitation payment records with a populated PAYEE-ID (FTX033) for a sub-capitated network provider that does not match a SUBMITTING-STATE-PROV-ID or PROV-IDENTIFIER value reported in the PRV file.
File Type Multiple Files
Measure ID RULE-8737
Measure Type Non-Claims Percentage
Content area MULTI PRO

Validation

Validation Type Inferential

Measure Priority

Measure Priority Medium
Focus Area N/A
Category Provider information

Claim Information

Claim Type N/A
Adjustment Type All Adjustment Types
Crossover Type N/A

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 PAYER-ID-TYPE • PAYER-ID • SUBMITTING-STATE-PROV-ID
DD Data Element Number FTX029 • FTX028 • PRV019

Annotation N/A
Specification RULE-8737