FALSE NEGATIVES

What is FALSE NEGATIVES?

FALSE NEGATIVES meaning Occur when the medical record contains evidence of a service that does not exist in the encounter data. This is the most common problem in partially or fully capitated plans because the provider does not need to submit an encounter in order to receive payment for the service, and therefore may have a weaker incentive to conform to data collection standards.

 

reference: Centers for Medicare & Medicaid Services

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