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Historical Status Indicators Report

 

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? 

FieldData Dictionary Definition
Plan H NoThe Contract number (H Number) related to the member's data on the row
Plan NameThe name associated with the Contract number (H Number) in Voyager
Provider Group IDThe ID for the Provider Group associated with the Member's Primary Care Physician (PCP) in Voyager
PCP NameThe active provider's name (First, MI, Last) identified as the Members PCP
Voyager PCP IDPlan's Voyager ID
External PCP ID (HP)Plan's ID associated with the provider acting as that Member's PCP
PCP Street AddressThe address information for the PCP in Voyager
PCP CityCity associated with the PCP in Voyager
PCP StateState associated with the PCP in Voyager
PCP ZipZip code associated with the PCP in Voyager
PCP PhonePhone associated with the PCP in Voyager
PCP FaxFax number associated with the PCP in Voyager
Voyager Member IDThe Voyager system ID associated with the Member
Member Last NameThe last name of the Member
Member First NameThe 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 DateThe Member's End Date for the most recent eligibility span in Voyager
RAF Type CodeThe 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 StatusThe 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 ScoreThe Member's risk score for the previous year (PY)
Current Year Risk ScoreThe Members risk score for the current year (PY)
Suspect HCCThe CMS Hierarchical Chronic Condition (HCC) code for a single suspected HCC
Suspect HCC SourceThe source for CMS Hierarchical Chronic Condition (HCC) code for a single suspected HCC
Suspect HCC Source ReferenceThis field helps to provide specific source information for how the HCC Suspect is generated
Suspect HCC NotesThis field, along with Suspect HCC Source Reference, helps to provide specific source information for how the HCC Suspect is generated
Last DOS PCPThe most recent Date of Service (DOS) when the Primary Care Physician (PCP) coded that HCC Suspect
Last DOS Other ProviderThe most recent DOS that any other provider coded that HCC Suspect
Name - Other ProviderThe name of any other provider who coded that HCC Suspect
Specialty Type Other ProviderThe provider specially for the physician who most recently coded the HCC Suspect

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