Once payer-submitted data has successfully passed the extensive initial validation and quality tests performed by CIVHC and data manager, the data are ready to be ingested into the warehouse. Previous queries have detailed the process for the monthly submission and intake of claims data to the Colorado All Payer Claims Database (CO APCD). This Read more
Each month, health insurance payers submit millions of medical, professional, pharmacy, dental, and vision claims for inclusion in the Colorado All Payer Claims Database (CO APCD). CIVHC continuously works closely with submitters to ensure they understand the submission requirements and that the process is as smooth as possible. After submissions pass Read more
As administrator of the Colorado All Payer Claims Database (CO APCD), CIVHC is required by statute not only to maintain the database, but to continually improve the quality and utility of the CO APCD. One of the most essential activities to enhancing the CO APCD is annually updating the CO APCD Rule and Data Submission Read more
In fiscal year 2023-2024, CIVHC’s Data Solutions team implemented a new project management process, PhaseGate, to ensure projects moving through CIVHC’s teams are successful. The process divides development into distinct stages, or phases, separated by decision points, known as gates. The PhaseGate process is effective because it helps teams break larger, complex projects Read more
Medicare Data in the CO APCD The Colorado All Payer Claims Database (CO APCD) contains over 1.3 billion claims, with more added every month. These claims are submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Read more
The Colorado All Payer Claims Database (CO APCD) contains over 1.3 billion claims, with more added every month. These claims are submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Fee-for-Service (FFS). The CO APCD Read more
The Colorado All Payer Claims Database (CO APCD) contains over 1.3 billion claims, with more added every month. These claims are submitted by commercial health insurance plans, including Medicare Advantage, voluntarily submitted Employee Retirement Income Security Act (ERISA) and mandated non-ERISA self-insured employer plans, Medicaid, and Medicare Fee-for-Service (FFS). The CO APCD Read more
A previous query defined the different nuances encompassed under the term “data quality” to help shed light on the myriad factors that can impact the output from the Colorado All Payer Claims Database (CO APCD). This piece will outline some baseline expectations for users who are new to claims data. Claims Data Read more
Claims data is very different than other types of data typically encountered by actuaries, accountants, analysts, and researchers. If not prepared for the unique challenges it presents, it is easy to conclude that something is wrong with a data set. The phrase “data quality” is frequently used as a catch-all Read more
Non-Claims Data in the CO APCD The Colorado All Payer Claims Database (CO APCD) contains medical, dental, vision, and pharmacy claims from the majority of insured individuals in the state. However, claims data highlights only a portion of how the health care system functions. There are numerous other non-claims components Read more