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Cristy Crawford
Oct 16, 2024, 11:46:42 AM10/16/24
to Beneficiary Claims Data API (BCDA) Community
Just joining the fun! Is BCDA and CCLF the same thing? If not, where would we (ACO Reach) access BCDA? We receive our CCLF through 4i. Thanks in advance.
Beneficiary Claims Data API (BCDA) Community
Oct 17, 2024, 10:28:05 AM10/17/24
to Beneficiary Claims Data API (BCDA) Community
Hello and welcome to the BCDA community!
Similar to the Beneficiary Claims Data API (BCDA), Claim and Claim Line Feed (CCLF) files offer healthcare organizations access to Medicare Parts A, B, and D claims data. While both data sources are similar, there are some differences in format and update frequency.
Update timing: CCLF files update monthly. BCDA updates adjudicated claims weekly. Accountable Care organizations participating in the Realizing Equity, Access, and Community Health (ACO REACH) Model can also use BCDA to access partially adjudicated claims, which update daily using 2 additional files.
Format: While CCLF files include more detailed demographic and claims processing context in their 12 flat files, BCDA provides a snapshot of enrollees’ claims database across 3 data types (FHIR Resources). Additionally, BCDA uses the Bulk Fast Healthcare Interoperability Resources (FHIR) format, which results in differences in data mapping. Visit the Data Dictionary to review how fields map between BCDA and CCLF files.
Eligible organizations can use either or both source(s) for insight into their claims patterns, utilization, performance, and research. It’s important to choose what works best for your organization’s data processing workflow and needs.
Please see https://bcda.cms.gov for more information about BCDA and let us know if you have any questions or need tips to get started.
Thanks,
The BCDA Team
Similar to the Beneficiary Claims Data API (BCDA), Claim and Claim Line Feed (CCLF) files offer healthcare organizations access to Medicare Parts A, B, and D claims data. While both data sources are similar, there are some differences in format and update frequency.
Update timing: CCLF files update monthly. BCDA updates adjudicated claims weekly. Accountable Care organizations participating in the Realizing Equity, Access, and Community Health (ACO REACH) Model can also use BCDA to access partially adjudicated claims, which update daily using 2 additional files.
Format: While CCLF files include more detailed demographic and claims processing context in their 12 flat files, BCDA provides a snapshot of enrollees’ claims database across 3 data types (FHIR Resources). Additionally, BCDA uses the Bulk Fast Healthcare Interoperability Resources (FHIR) format, which results in differences in data mapping. Visit the Data Dictionary to review how fields map between BCDA and CCLF files.
Eligible organizations can use either or both source(s) for insight into their claims patterns, utilization, performance, and research. It’s important to choose what works best for your organization’s data processing workflow and needs.
Please see https://bcda.cms.gov for more information about BCDA and let us know if you have any questions or need tips to get started.
Thanks,
The BCDA Team
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