healthcare data dictionary example

He provides care to 800 Medicaid members, 400 Medicare, and 100 MAP members. The OASAS Market Data consists of all OASAS Certified Service Providers that can be counted towards network adequacy for Medicaid, HARP, HIV/SNP, FIDA, FIDAIDD, and SIPPL. The National Provider Identifier (NPI) is a unique identification number for covered health care providers. His board status= "2". Dr. Blue provides direct care to individuals enrolled in a NYSoH Dental QHP. Rubber stamped physician/advanced practice nurse/physician assistant (physician/APN/PA) signatures are not acceptable on any document within the medical record. One stop self-service shop to quickly identify the right Real World Data for your research project. Dr. Fahrenkopf is an Endodontist. A business glossary (also known as a data glossary) covers the business terminology or concepts for an entire organization. This data element for Hamilton Center would be coded with a "1". Language code must be found in the PNDS dictionary. This is an optional element requested by some managed care plans. HITEQ Center - Data Dictionary Tool and Template These facilities are: hospitals, diagnostic & treatment centers (clinics), long term home health care programs (LTHHCPs) residential health care facilities (nursing homes), certified home health care agencies (CHHAs) and hospice facilities. His MAP Panel Status would be "1", he will accept more MAP members at the clinic. Data Element Name: Residency Status for Primary Specialty Required For: Practice, Format Length: A/N1 Layout Field Location: W. This data element is to be primarily used for persons CURRENTLY in a residency program. Zerofill to the left, 9999=Not Applicable (for nonPCPs), Total Covered CHP members assigned to this provider at your managed care plan. Her entry for the evening hours indicator would be "1"=Yes. After the configuration, Dataedo will create a new repository and open its overview. It must be a valid entry. The Provider Location Permanent Facility Identifier (PFI) is the number associated with the specific location for an Article 28 licensed clinic or hospital. PDF Patient Discharge Data (PDD) Data Dictionary - Department of Health They must correspond to the appropriate HA OPCERT. They will not count toward the total number of Medicaid PCPs. A data dictionary acts as a reference guide on a dataset. The "snapshot" of Dr. Butchs schedule should capture the general pattern of her work routine. Dr. Smiths office is located in North Greenbush, NY. Enter "244111451" in this field. Since the data dictionary contains all the technical metadata, you can spot which teams or business units arent managing their data assets properly and fix those bad data practices. E.g., only ampicillin given in injection form. Lets explore this in detail. Data Element Name: FIDA Panel Size Required For: Practice, Format Length: N4 Layout Field Location: BN, Version Number\Effective Date: 6.8 October 2014. For purposes of this report, persons that are dually eligible in Medicaid and Medicare should only be counted once; they should be entered under the Medicare panel size. The Outcomes Health Plan contracts for all of the hospitals services. Should be a valid U.S. Total number of NYSOH Standard EP enrollees assigned to this provider at your plan. Ask any question about your data stack to your personal AI copilot. Data Element Name: Provider Location Facility Operating Certificate Required For: Practice, Format Length: A/N8 Layout Field Location: BZ, Version Number\Effective Date: 5.0 Nov. 2000 Revision Date: 5.0 Nov. 2000. A "Request Type" indicator has been added to the Data Dictionary variable descriptions. DO NOT leave blank. 1 = Commercial Provider; provides direct care to Commercial members. PICO for synthesis data file: Cumpston_et_al_2023_PICO.xlsx Physicians licensed prior to the Board Certification process should be coded as "2" (grandfathered) according to HEDIS guidelines and for the purposes of coding on the PNDS system. If your plan is not reporting OMH services, you may leave this data element blank. No fewer than nine (9) months a year must be spent in the continuity care setting. Dr. Cole provides direct care to individuals enrolled in a Medicaid Advantage program. Join over 5k data leaders from companies like Amazon, Apple, and Spotify who subscribe to our weekly newsletter. This data element is collected for the purpose of matching to the OMH Market Data. 1 = HARP Provider; provides direct care to enrollees in a HARP program. Dr. Nadler has just joined an HMO. This number is used for billing purposes under the Medicaid feefor service system and is used for identification of services provided under managed care with the Medicaid Encounter Data System. Format Length: A/N2 Layout Field Location: E. The name of the State in which the contracted service center is located. An open panel means the provider is able to accept new members. Enter "0". A good example of a data dictionary is the one used by ORNL (Oak Ridge National Laboratory). The PACE Provider Indicator is used to determine if a service center or facility provides care to PACE members. She was assigned 2,000 members by the plan; none of them are Medicare enrollees. List each site separately. 