Read about the team’s weekly work to review, problem-solve, and analyze encounter data coding or procedural standards and learn how you can get involved.
See encounter data submission resources, requirements, and contacts from the major Medi-Cal health plans in this printable reference guide.
Reduce duplicate encounters, a leading cause of submission rejections and poor encounter data quality, with this resource that highlights recommended actions for regulators, plans, and submitters.
Prevent common encounter and claims submission errors that result in rework, reduced revenue, and potentially delayed patient care with this printable, easy-to-follow checklist.
Use this template to review duplicate logic requirements from across the healthcare industry.
Use this tool during encounter reconciliation to identify the minimum data elements necessary for plans to include in a file sent to the delegates.
Learn how to create and maintain a Trace ID to efficiently track down an original encounter when a correction is needed.
Use this resource to understand error response file structure and content, including TA1, 999, and 277 files, to quickly address encounters that require correction and resubmission.
Follow these recommended actions for submitting newborn encounters to adhere to DHCS requirements and standardize the submission process for all stakeholders.
Health plans can use these recommendations to align EDI companion guide with industry standards for improved encounter data exchange.