FQHC Wrap Claims compared to FQHC MCP Submitted Data
As part of the application process, DHCS compares the FQHC wrap claims submitted to DHCS for PPS reimbursement against the claims received from MCPs for the FQHC to identify how many claims match between systems. To facilitate an FQHC’s ability to review this matching percentage for each NPI, we have developed the below dashboard.
This dashboard will show, for each NPI, the percentage of wrap claims with corresponding MCP encounters. To qualify for the FQHC APM, a site must have at least a 66% match rate.
Dashboard
For more information, go to Federally Qualified Health Center Wrap Payment and Managed Care Encounter – Dataset – California Health and Human Services Open Data Portal