Often times, there is a series of claims for the same inpatient stay, which vary across multiple care settings (Emergency Room->IP Admission -> others –>Continued IP stay). Instead of only generating a single encounter activity to the inpatient facility, these different activities were often generating a claim and an encounter.
This methodology has been enhanced to allow for closer alignment with how these encounters are grouped based on our knowledge with the state data.
Contact your Customer Success Manager for more information.
