list. 1: Yes, 2: No Plan Paid Single, 50 words. Amount (Net Nothing Payment) required list. 1: Yes, 2: No Capitation Single, 50 Financials Nothing (per required Provider / list. Facility) 1: Yes, 2: No [1] If a portion of Applicant provider payments are capitated. If capitation does not check and “No” state “Not applicable, no provider payments are capitated” in the rightmost column. 12.4 Can Applicant provide member and subscriber IDs assigned by the Exchange on all records submitted? In the absence of other Personally Identifiable Information (PII), these elements are critical for the HEI Vendor to generate unique encrypted member identifiers linking eligibility to claims and encounter data, enabling the HEI Vendor to follow the health care experience of each de-identified member, even if he or she moves from one plan to another. If not, or if yes with deviation, explain. If unable or unwilling to provide all requested detail, elaborate on problematic data elements, estimating the number and percentage of affected enrollments, claims, and encounters. No space for details provided. Detail to be Provided Response If No or Yes with deviation, explain.
list. 1: Yes, 2: No Plan Paid Amount (Net Payment) Single, list. 1: Yes, 2: No 50 words. Nothing required Capitation Financials (per Provider / Facility) [1] If a portion of Applicant provider payments are capitated. If capitation does not check “No” and state “Not applicable, no provider payments are capitated” in the rightmost column. Single, list. 1: Yes, 2: No 50 Nothing required 12.4 Can Applicant provide member and subscriber IDs assigned by the Exchange on all records submitted? In the absence of other Personally Identifiable Information (PII), these elements are critical for the HEI Vendor to generate unique encrypted member identifiers linking eligibility to claims and encounter data, enabling the HEI Vendor to follow the health care experience of each de-identified member, even if he or she moves from one plan to another. If not, or if yes with deviation, explain. If unable or unwilling to provide all requested detail, elaborate on problematic data elements, estimating the number and percentage of affected enrollments, claims, and encounters. No space for details provided. Detail to be Provided Response If No or Yes with deviation, explain.
CCSB%20QHP%20Certification%20Application%20Plan%20Year%202019%20Quarterly%20Application_Final.docx