Skip to end of banner
Go to start of banner

Issue: Cigna B Medical Claims Versioning

Skip to end of metadata
Go to start of metadata

You are viewing an old version of this page. View the current version.

Compare with Current View Page History

« Previous Version 8 Current »



Number

0053

Submitting Entity (SE)

67369

Add Date

 

Update Date

Update

Description

Versioning issues exist for all data where paid date (MC017) is > 2017-02-28.  To identify the most recent update, group the Claim Number (MC004) and Claim Line (MC005) together and sort by Paid Date (MC017). The MC004 – MC005 combination with the highest MC017 is the final version (NOTE: if there is a tie, record with positive Count of Services Rendered – MC061 is the one to keep, disregard the others). If the Claim Status (MC138) of that final version is B, D, or V and/or the Count of Services Rendered – MC061 is negative, disregard all versions of that Claim-Claim Line combination.   Alternatively, analyses could use only historical data (MC017 <= 2017-02-28) which contain final paid claims.

This issue is present for data requests fulfilled after January 2019.

Active/Resolved

Active

Action / Resolution

Versioning rules are being developed with the submitter.  No ETA at this time.

Category 1

Versioning

Category 2

Data Quality

Tip / Issue

Issue



  • No labels