Claims data vendor adds 4 years of Medicare billing info to holdings

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FAIR Health, which operates the largest repository holding private health care and dental claims, totaling some 23 billion records, now is adding four recent years of Medicare claims data to its holdings.

Last year, the Centers for Medicare and Medicaid Services designated FAIR Health as a qualified entity to receive Medicare data. Now, the company is one of four vendors certified by CMS to receive claims for Medicare Parts A, B and D that the agency receives from across the nation.

As of this month, FAIR Health has received all claims for Parts A and B services nationwide from January 2013 through September 2016, as well as all Part D claims from 2013 through 2015. The company expects to receive remaining claims within a month. Moving forward, it anticipates receiving Parts A and B claims data quarterly and Part D data annually.

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In total, the initial Medicare claims the company has or will get represent billing information from more than 55 million persons enrolled in Medicare Parts A and B. “These claims will supplement FAIR Health’s collection of private claims from both fully insured and self-insured plans that represent more than 150 million individuals,” the company said in a statement.

Fair Health holds private claims dating to 2002; it adds more than 2 billion more private claims annually. As part of its agreement with CMS, the company will publish public quality reports and data analysis of private and Medicare claims. The company also says it will use the Medicare claims for internal analysis as it creates new products and services.

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