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.
The information that is collected about a patient, or a group of patients, and the services that they have received from health care providers is what encounter data is comprised of. There are a number of aspects within this that are looked at more deeply. Encounter data will include, when and where the services were provided as well as who provided the services, and who the services were provided to. The use of encounter data can vary, but in many cases it is used as a way to help to develop a cost profile of a group of clients, or an individual. This is one of the main factors looked at when a health insurance company is trying to determine if a raise in premium costs for a group is necessary or warranted.
Encounter data will look at a number of basic questions about the service and individual such as when and where the service was provided as well as who provided what service. One of the main aspects considered with encounter data is the cost of each service that is provided. Encounter data, when recorded correctly and accurately can help insurance companies as well as health care providers to lower the costs where they can. However, there are a number of roadblocks prohibiting this from happening.
Since the health care reform initiative began, and the Affordable Care Act was established, more emphasis has been placed on the importance of encounter data and the collection and use of the information. Many states have begun to initiate sanctions about the collection of encounter data, while others are offering incentives for higher quality collection and analyzing of the data. Many people believe that the collection and use of encounter data is a good way to determine where cost savings can be best found within the growing expenses of our health care system. When encounter data is collected incorrectly it could lead to higher costs than what was projected which could increase premiums or the cost for health insurance.
Encounter data is one of the most primary forms of service records for patients and health care providers. It is a record of the services that they have received, and when not executed correctly can provide information that leads to higher, or much lower estimations of yearly health care costs. In many cases it has been found that a lack of correct and accurate encounter data will lead to a possible increase of health care costs. In other cases, the incorrectly, or not collected, encounter data translates to a risk adjustment that is too little, and then costs the health plan provider excess funds to make up the difference. Many states are beginning to enforce more accurate encounter Data collection, and others are offering incentives for providing more of this data.
The information that is collected about a patient, or a group of patients, and the services that they have received from health care providers is what encounter data is comprised of. There are a number of aspects within this that are looked at more deeply. Encounter data will include, when and where the services were provided as well as who provided the services, and who the services were provided to. The use of encounter data can vary, but in many cases it is used as a way to help to develop a cost profile of a group of clients, or an individual. This is one of the main factors looked at when a health insurance company is trying to determine if a raise in premium costs for a group is necessary or warranted.
Encounter data will look at a number of basic questions about the service and individual such as when and where the service was provided as well as who provided what service. One of the main aspects considered with encounter data is the cost of each service that is provided. Encounter data, when recorded correctly and accurately can help insurance companies as well as health care providers to lower the costs where they can. However, there are a number of roadblocks prohibiting this from happening.
Since the health care reform initiative began, and the Affordable Care Act was established, more emphasis has been placed on the importance of encounter data and the collection and use of the information. Many states have begun to initiate sanctions about the collection of encounter data, while others are offering incentives for higher quality collection and analyzing of the data. Many people believe that the collection and use of encounter data is a good way to determine where cost savings can be best found within the growing expenses of our health care system. When encounter data is collected incorrectly it could lead to higher costs than what was projected which could increase premiums or the cost for health insurance.
Encounter data is one of the most primary forms of service records for patients and health care providers. It is a record of the services that they have received, and when not executed correctly can provide information that leads to higher, or much lower estimations of yearly health care costs. In many cases it has been found that a lack of correct and accurate encounter data will lead to a possible increase of health care costs. In other cases, the incorrectly, or not collected, encounter data translates to a risk adjustment that is too little, and then costs the health plan provider excess funds to make up the difference. Many states are beginning to enforce more accurate encounter Data collection, and others are offering incentives for providing more of this data.
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