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Encounter reconciliation report

August 2022

Developed by the Health Industry Collaboration Effort (HICE) Encounters Standardization Team, this resource was created as a best practice to identify the minimum data elements necessary for plans to include in a file sent to the delegates for an encounter reconciliation. The resource includes the most commonly used encounter data elements.

Author

Health Industry Collaboration Effort (HICE) Encounters Standardization Team

Why use it

The Encounter Reconciliation Report is intended for Provider Organizations and Delegates that work with claims or encounters to verify what the plan has against what the delegate may have in their system to identify missing data. This report is designed to be a quick tool and resource for healthcare organizations to use during encounter reconciliation.

Who it’s for

The Encounter Reconciliation Report is intended for healthcare organizations, such as provider organizations and delegates, that work with claims or encounters to perform encounter reconciliation.

Key take-aways

This report provides information and examples to verify what the plan has against what the delegate may have in their system to identify missing data, including:

  • The most commonly used encounter data elements
  • The minimum data elements necessary for plans to include in a file sent to the delegates for an encounter reconciliation

Have edits or additions for this resource? Please let us know.

IHA’s Resource Hub is made possible through a grant from Health Net, LLC’s Encounter Data Improvement Program.

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