ACA releases major upgrade to MASTRR™ Monitor OLAP database

• Denials - This release includes measures derived from the HealthChoices Denial Log File, including the number of denial events, the number of denied services, and unduplicated count of the number of consumers for whom services were denied. New dimensions related to denials include Denial Reason and Denial Type.
• Episodes - The OLAP database now includes measures related to services episodes. Episodes are constructed based on dates of service from claims for the same consumer, provider and service. New measures include Episode Length of Stay and Episode County. These measures are primarily useful for use with inpatient services.
• Capitation Revenue - The OLAP database now includes a measure of capitation revenue (Capitation Gross) as derived from the Remittance Advice (Capitation) File as transmitted in the HIPAA 820 transaction set. There is also a new measure of anticipated capitation (Estimated Capitation) based on membership data.

• Zip Code - This release utilizes zip code information provided for members in HealthChoices eligibility files to derive a "Residence" dimension, indicating where consumers reside at any point in time.
• Autism Spectrum Diagnosis (ASDx) - For the purposes of denial reporting, this release includes an indicator as to whether the diagnosis associated with the claim, episode, or denial falls into the autism spectrum (ASDx = "Y") or not.