Oklahoma Medicaid Encounters Report

Owned by Dylan Nigh
Apr 28, 2023
2 min read

Note: This report may still help with meeting MIPS requirements, but is likely out of date. 

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The Oklahoma Medicaid report calculates the percentage of patient encounters that are considered as an encounter with a Medicaid Patient, as per the state of Oklahoma's guidelines.

The definitions and requirements for this report were specifically written to meet Oklahoma's standards, though these could be the same for a number of other states.

The report can be filtered by Providers, Offices, and Office Visit Start and End Dates.

This report will separate encounters into three categories-

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  • Medicaid- Encounters will display in this group if the charges were billed to Medicaid. This will include both encounter on claims that have been paid and closed and those that have been billed but are not yet paid.

  • Non-Billed Medicaid- Encounters will display in this group if the charges were not billed to Medicaid, but the patient had active Medicaid insurance on file. To be sure that this is valid insurance even though it may not be billed, MacPractice checks for the Plan Type of Medicaid, a Start Date on the insurance before the date of the encounter, and for the Subscriber ID to be filled in.

  • NOT Medicaid- Encounters will display in this group if they don't belong in the other two. This will include all encounters that were never billed to Medicaid and have no indication that the patient currently holds Medicaid insurance at the time of their encounter.

All categories display the following columns:

  • # of Office Visits: This is the number of Office Visits in which transactions occurred.

  • % of Office Visits: This is the percentage of Office Visits that are either NOT Medicaid, Medicaid Non-Billed, or Medicaid encounters.

Click the disclosure triangle on any group to display each patient encounter counted within the group. Each group includes the following columns:

  • Patient #: the Patient ability.

  • Member ID: The Subscriber ID on the patient's Medicaid insurance.

  • Date Of Service: The date of the encounter.

  • Primary Diagnosis: The first diagnosis code entered onto the charge.

  • Office/Provider: The Office ID and the Provider User ID listed on the charge made for the encounter.

  • Insurance Provider IDs: This will display the paper and electronic IDs of the provider on the charge.