Measure Description
Among professional billing or claims service line items from sources with line-level financial data coverage, the percentage with zero-dollar or missing allowed and paid amounts
Metadata
- Measure Type: Rate Measure
- Temporal Structure: Event
- Component Class: Normal-Form
- Denominator Case Field: Service Line Item Document ID
- Target Direction: Down
Denominator Description
Professional billing or claims service line items
Numerator Description
Denominator observations with missing or zero-valued line allowed amount, line plan paid amount, line COB paid amount, and line patient paid amount.
Published Fields
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Data Model Keys
- Patient ID
- Billing Provider ID
- Service Provider ID
- Payor ID
- Plan ID
- Service Line Item Document ID
- Source ID
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Date Fields
- Covered Start Date
- Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
- Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
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Provider Fields
- Billing Primary NUCC Provider Taxonomy Description
- Service Provider Description
- Service Primary NUCC Provider Taxonomy Description
-
Insurance Fields
- Plan Description
- Plan Financial Class Description
-
Clinical Services Fields
- HCPCS Code
-
Billing and Claims Fields
- Is Anesthesia Billing Format
- CMS Place of Service Code
- Is Service Line Number 1
-
Financial Fields
- Service Line Item Charge Amount
-
Numerator Fields
- Is Positive Allowed or Paid Amounts
-
Measure Fields
- Denominator