Health insurance companies use a number of different factors when considering and making the appropriate cost decisions on health plan premiums. On a year to year basis, each individual health care plan is looked at and it is decided whether or not the premium for that plan stays at the same amount, is lowered, or is raised. While there are a number of different factors to consider, one of the main aspects that is looked at by health insurance companies is the encounter data for that particular patient or client.
Encounter data is the information that is gathered by health care providers about the services that a particular patient or client utilized. This data also includes the reason the services were needed and rendered as well as other additional patient information. Encounter data is used by health insurance providers as a way to create accurate cost profiles for a individual, or a group of plan members who have similar health issues. It is this information that is used when the health insurance companies are deliberating about raising the premiums or maintaining the current monthly or annual costs.
Encounter data centers around a group of core questions about the services provided. It considers the when, what, where, who and how much of the interaction between patient and health care providers. As well as detailing the services rendered, it also includes, descriptions, dates and costs of each different and specific service.
Many states have enacted a number of incentives for high quality encounter data reporting, and others have put in place sanctions for not reporting encounter data, or reporting it incorrectly. One of the largest challenges for the success of encounter reporting is having a set of codes and coding standards that span over the different health fields and allow for a specific and detailed report of encounter data. It is thought that properly reported and detailed encounter data can lead to lower health care costs in the future, however there are still a number of steps that need to be achieved in order for this to become a real cost saving option for the rising health care costs.
To learn more about Encounter Data go to Altegra Health.
Encounter data is the information that is gathered by health care providers about the services that a particular patient or client utilized. This data also includes the reason the services were needed and rendered as well as other additional patient information. Encounter data is used by health insurance providers as a way to create accurate cost profiles for a individual, or a group of plan members who have similar health issues. It is this information that is used when the health insurance companies are deliberating about raising the premiums or maintaining the current monthly or annual costs.
Encounter data centers around a group of core questions about the services provided. It considers the when, what, where, who and how much of the interaction between patient and health care providers. As well as detailing the services rendered, it also includes, descriptions, dates and costs of each different and specific service.
Many states have enacted a number of incentives for high quality encounter data reporting, and others have put in place sanctions for not reporting encounter data, or reporting it incorrectly. One of the largest challenges for the success of encounter reporting is having a set of codes and coding standards that span over the different health fields and allow for a specific and detailed report of encounter data. It is thought that properly reported and detailed encounter data can lead to lower health care costs in the future, however there are still a number of steps that need to be achieved in order for this to become a real cost saving option for the rising health care costs.
To learn more about Encounter Data go to Altegra Health.
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