Report Name
ENR Status Report
About This Report
This report provides the validation results of each data element of the ENR validation process by HIOS.
Project Type
IVA
Service Type
Full Service, Clinical Only
Intended User
Manager / Technical User
Best For
An IVA Program manager can track the program results and efficacy for ENR Audits.
Using This Report
- Download the report and use within Excel
- Track down all the validation results of the ENR chases including Member ID Validation Result, Enrollee First Name Validation Result, Enrollee Last Name Validation Result, Enrollee Gender Validation Result, Enrollee Date of Birth Validation Result, Plan ID Validation Result, Enrollment Start Date Validation Result, Enrollment End Date Validation Result, Premium Amount Validation Result, Rating Area Validation Result
- Access the EDGE Data and the data found by reviewer for each data element of the ENR chases
What Information Can I Filter?
| Project |
| Enrollee ID |
| Member ID |
| Client Member ID |
| Stratum Level |
What Do The Fields Mean?
| Field | Data Dictionary Definition |
| Enrollee Count | (Original Measure: Member Count) Count of members in the Issuer's Enrollment sample. |
| Screenshots Received | (Original Measure: Vw Mr50 Chase Workflow Summary Count, filtered to Workflow Status = 'Abstraction' or 'Overread' or 'Overread2' or 'Delivery' or 'Completed') A distinct count measure of the screenshots/charts that have completed the 'Chart QA' Workflow Status |
| ENR Chases Validated MRR | (Original measure: Ea Enrollment Count) A distinct count measure of the associated data items |
| ENR Chases in OR1 | (Original Measure: Vw Mr50 Chase Workflow Summary Count, filtered to Workflow Status = 'Overread') A distinct count measure of the associated data items |
| ENR Chases Validated OR1 | (Original measure: Ea Enrollment Count, filtered to Workflow Status = 'Overread2' and Enr Validated = '1') A distinct count measure of the associated data items |
| ENR Chases in OR2 | (Original Measure: Vw Mr50 Chase Workflow Summary Count, filtered to Workflow Status = 'Overead2') A distinct count measure of the associated data items |
| ENR Chases Validated OR2 | (Original measure: Ea Enrollment Count, filtered to Workflow Status = 'Delivery' and Enr Validated = '1') A distinct count measure of the associated data items |
| ENR Chases Completed | (Original Measure: Vw Mr50 Chase Workflow Summary Count, filtered to Workflow Status = 'Delivery' or 'Completed') A distinct count measure of the associated data items |
| ENR Chases No Match MRR | (Original measure: Ea Enrollment Count, filtered to Workflow Status = 'Overread' and Enr Validated != '1') A distinct count measure of the associated data items |
| ENR Chases No Match OR1 | (Original measure: Ea Enrollment Count, filtered to Workflow Status = 'Overread2' and Enr Validated != '1') A distinct count measure of the associated data items |
| ENR Chases No Match OR2 | (Original measure: Ea Enrollment Count, filtered to Workflow Status = 'Delivery' or 'Completed' and Enr Validated != '1') A distinct count measure of the associated data items |
| ENR Status Report (Table) | Displays all relevant data for ENR chases |
| Project ID | The internal identifier associated with a project |
| Project Name | The name associated with a project |
| HIOS | Plan identifier for IVA plans only |
| Measure Year | The measure year associated with a project |
| Client ID | The internal identifier associated with a client |
| Client Name | Name of the Client |
| Chase ID | The internal identifier associated with a chase |
| Current Chase Status | The status of a chase, based upon its workflow status and pend and invoice status |
| Measure ID | Internal identifier associated with a measure code |
| Member ID | The internal identifier associated with a member |
| Client Member ID | The client 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 |
| Member DOB Date | The date of birth of the member |
| Member Gender | The gender of a member |
| Subscriber Indicator | Flag indicates when an enrollee is a subscriber to a plan, if not, the enrollee is a dependent of another subscriber |
| EDGE Member ID | The member ID provided by the government for IVA ENR validation |
| Member ID by Reviewer | The member ID identified by the auditor for IVA ENR validation |
| Member ID Page Number | The page number that the member ID appears on for IVA ENR validation |
| Member ID Validation Result | Determines if the member ID matched between the source data and the auditor's findings for IVA ENR validation |
| Member ID Validation Comment | Comment provided by the auditor in regards to the member ID for IVA ENR validation |
| EDGE Enrollee First Name | The first name of the associated enrollee provided by the government for IVA ENR validation |
| Enrollee First Name by Reviewer | The first name of the associated enrollee identified by the auditor for IVA ENR validation |
| Enrollee First Name Page Number | The page number that the first name of the enrollee appears on for IVA ENR validation |
| Enrollee First Name Validation Result | Determines if the first name of the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Enrollee First Name Validation Comment | Comment provided by the auditor in regards to the first name of the enrollee for IVA ENR validation |
| EDGE Enrollee Last Name | The last name of the associated enrollee provided by the government for IVA ENR validation |
| Enrollee Last Name by Reviewer | The last name of the associated enrollee identified by the auditor for IVA ENR validation |
| Enrollee Last Name Page Number | The page number that the last name of the enrollee appears on for IVA ENR validation |
