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?
| Field | Data Dictionary Definition |
| Client ID | The internal identifier associated with a client |
| Client Name | Name of the Client |
| Project ID | The internal identifier associated with a project |
| Project Name | The name associated with a project |
| HIOS | Plan identifier for IVA plans only |
| Member ID | The internal identifier associated with a member |
| Enrollee ID | Client or government supplied identifier for a member (outside of the Member ID field) |
| Full Name | The first and last name of a member |
| Gender | The gender of a member |
| Date of Birth | The date of birth of the member |
| Stratum Level | The 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 HCC | The list provided by the government of recognized HCCs for a given enrollee in IVA |
| Chase ID | The internal identifier associated with a chase |
| Measure | Determines the type of an associated chase, which indicates what the coder is seeking to validate |
| Parent Chase ID | The Chase ID of the original chase that spawned the (non-parent) Chase ID associated |
| Parent Chase Measure | Determines the type of an associated parent chase, which indicates what the coder is seeking to validate in the original chase |
| Workflow Status ID | The internal identifier associated with the workflow status of a given chase |
| Workflow Status | The current workflow state of a given chase |
| Current Chase Status | The current status of a chase |
| Pend Code | An 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 Description | Description of a pend code |
| Pend Status | Status of a pend code |
| Client AID | Internal identifier for a chase location |
| AID | Internal Address Identifier (AID) associated with a chase address that has been cleaned/combined and added to the master document source table |
| Group Name | The name associated with an AID (if available) |
| Data Load Group Name | The name associated with a data load address |
| Address1 | First line of processed data load (master) address |
| Address2 | Second line of processed data load (master) address |
| City | City associated with a processed data load (master) address |
| State | Geographical state associated with a processed data load (master) address |
| Zip Code | Zip code associated with a processed data load (master) address |
| EDGE Unsub List | The list of EDGE HCCs that are not substantiated by any chase ID associated to the member |
| EDGE Unsub List Count | The count of EDGE HCCs that are not substantiated by any chase ID associated to the member |
| EDGE Sub List Count | The count of EDGE HCCs that are substantiated by any chase ID associated to the member |
| EDGE Sub List | The list of EDGE HCCs that are substantiated by any chase ID associated to the member |
| RADVDE Unsub Chase | The list of EDGE HCCs that are not substantiated within the associated chase |
| RADVDE Sub Chase | The list of EDGE HCCs that are substantiated within the associated chase |