Medicare Provider Analysis and Review (MedPAR) File A HCFA data file that contains charge data and clinical characteristics, such as diagnoses and procedures, for every hospital inpatient bill submitted to Medicare for payment.
What is MedPAR data?
These data sets provide information on:
- Patient demographics.
- Diagnoses.
- Procedures.
- Admission source.
- Discharge status.
- Length of stay.
- Charges.
Who are the Medicare providers?
You can go to any Medicare-approved doctor, other health care provider, or hospital that accepts the plan's payment terms and agrees to treat you. Not all providers will. If you join a PFFS Plan that has a network, you can also see any of the network providers who have agreed to always treat plan members.
What is Pecos Medicare provider enrollment?
What is PECOS? PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims. This tool is made available based on a CMS data file from 11-08-2021. The information is not warranted or guaranteed.
What is Medicare Advantage provider?
Types of Medicare Advantage Plans
- Must receive your care from providers in your plan’s network except in the case of emergency care or out-of-area dialysis
- Requires choosing a primary care provider
- Typically covers prescription drugs
- Requires specialty referrals
What is MedPAR data used for?
MEDPAR contains data from claims for services provided to beneficiaries admitted to Medicare-certified inpatient hospitals and skilled nursing facilities, which are identified in the database. Report card sponsors can use these data to calculate measures relating to hospital quality, conditions, and procedures.
Why is MedPAR data collected?
The dataset is useful for tracking patterns of inpatient care for patients with various medical conditions. It also contains information related to the medical and surgical procedures that patients underwent during their stays in inpatient facilities.
Does MedPAR data include Medicare Advantage?
As stated previously, in contrast to the Inpatient LDS and RIF, both the MedPAR LDS and RIF contain some stays covered under Medicare Advantage (MA).
What is Medicare Provider Analysis Review Medpar?
The Medicare Provider Analysis and Review (MEDPAR) file contains records for 100% of Medicare beneficiaries who use hospital inpatient services. The records are stripped of most data elements that will permit identification of beneficiaries.
What are the two most common types of databases found in healthcare?
The two most common types of databases found in healthcare... relational and object-oriented databases.
What is SAF data?
Summary. The Outpatient Standard Analytical File (SAF) contains procedure-level claims and billing data for Medicare Part B beneficiaries receiving services from institutional-affiliated outpatient health providers (including emergency room visits not resulting in inpatient hospital stays).
What is Hcup database?
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of databases, software tools and related products developed through a Federal-State-Industry partnership and sponsored by AHRQ.
What is NCH in Medicare?
The National Claims History (NCH) data dictionary RIF reports contain the metadata information on the NCH Inpatient/Skilled Nursing Facility (SNF), Outpatient, Home Health Agency (HHA), Hospice, Carrier and DMERC claims data.
Healthcare Cost and Utilization Project (HCUP)
HCUP is a family of health care databases and tools sponsored by the Agency for Healthcare Research and Quality (AHRQ).
Medicare Provider Analysis and Review (MEDPAR)
This data file, available from the Centers for Medicare & Medicaid Services (CMS), contains records on all Medicare beneficiaries who use hospital inpatient services.
Also in "Measures of Hospital Quality"
Internet Citation: Databases Used for Hospital Quality Measures. Content last reviewed June 2016. Agency for Healthcare Research and Quality, Rockville, MD.
