EPS1
CMS-Required Outcome
CMS-required outcome
The system ingests encounter data (submissions and re-submissions) from MCOs and sends quality transaction feedback back to the plans to ensure appropriate industry standard format. (Quality transaction checks include, but are not limited to: completeness, missing information, formatting, and the TR3 implementation guide business rules validations).
Default metrics
- Percentage of timely encounter submissions from MCOs.
Regulatory sources