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Criteria to determine the cost category for health care encounters using New York State Dept of Health methodology

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NYS_MMCOR

Contains T-SQL criteria for determining the category of service for healthcare encounters per the
NYSDOH (New York State Department of Health)
MEDICAID ENCOUNTER DATA REPORTING FOR APD (All Payer Database) AND MMCOR (Medicaid Managed Care Operating Report) CATEGORY OF SERVICE
Service Utilization and Cost Reporting Guide.
Commonly know as the MMCOR guide

  1. Execute these scripts to create and populate the look up tables:
     These 2 tables can be used to do a lookup by MMIS id to determine if the provider of service is an Ambulatory Surgery Center or a Hospital
     CreateAndPopulate_luAmbulatorySurgeryCenter.sql
     CreateAndPopulate_luHospitals.sql
     These 3 tables are used for reporting:
     CreateAndPopulate_luCategoryOfService.sql
     CreateAndPopulate_luMMCORCostReportCategory.sql
     CreateAndPopulate_luServiceType.sql

  2. Create tbl_Encounters. This is where you will populate your encounters.
     Create_tblEncounters.sql

  3. Use Populate_tblEncounters.sql as a template to insert your own encounters into tbl_Encounters.

4. Create and execute the stored procedure: usp_UpdateServiceTypeCode.sql This will allocate an MMCOR category (MMCORCostReportCategoryId) to each encounter

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Criteria to determine the cost category for health care encounters using New York State Dept of Health methodology

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