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Encounter data for community health centers

April 2024

Encounter data isn’t just about ensuring clean claims for improved revenue. Poor encounter data impacts all the people, programs, and systems that use the data to manage the health of populations, reduce the overall costs of care, and improve payments to providers and health centers. By partnering with community health centers to create this resource, we hope to present a meaningful and useful tool to support process improvement of encounter data and claims submissions to payors in preparation for increased value-based care payment structures.

Author

California Medical Association Physician Services Org (CMA-PSO)

Why use it

This resource highlights bite-sized quality improvement use cases taken from community health centers throughout California. Each use case offers an overview of the problem, a solution tried, and noted outcomes. Health centers may find it useful to see examples of how some of their peers approach issues with data capture, coding, and documentation to generate cleaner claims (encounter) data.

Who it’s for

This article provides real health center scenarios and best practices. It is suitable for all staff at a community health center.

Key take-aways

Understanding and improving inefficient processes, correcting outdated workflows, and updating system resources directly supports higher quality encounter data that allows for:

  • Higher quality patient care and improved outcomes
  • Meeting organizational and external quality goals
  • Improved financial well-being of the health center

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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