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IVA Pursuit Prioritization

Report Name
IVA Pursuit Prioritization


About This Report

This report sorts IVA pursuit chases (ATT, DOB, GEN, & DOS) by necessary HCC count.


Project Type

IVA


Service Type

Full Service, Clinical Only


Intended User

Manager / Technical User


Best For

A program manager can use this report to determine which pursuits are necessary to complete for program success. 


Using This Report

  • Download the report and use within Excel
  • Create pivot table to group values that aggregate the individual line items to discrete categories



What Information Can I Filter?

Project
Measure
Enrollee ID
Member ID
Client Member ID
Claim ID
Chase ID
Stratum Level
Condition Category
Chase Status



 What Do The Fields Mean? 

FieldData Dictionary Definition
Client IDThe internal identifier associated with a client
Client NameName of the Client
Project IDThe internal identifier associated with a project
Project NameThe name associated with a project
HIOSPlan identifier for IVA plans only
Member IDThe internal identifier associated with a member
Enrollee IDClient or government supplied identifier for a member (outside of the Member ID field)
Full NameThe first and last name of a member
GenderThe gender of a member
Date of BirthThe date of birth of the member
Stratum LevelThe stratum indicator of the stratum in which the enrollee was included. Strata 1-9 represent low, medium and high-risk enrollees with at least one (1) HCC or (1) RXC for each age model. Stratum 10 includes enrollees with no HCCs and no RXCs. Note: Only the adult RA model includes RXCs therefore only the adult strata 1-3 will include enrollees with RXCs
EDGE HCCThe list provided by the government of recognized HCCs for a given enrollee in IVA
Chase IDThe internal identifier associated with a chase
MeasureDetermines the type of an associated chase, which indicates what the coder is seeking to validate
Parent Chase IDThe Chase ID of the original chase that spawned the (non-parent) Chase ID associated
Parent Chase MeasureDetermines the type of an associated parent chase, which indicates what the coder is seeking to validate in the original chase
Workflow Status IDThe internal identifier associated with the workflow status of a given chase
Workflow StatusThe current workflow state of a given chase
Current Chase StatusThe current status of a chase
Pend CodeAn internal identifier for the various reasons that a chase may be pended, awaiting further action/or info to collect or code a medical record
Pend Code DescriptionDescription of a pend code
Pend StatusStatus of a pend code
Client AIDInternal identifier for a chase location
AIDInternal Address Identifier (AID) associated with a chase address that has been cleaned/combined and added to the master document source table
Group NameThe name associated with an AID (if available)
Data Load Group NameThe name associated with a data load address
Address1First line of processed data load (master) address
Address2Second line of processed data load (master) address
CityCity associated with a processed data load (master) address
StateGeographical state associated with a processed data load (master) address
Zip CodeZip code associated with a processed data load (master) address
EDGE Unsub ListThe list of EDGE HCCs that are not substantiated by any chase ID associated to the member
EDGE Unsub List CountThe count of EDGE HCCs that are not substantiated by any chase ID associated to the member
EDGE Sub List CountThe count of EDGE HCCs that are substantiated by any chase ID associated to the member
EDGE Sub ListThe list of EDGE HCCs that are substantiated by any chase ID associated to the member
RADVDE Unsub ChaseThe list of EDGE HCCs that are not substantiated within the associated chase
RADVDE Sub ChaseThe list of EDGE HCCs that are substantiated within the associated chase










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