Delaware Administrative Code
Title 1 - Authorities, Boards and Commissions
100 - Delaware Health Information Network
103 - Delaware Health Care Claims Database Data Collection Regulation
Attachment A - Reporting Schedule

Universal Citation: 1 DE Admin Code A

Current through Register Vol. 28, No. 3, September 1, 2024

1. Test Files

Reporting Entities shall submit one month of Required Claims Data files containing Member, Claims, Prescription Drugs and a sample of Provider data not more than 180 days after the effective date of this rule or as otherwise approved by the HCCD Administrator.

2. Historical Files

Reporting Entities shall submit Required Claims Data files for the previous four full calendar years that conform to required file formats on the 181st day after the effective date of this rule.

3. Partial year submission for the current calendar year

Reporting Entities shall submit Claims Data files for claims adjudicated in the elapsed months of the current calendar year, as directed by the HCCD Administrator.

4. Ongoing Data Submission

Reporting Entities shall submit monthly files containing claims paid and encounters adjudicated during the prior calendar month within 30 calendar days of the last day of the following month. The schedule for this submission is provided below and will continue in similar format in subsequent years. Submission dates falling on a weekend or legal holiday are extended to the next following business day.

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