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Attachment #1: Examples of Encounter Data. Surgical Codes Admission Dates Discharge Dates Patient Status Code Long-term care Number of days X-Rays and Imaging Laboratory Services. “ What diagnosis was made? What tests were performed? What treatments were provided? ”. Health Plan ID
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Attachment #1: Examples of Encounter Data • Surgical Codes • Admission Dates • Discharge Dates • Patient Status Code • Long-term care • Number of days • X-Rays and Imaging • Laboratory Services “What diagnosis was made? What tests were performed? What treatments were provided?” Health Plan ID Beneficiary ID Date of Service Place of Service Provider Name Provider Number Prior Authorizations Referrals Diagnosis Codes Procedure Codes Medications/Prescriptions
Attachment #2: HEDIS Measurements • Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis • HbA1c Testing indicator used for Auto Assignment (Diabetes) • Children & Adolescents' Access to Primary Care Practitioners* • Immunizations for Adolescents* • Ambulatory care: Outpatient visits, Emergency Department visits* • Annual Monitoring for Patients on Persistent Medications (w/out anticonvulsant indicator)* • All-Cause Readmissions - Statewide Collaborative QIP measure* * New for 2012 Well-Child Visits (Years 3-6) Adolescent Well-Care Visits Childhood Immunization Status-Combo 3 Prenatal & Postpartum Care (Timeliness of Prenatal Care, Postpartum Care) Use of Imaging Studies for Low Back Pain Cervical Cancer Screening Weight Assessment & Counseling for Nutrition & Physical Activity for Children & Adolescents Comprehensive Diabetes Care (e.g. Eye exam, LDL-C screening & control, HbA1c testing & control, medical attention for Nephropathy, blood pressure)