1 = Open to new and existing NYSOH Standard EP members 2 = Existing NYSOH Standard EP members only, 3 = Closed NYSOH Standard EP Panel 9 = Not Applicable for NonPCP, Data Element Name: NYSOH EP plus Adult Vision & Dental Ind Panel Status Required For: Practice, Format Length: A/N1 Layout Field Location: BA. NewIntroducing Atlan AI the first ever copilot for data teams.Join the waitlist, The role of active metadata in the modern data stack, A deep dive into the 10 data trends you should know. Please ensure that the QHP network(s) submitted through the PNDS system align(s) with the QHP network(s) submitted in the Health Insurer Participation Proposal, along with your Network Template submitted through the System for Electronic Rate and Form Filing (SERFF). The SIPPL (specialized I/DD plans provider led) Indicator is used to determine if a provider (PCP and/or Specialist) provides care to members in a SIPPL program. A total of 35 would be entered into the total office hours data element. To request a formal waiver for a PCP, a letter must be submitted to: The following information must be provided in the letter: In addition, the request for a waiver should affirm the following information: Medical Resident Exception: Effective July 1998, medical residents are not permitted to be designated as Medicaid Primary Care Provider. 1. ALL REC = All Records for all payersALL PCPs = All PCPsALL Physician REC = all with type 01=MD or type 12=DOALL MED & SNP REC = All Medicaid and HIV SNP Records, A = Alpha format onlyN = Numeric format onlyA/N = Alpha Numeric, ALL REC=All RecordsALL Hosp and Clinics = All Hospitals ((Designated Service 011) and (Designated Service 321, Article 28 Clinic)), A = Alpha format onlyN = Numeric format only ClinicsA/N = Alpha Numeric(Numbers in text format), _____________________________________________________________________________________________, Data Element Name: Last Name Required For: Identification, Format Length: A25 Layout Field Location: A, Version Number\Effective Date: 1 Dec. 1996. . This should be specific to providers site location. Any researcher can look up the terms they need using these dictionaries to make sense of their planetary data. Dr. Granola has just joined an HMO. Form 099MISC) whenever payments are made to the provider. If the provider has more than one location, each location should be listed separately. For example, it provides a format to document all items in a given report, and . Data Element Name: FIDA IDD Panel Status Required For: Practice, Format Length: A/N1 Layout Field Location: HU. Data Element Name: Provider Email Address Required For: Contact Info, Format Length: A/N40 Layout Field Location: CM, Version Number\Effective Date: 6.2 Dec. 2008. The type of patient encounter such as inpatient, outpatient, observation, etc. The code for Internal Medicine is "060.". Data standardization is the critical process of bringing data into a common format that allows for collaborative research, large-scale analytics, and sharing of sophisticated tools and methodologies. Elaine Weir is a registered nurse (RN). Data Dictionary - Examples | Ag Data Commons - USDA Healthcare data can vary greatly from one organization to the next. The NYSOH Standard EP Panel Status refers to the availability of a physician to accept new NYSOH Standard EP members. 1 = Open to new and existing Commercial members 2 = Existing Commercial members/enrollees only. A data dictionary gets everyone on the same page regarding metric and term definitions in your company. Data Element Name: OMH ID Required For: Service, Format Length: A/N10 Layout Field Location: CY, Version Number\Effective Date: 8.2 October 2018. This is a critical edit data element for all providers. He provides care to Medicare members of New Health. Increased reuse of data What is in a Data Dictionary? Places of public accommodation are required to remove barriers to ensure access. Data Element Name: Partial CAPS Indicator Required For: Service, Format Length: A/N1 Layout Field Location: V. The Partial CAPS Provider Indicator is used to determine if a service center or facility provides care to Partial CAPS members. The last name "Smith" should be entered in this field. He also has a physician assistant who works thirty (30) hours a week. Provider type refers to the general degree and licensure received by the provider. A 16hour per week attending may have no more than four (4) residents on his/her team. Not all providers may have a site name. The business glossary is considered to be a prerequisite for any data governance program and should be available before you start building a data dictionary. Data Element Name: Town/City Required For: Location, Format Length: A/N30 Layout Field Location: J. The revised data dictionary in Excel format - PAHO Data Element