URSA-CORE-934: Institutional Headers with Critical Missing Data

Measure Description

Among institutional claim or bill header records, the percentage with at least one unpopulated critical field; critical fields are: Patient ID, Billing Provider ID, Claim Covered Start Date, and Type of Bill Code.

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Event
• Component Class: Normal-Form
• Denominator Case Field: Document ID
• Target Direction: Down

Denominator Description

One per institutional claim or bill header record.

Numerator Description

One per qualifying denominator observation with at least one unpopulated critical field; critical fields are: Patient ID, Billing Provider ID, Claim Covered Start Date, and Type of Bill Code.

Published Fields

• Data Model Keys

  • Document ID
  • Patient ID
  • Institutional Claim ID
  • Institutional Bill ID
  • Billing Provider ID
  • Plan ID
  • Payor ID
  • Source ID

• 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)

• Billing and Claims Fields

  • CMS Type of Bill Code

• Numerator Fields

  • Is Patient ID NULL
  • Is Billing Provider ID NULL
  • Is Claim Covered Start Date NULL
  • Is CMS Type of Bill Code NULL

• Metadata Fields

  • Document Type Description

• Measure Fields

  • Denominator