Question: What is a claim or encounter identifier?

Definition: Code indicating whether the transaction is a claim or reporting encounter information.

What is an encounter identifier?

An encounter is a system-assigned identification number tied to an episode of care.

What is an encounter claim?

What is Encounter/Claims Data? Encounter/Claims Data is defined as medical information submitted by health care providers (physicians, hospitals, Ancillaries, etc.) which documents both the clinical conditions, services and items delivered to the member to treat their conditions.

What is encounter information?

Encounter Information. An episode defined by an interaction between a healthcare provider and the subject of care in which healthcare-related activities take place.

Is an encounter a claim?

Encounter data are often referred to as claims data although in the MA program under capitated payment no claim for payment may actually be made.

What is the difference between encounter and fee for service?

Encounter data are similar to FFS claims data, but encounter data (1) are not tied to per-service payment from the state to the managed care organization (MCO), because the state is not paying for individual services, and (2) do not include a Medicaid-paid amount, although many states collect the amounts MCOs pay

What are the types of encounter?

Amongst them are ambulatory, emergency, home health, inpatient and virtual encounters. An Encounter encompasses the lifecycle from pre-admission, the actual encounter (for ambulatory encounters), and admission, stay and discharge (for inpatient encounters).

What is the medical definition for encounter form?

en·coun·ter form A service form also called a superbill that lists health care procedure codes completed during a patients office visit.

What is an example of fee for service?

A method in which doctors and other health care providers are paid for each service performed. Examples of services include tests and office visits.

What are the advantages of fee for service?

A Fee for Service plan generally offers the widest network of doctors and hospitals (compared to other types of plans, which limit access to some providers). Fee-for-service can involve two separate policies: Basic Coverage. Helps pay for normal daily health care, doctor visits, hospitalization and surgery.

What are the three types of service encounter?

There are three general types of service encounters – remote encounters, phone encounters, and face-to-face encounters. A customer may experience any of these types of service encounters, or a combination of all three in his/her relations with a service firm.

What is mean by service encounter?

Service encounter is generally defined as a consumers direct contact with a service provider, including both face-to-face interaction and experience [7]. [8] defines service encounter as “any discrete interaction between the customer and the service provider relevant to a core service offering”.

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