Name: Commercial NonMCO Medical Ind 18 Required For: Provider, Format Length: A/N1 Layout Field Location: AB, BQBW, Version Number\Effective Date: 1 Sep. 2016 Revision Date: 9 May 2019. Residents meeting these criteria provide increased Medicaid capacity for enrollment to their team according to the following formula: In order for a resident to provide continuity of care to an enrollee, both the resident and the attending PCP must have regular hours in the continuity site and must be scheduled to be in the site, together, the majority of the time. His FIDA Panel Status would be "1", he will accept more FIDA members at the clinic. What tests or checks did you run to determine whether your data is trustworthy? Enter the local address for each draw station and the approved PFI number for the corresponding operating number of the main site. All other records must be zerofilled. Leave this field blank. Zerofill to the left, 9999=Not Applicable (for nonPCPs), Total Covered HIV SNP members assigned to this provider at your managed care plan. The DoctorsRUs Certified Home Health Agency is located in Queens county, and services the 5 boroughs of New York City. The "Number of Professionals at Service Center" would be "0". This is a critical data element and cannot be left blank when reporting the following facilities/services: This filed must be left blank for all other services. Hospitals must document the administration of each medication, as reported by the patient (or the patient's caregiver/support person where appropriate), in the patient's medical record [42CFR482.23(c)(6)]. Those services should not be included in the submission. Smith Kidney Center provides dialysis care for the All Health Medicaid Managed Care Plan that is also certified to participate in the NYS CHP insurance program. Panel size is the total number of capitated Commercial members assigned to this provider at your managed care plan. Enter "Bronx" for the Town/City. For nonresidents, zerofill the data element. (The permanent facility indicator, PFI, number is used to identify the location of the facility and remains the same even if the facility changes ownership. Enter "1224445655" in this field. Medicaid Advantage Panel Status refers to the availability of a physician to accept new Medicaid Advantage members which may be either an existing member within the managed care plan or a member joining the plan for the first time. For example, it provides a format to document all items in a given report, and related EHR data. Data Element Name: Managed Care Plans Facility ID Required For: Service, Format Length: A/N20 Layout Field Location: O, Version Number\Effective Date: 4.0 Oct. 1999 Revision Date: 8 Jul. He provides direct care to CHP children. The following PFI numbers: 1168, 1181 and 1176 should be entered in the corresponding data elements HA PFI #1 #3 as 001168, 001181 and 001176. The edit validation is processed by comparing the submitted OASAS PRU, OASAS Provider Number, and services codes to the NYS OASAS Market Data file. This uses the same codes and definition. When submitting OASAS services listed above, the OASAS PRU number field. Such residents would not add to the capacity of that attending to empanel enrollees, however. He provides care to 800 Medicaid members, 400 Medicare members, and 100 NYSoH Medical members. For PCPs (or other providers) who have no inpatient care, enter "999999" in the Hospital PFI number. Dr. Marley has 3,000 current managed care members; 1,500 of these members are Commercial, 700 are Medicaid, 500 are Medicare and 300 are MAP. There may be no more than four residents per an attending physician who has sixteen (16) hours per week per location. For purposes of this report, persons that are dually eligible in Medicaid and Medicare should be included under the Medicare panel size. Both data dictionaries and the business glossary are considered to be integral parts of the modern data catalog. Data Element Name: National Provider Identifier (NPI) Required For: Identification, Format Length: A/N10 Layout Field Location: C, Version Number\Effective Date: 6.5 Feb 2010. The document on the following page is to be signed by the Chief Executive Officer (CEO) of the managed care organization/health insurer/Special Needs Program (SNP) and notarized as the formal attestation that the electronic submission of data will represent the total and accurate contracted network for the managed care organization/health insurer/SNP. This location is not certified by OASAS to offer Residential Substance Abuse Treatment Services. Dr. Wu has 900 HIV SNP members assigned. The fax area code for the providers office fax. An existing panel indicates that a physician will only accept members currently enrolled in the plan with another provider. Hospitals are not included in this data element so you do not need to list the providers who work for Blue Mountain Hospital. A closed panel indicates that a physician cannot accept new SIPPL members at the present time. Cost Approach Definition, Articles H