| Enrollee Last Name Validation Result | Determines if the last name of the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Enrollee Last Name Validation Comment | Comment provided by the auditor in regards to the last name of the enrollee for IVA ENR validation |
| EDGE Enrollee Gender | The gender of the associated enrollee provided by the government for IVA ENR validation |
| Enrollee Gender by Reviewer | The gender of the associated enrollee identified by the auditor for IVA ENR validation |
| Enrollee Gender Page Number | The page number that the gender of the enrollee appears on for IVA ENR validation |
| Enrollee Gender Validation Result | Determines if the gender of the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Enrollee Gender Validation Comment | Comment provided by the auditor in regards to the gender of the enrollee for IVA ENR validation |
| EDGE Enrollee Date of Birth | The date of birth of the associated enrollee provided by the government for IVA ENR validation |
| Enrollee Date of Birth by Reviewer | The date of birth of the associated enrollee identified by the auditor for IVA ENR validation |
| Enrollee Date of Birth Page Number | The page number that the date of birth of the enrollee appears on for IVA ENR validation |
| Enrollee Date of Birth Validation Result | Determines if the date of birth of the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Enrollee Date of Birth Validation Comment | Comment provided by the auditor in regards to the date of birth of the enrollee for IVA ENR validation |
| EDGE Plan ID | The plan id of the associated enrollee provided by the government for IVA ENR validation |
| Plan ID by Reviewer | The plan id of the associated enrollee identified by the auditor for IVA ENR validation |
| Plan ID Page Number | The page number that the plan id of the enrollee appears on for IVA ENR validation |
| Plan ID Validation Result | Determines if the plan id of the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Plan ID Validation Comment | Comment provided by the auditor in regards to the plan id of the enrollee for IVA ENR validation |
| EDGE Enrollment Start Date | The start date of enrollment of the associated enrollee identified by the auditor for IVA ENR validation |
| Enrollment Start Date by Reviewer | The start date of enrollment of the associated enrollee identified by the auditor for IVA ENR validation |
| Enrollment Start Date Page Number | The page number that the start date of enrollment of the enrollee appears on for IVA ENR validation |
| Enrollment Start Date Validation Result | Determines if the enrollment start date of the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Enrollment Start Date Validation Comment | Comment provided by the auditor in regards to the enrollment start date of the enrollee for IVA ENR validation |
| EDGE Enrollment End Date | The end date of enrollment of the associated enrollee identified by the government for IVA ENR validation |
| Enrollment End Date by Reviewer | The end date of enrollment of the associated enrollee identified by the auditor for IVA ENR validation |
| Enrollment End Date Page Number | The page number that the end date of enrollment of the enrollee appears on for IVA ENR validation |
| Enrollment End Date Validation Result | Determines if the enrollment end date of the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Enrollment End Date Validation Comment | Comment provided by the auditor in regards to the enrollment end date of the enrollee for IVA ENR validation |
| EDGE Premium Amount | The premium amount associated with the enrollee identified by the government for IVA ENR validation |
| Premium Amount by Reviewer | The premium amount associated with the enrollee identified by the auditor for IVA ENR validation |
| Premium Amount Page Number | The page number that the premium amount associated with the enrollee appears on for IVA ENR validation |
| Premium Amount Validation Result | Determines if the premium amount associated with the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Premium Amount Validation Comment | Comment provided by the auditor in regards to the premium amount associated with the enrollee for IVA ENR validation |
| APTC Amount by Reviewer | The APTC (advanced premium tax payment) associated with the enrollee identified by the auditor for IVA ENR validation |
| Aptc Amount Page Number | The page number that the APTC (advanced premium tax payment) associated with the enrollee appears on for IVA ENR validation |
| EDGE Rating Area | The rating area associated with the enrollee identified by the government for IVA ENR validation |
| Rating Area by Reviewer | The rating area associated with the enrollee identified by the auditor for IVA ENR validation |
| Rating Area Page Number | The page number that the rating area associated with the enrollee appears on for IVA ENR validation |
| Rating Area Validation Result | Determines if the rating area associated with the enrollee matched between the source data and the auditor's findings for IVA ENR validation |
| Rating Area Validation Comment | Comment provided by the auditor in regards to the rating area associated with the enrollee for IVA ENR validation |
| Enr Validated | Flag that indicates that all ENR data elements have been validated for the given enrollee |
| Reviewer User ID | The user id of the abstractor |
| Reviewer User Name | The name of the user associated with an abstraction |
| Review Date | The date that the chart attached to a chase has been coded or abstracted |
| Senior Reviewer User ID | The user ID of the OR2 coder, or if not relevant, the OR1 coder |
| Senior Reviewer Name | The user name of the OR2 coder, or if not relevant, the OR1 coder |
| Senior Review Date | The date the chase was over read either in OR2 or in OR1 if OR2 was not completed |
| Reviewer Type | Determines if the last coder of a chase is Primary if the original abstractor or Senior if overread |