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Managed care organization examples include: Independent Physician or Practice Associations. Integrated Delivery Organizations. Physician Practice Management Companies. Group Purchasing Organizations. Accountable Care Organizations. Integrated Delivery Systems. Physician-Hospital Organizations.
Encounters (Visits) are defined to include a documented, face-to-face contact between a user and a provider who exercises independent judgment in the provision of services to the individual. To be included as an encounter, services rendered must be documented.
Medicare Advantage encounter data is intended to capture the details of a Medicare Advantage beneficiarys health and treatment based on encounters with clinicians. This data is used to understand the health status of enrollees.
What is Encounter Data? Encounter data is detailed data generated by health care providers, such as doctors and hospitals, that documents both the clinical conditions they diagnose as well as the services and items delivered to beneficiaries to treat these conditions.
What is Encounter Data? Encounter data is detailed data generated by health care providers, such as doctors and hospitals, that documents both the clinical conditions they diagnose as well as the services and items delivered to beneficiaries to treat these conditions.
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Encounter data are the records of services delivered to Medicaid beneficiaries enrolled in managed care plans that receive a capitated, per-member-per-month payment. These records allow the Medicaid agency to track the services received by members enrolled in managed care.
Californias government collects vast amounts of clinical and cost data about the care it provides to the 12 million people enrolled in Medi-Cal, the nations largest Medicaid program.
While claims data ensures payment accuracy for providers paid under fee-for-service care models, encounter data serves the same administrative purpose for capitated care models at both the provider and the health plan levels.
What is Encounter Data? Encounter data is detailed data generated by health care providers, such as doctors and hospitals, that documents both the clinical conditions they diagnose as well as the services and items delivered to beneficiaries to treat these conditions.
There are three types of managed care plans: Health Maintenance Organizations (HMO) usually only pay for care within the network. Preferred Provider Organizations (PPO) usually pay more if you get care within the network. Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care.

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