Welcome
Login  Sign up

ENR Status Report

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?  

FieldData 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 IDThe internal identifier associated with a project
Project NameThe name associated with a project
HIOSPlan identifier for IVA plans only
Measure YearThe measure year associated with a project
Client IDThe internal identifier associated with a client
Client NameName of the Client
Chase IDThe internal identifier associated with a chase
Current Chase StatusThe status of a chase, based upon its workflow status and pend and invoice status
Measure IDInternal identifier associated with a measure code
Member IDThe internal identifier associated with a member
Client Member IDThe client 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
Member DOB  DateThe date of birth of the member
Member GenderThe gender of a member
Subscriber IndicatorFlag indicates when an enrollee is a subscriber to a plan, if not, the enrollee is a dependent of another subscriber
EDGE Member IDThe member ID provided by the government for IVA ENR validation
Member ID by ReviewerThe member ID identified by the auditor for IVA ENR validation
Member ID Page NumberThe page number that the member ID appears on for IVA ENR validation
Member ID Validation ResultDetermines if the member ID matched between the source data and the auditor's findings for IVA ENR validation
Member ID Validation CommentComment provided by the auditor in regards to the member ID for IVA ENR validation
EDGE Enrollee First NameThe first name of the associated enrollee provided by the government for IVA ENR validation
Enrollee First Name by ReviewerThe first name of the associated enrollee identified by the auditor for IVA ENR validation
Enrollee First Name Page NumberThe page number that the first name of the enrollee appears on for IVA ENR validation
Enrollee First Name Validation ResultDetermines 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 CommentComment provided by the auditor in regards to the first name of the enrollee for IVA ENR validation
EDGE Enrollee Last NameThe last name of the associated enrollee provided by the government for IVA ENR validation
Enrollee Last Name by ReviewerThe last name of the associated enrollee identified by the auditor for IVA ENR validation
Enrollee Last Name Page NumberThe page number that the last name of the enrollee appears on for IVA ENR validation
Enrollee Last Name Validation ResultDetermines 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 CommentComment provided by the auditor in regards to the last name of the enrollee for IVA ENR validation
EDGE Enrollee GenderThe gender of the associated enrollee provided by the government for IVA ENR validation
Enrollee Gender by ReviewerThe gender of the associated enrollee identified by the auditor for IVA ENR validation
Enrollee Gender Page NumberThe page number that the gender of the enrollee appears on for IVA ENR validation
Enrollee Gender Validation ResultDetermines if the gender of the enrollee matched between the source data and the auditor's findings for IVA ENR validation
Enrollee Gender Validation CommentComment provided by the auditor in regards to the gender of the enrollee for IVA ENR validation
EDGE Enrollee Date of BirthThe date of birth of the associated enrollee provided by the government for IVA ENR validation
Enrollee Date of Birth by ReviewerThe date of birth of the associated enrollee identified by the auditor for IVA ENR validation
Enrollee Date of Birth Page NumberThe page number that the date of birth of the enrollee appears on for IVA ENR validation
Enrollee Date of Birth Validation ResultDetermines 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 CommentComment provided by the auditor in regards to the date of birth of the enrollee for IVA ENR validation
EDGE Plan IDThe plan id of the associated enrollee provided by the government for IVA ENR validation
Plan ID by ReviewerThe plan id of the associated enrollee identified by the auditor for IVA ENR validation
Plan ID Page NumberThe page number that the plan id of the enrollee appears on for IVA ENR validation
Plan ID Validation ResultDetermines if the plan id of the enrollee matched between the source data and the auditor's findings for IVA ENR validation
Plan ID Validation CommentComment provided by the auditor in regards to the plan id of the enrollee for IVA ENR validation
EDGE Enrollment Start DateThe start date of enrollment of the associated enrollee identified by the auditor for IVA ENR validation
Enrollment Start Date by ReviewerThe start date of enrollment of the associated enrollee identified by the auditor for IVA ENR validation
Enrollment Start Date Page NumberThe page number that the start date of enrollment of the enrollee appears on for IVA ENR validation
Enrollment Start Date Validation ResultDetermines 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 CommentComment provided by the auditor in regards to the enrollment start date of the enrollee for IVA ENR validation
EDGE Enrollment End DateThe end date of enrollment of the associated enrollee identified by the government for IVA ENR validation
Enrollment End Date by ReviewerThe end date of enrollment of the associated enrollee identified by the auditor for IVA ENR validation
Enrollment End Date Page NumberThe page number that the end date of enrollment of the enrollee appears on for IVA ENR validation
Enrollment End Date Validation ResultDetermines 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 CommentComment provided by the auditor in regards to the enrollment end date of the enrollee for IVA ENR validation
EDGE Premium AmountThe premium amount associated with the enrollee identified by the government for IVA ENR validation
Premium Amount by ReviewerThe premium amount associated with the enrollee identified by the auditor for IVA ENR validation
Premium Amount Page NumberThe page number that the premium amount associated with the enrollee appears on for IVA ENR validation
Premium Amount Validation ResultDetermines 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 CommentComment provided by the auditor in regards to the premium amount associated with the enrollee for IVA ENR validation
APTC Amount by ReviewerThe APTC (advanced premium tax payment) associated with the enrollee identified by the auditor for IVA ENR validation
Aptc Amount Page NumberThe page number that the APTC (advanced premium tax payment) associated with the enrollee appears on for IVA ENR validation
EDGE Rating AreaThe rating area associated with the enrollee identified by the government for IVA ENR validation
Rating Area by ReviewerThe rating area associated with the enrollee identified by the auditor for IVA ENR validation
Rating Area Page NumberThe page number that the rating area associated with the enrollee appears on for IVA ENR validation
Rating Area Validation ResultDetermines 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 CommentComment provided by the auditor in regards to the rating area associated with the enrollee for IVA ENR validation
Enr ValidatedFlag that indicates that all ENR data elements have been validated for the given enrollee
Reviewer User IDThe user id of the abstractor
Reviewer User NameThe name of the user associated with an abstraction
Review DateThe date that the chart attached to a chase has been coded or abstracted
Senior Reviewer User IDThe user ID of the OR2 coder, or if not relevant, the OR1 coder
Senior Reviewer NameThe user name of the OR2 coder, or if not relevant, the OR1 coder
Senior Review DateThe date the chase was over read either in OR2 or in OR1 if OR2 was not completed
Reviewer TypeDetermines if the last coder of a chase is Primary if the original abstractor or Senior if overread



Did you find it helpful? Yes No

Send feedback
Sorry we couldn't be helpful. Help us improve this article with your feedback.