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IVA HST Prioritization

Report Name
IVA HST Prioritization


About This Report

This report provides HST chases sorted by priority, with priority defined as the number of RADVDE/EDGE HCCs that could potentially be satisfied by the chase and are not substantiated by other chases for the member. 


Project Type

IVA


Service Type

Full Service, Clinical Only


Intended User

Manager / Technical User


Best For

Knowing the priority in which HST chases need to be pursued for maximum EDGE substantiation.  


Using This Report

  • Download the report and use within Excel
  • Identify members with no RADVDE/EDGE chases Substantiated, Members with high RADVDE/EDGE HCC Unsubstantiated chases, etc.


What Information Can I Filter?

Project
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
Priority Chase Count(Original Measure: IVA Prioritization Source Count) A distinct count measure of the associated data items filtered to measure = 'HST' and Workflow Status = 'Chart Collection' or 'Waiting for Chart'
Priority Chase Reporting Status Counts (Graph)Displays the count of priority chases by different statuses
Client IDThe internal identifier associated with a client
Client NameName of the Client
Project IDThe internal identifier associated with a client
Project NameThe name associated with a project
HIOSThe name associated with a project
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
Date of BirthThe date of birth of the member
GenderThe gender of a 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
Chase TagsShort phrases used to categorize chases. These tags allow users to organize chases more efficiently
Chase Assigned ToThe name of the user that a given chase is assigned to
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
Co Retrieval Owner

The organization that is retrieving the chase

Expected Retrieval Method
The expected method to retrieve medical charts for a given 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 StatusDescription 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
AID TagsShort phrases used to categorize AIDs. These tags allow users to organize AIDs more efficiently
Special Handling ReasonThis AID has a unique set of needs
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
Zip CodeZip code associated with a processed data load (master) address
StateGeographical state 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
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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