Since 2019, the Centers for Medicare & Medicaid Services (CMS) have been issuing Encounter Data Report Cards to Medicare Advantage Organizations (MAOs). These report cards are essential tools that help MAOs assess the completeness and accuracy of their encounter data submissions. By highlighting areas where submission patterns may be below expectations, CMS provides MAOs with the opportunity to enhance their data reporting processes, ensuring compliance and improving the quality of care provided to beneficiaries.
The Medicare Advantage Encounter Data Submission Performance Reports for the third quarter of 2024 are now accessible. These reports offer detailed insights into each organization's data submission performance, enabling MAOs to identify specific areas for improvement. Regular review of these reports is crucial for maintaining data integrity and aligning with CMS standards.
To access your organization's Q3 2024 report, navigate through the Health Plan Management System (HPMS) as follows:
Log in to HPMS: Ensure you have the necessary credentials to access the system.
Navigate to the Encounter Data Section:
Risk Adjustment > Encounter Data > Submission Performance > 2024 November Update
This pathway will lead you to the latest submission performance reports.
For detailed guidance on accessing and interpreting these reports, CMS provides a comprehensive job aid, which can be found here:
If you have any questions or require further assistance regarding your Submission Performance Report, please reach out to CMS directly. You can email the Risk Adjustment Operations team at RiskAdjustmentOperations@cms.hhs.gov. To ensure a prompt and accurate response, include the subject line: "Encounter Data Submission Performance Report, Q3 2024 Update."
Regular analysis of these reports is vital for MAOs to maintain compliance with CMS requirements and to enhance the quality of data submissions. By proactively addressing any identified issues, organizations can contribute to the overall effectiveness and efficiency of the Medicare Advantage program.
For more information on best practices for encounter data submission, CMS offers guidance to assist organizations in meeting submission requirements:
Staying informed and utilizing these resources will aid in ensuring the accuracy and completeness of your encounter data submissions.