Data validation entails confirming that the data Manifest MedEx (MX) received from a participant (hospital, ambulatory clinic, lab, etc.)

• Occurred on the encounter and date of service indicated
• Contains the same information in the system of record (typically the EHR) of the original source as received by MX

• The auditor assigned to MX by NCQA determines which provider organizations need to be validated and randomly selects the patient encounters to review
• MX contacts the participant to retrieve a printout from the EHR for the identified patient encounter

MX will send an email to the participant to alert them to the need for the audit data and to set up a time to meet to collect the data.

• Yes, the use of data for auditing purposes is included in the participant agreement and there is an executed Business Associate Agreement (BAA) between MX and the participant.
• There is also an executed BAA between MX and the auditor

The auditor for NCQA requests a pdf printout from the source whenever possible. A screenshot can be a substituted but must be legible, so is not preferred. The following information is needed on the document:

• Patient name
• Patient date of birth
• Facility name
• Provider name
• Signature page of Encounter/Procedure report
• Date of service
• Clinical data relevant to audit

The only patient data audited is data the participant has already shared with MX. No additional patient information is requested.

MX will schedule an online meeting with the participant facility to go over the list of patients. The intent will be to work together during the online meeting to gather the required information at that time.

The data will be uploaded to a secure file location.