Report Name
Historical Status Indicators Extract
About This Report
The HSI report assists a manager or technical user in understanding declines in RAF scores, open suspected condition requiring action and member visit tracking.
Project Type
Risk Adjustment Audit, Member Tracking, Risk Score Trending and HCC Tracking, Suspected Condition Identification
Service Type
Full Service, Platform Only, Risk Adjustment Suspecting
Intended User
Manager / Technical User
Best For
Retrospective, Concurrent, and Prospective Risk Activities
Using This Report
- Download the report and use within Excel
What Information Can I Filter?
| Project |
What Do The Fields Mean?
| Field | Data Dictionary Definition |
| Plan H No | The Contract number (H Number) related to the member's data on the row |
| Plan Name | The name associated with the Contract number (H Number) in Voyager |
| Provider Group ID | The ID for the Provider Group associated with the Member's Primary Care Physician (PCP) in Voyager |
| PCP Name | The active provider's name (First, MI, Last) identified as the Members PCP |
| Voyager PCP ID | Plan's Voyager ID |
| External PCP ID (HP) | Plan's ID associated with the provider acting as that Member's PCP |
| PCP Street Address | The address information for the PCP in Voyager |
| PCP City | City associated with the PCP in Voyager |
| PCP State | State associated with the PCP in Voyager |
| PCP Zip | Zip code associated with the PCP in Voyager |
| PCP Phone | Phone associated with the PCP in Voyager |
| PCP Fax | Fax number associated with the PCP in Voyager |
| Voyager Member ID | The Voyager system ID associated with the Member |
| Member Last Name | The last name of the Member |
| Member First Name | The frst name of the Member |
| CMS Member ID (HICN) | The Member's Health Insurance Claim Number (HICN) assigned by CMS |
| External Member ID (HP) | The Member's Plan ID |
| DOB | The Members date of birth |
| Effective Date | The Member's Start Date for the current eligibility span in Voyager |
| Disenrollment Date | The Member's End Date for the most recent eligibility span in Voyager |
| RAF Type Code | The Members current living status as of the most recent Monthly Membership Report (MMR) from CMS. Typical entries include: CN= Community Non-Dual (2017 data only, 2016 and earlier, type code = C) , I= Institutional, H= Hospice |
| Disabled Status | The Yes/No flag for the Member's status as Disabled per CMS: 0 = No, 1 = Yes |
| ESRD | The Member's status for End Stage Renal Disease (ESRD) per CMS: True = Yes, False = No |
| Last Year HCC(s) | The comma separated list of Hierarchical Chronic Conditions (HCC) for that Member for the previous payment year (PY) |
| Current Year HCC(s) | The comma separated list of Hierarchical Chronic Conditions (HCC) for that Member for the current payment year (PY) |
| Last Year Risk Score | The Member's risk score for the previous year (PY) |
| Current Year Risk Score | The Members risk score for the current year (PY) |
| Suspect HCC | The CMS Hierarchical Chronic Condition (HCC) code for a single suspected HCC |
| Suspect HCC Source | The source for CMS Hierarchical Chronic Condition (HCC) code for a single suspected HCC |
| Suspect HCC Source Reference | This field helps to provide specific source information for how the HCC Suspect is generated |
| Suspect HCC Notes | This field, along with Suspect HCC Source Reference, helps to provide specific source information for how the HCC Suspect is generated |
| Last DOS PCP | The most recent Date of Service (DOS) when the Primary Care Physician (PCP) coded that HCC Suspect |
| Last DOS Other Provider | The most recent DOS that any other provider coded that HCC Suspect |
| Name - Other Provider | The name of any other provider who coded that HCC Suspect |
| Specialty Type Other Provider | The provider specially for the physician who most recently coded the HCC Suspect |