Time of treatment (TOT) & partially vs fully adjudicated claims

[Derrick P]

Hi everyone,

New to the group.

We have been running through some use cases at our company to see if BCDA could add some value. 2 specific examples are 1) we heard the Time of Treatment (TOT) for dialysis would be available and 2) we would see much claims much faster compared to CCLF. 

After a few rounds of analysis, we have never been able to find the TOT in any of the data, and we are still seeing 2-3 week lag in the claims such as hospitalizations. Which make us think that the benefit of the partial adjudicated claims touted to be available in 2-4 days does not apply to hospitalizations. Are any of you experiencing similar lags in looking at hospitalization/DC claims? Is there an indicator that shows which are partially vs fully adjudicated?

[Beneficiary Claims Data API (BCDA) Community]

Hi Derrick,

Thank you for the questions regarding Time of treatment for dialysis and the availability of partially adjudicated claims data.

All claims data shared by BCDA or other CMS sources will become available only after the date the provider organization submits the claim to CMS. This varies, especially depending on the type of claim, but can often take a week or two. BCDA's partially adjudicated claims are available 2-4 days after claim submission.

At this time, only REACH ACOs using BCDA v2 have access to partially adjudicated claims data. If you're working with a REACH ACO, BCDA will return partially adjudicated claims data as Claim and ClaimResponse resources and fully adjudicated claims data as ExplanationOfBenefit resources. Learn more about accessing BCDA's partially adjudicated claims data.

BCDA does not currently provide the duration of treatment for dialysis. We will evaluate if this additional data field can be included in the next version of BCDA. Could you share more details about how this information would be used by your organization?

Thanks,
The BCDA Team

[Derrick P]

I'm a little confused. Are partially adjudicated claims only available for REACH ACOs or available to all with access to BCDA?

Treatment time is very valuable to know as every 15 minutes reduction in dialysis time from prescribed 4 hour treatments increases mortality risk by 12%. For value based care, we work with providers who have patients that dialyze at various dialysis companies which we may not have a data relationship. Having this in the claims data would be extremely beneficial.

[Derrick P]

A little confused, are partially adjudicated claims available only to REACH ACOS?

Time of treatment is extremely valuable to know for a Kidney Disease perspective. For every 15 minutes missed from a 4 hour dialysis treatment, increases patient mortality rate by 12%. Patients routinely cut their dialysis short not knowing the impacts. Knowing which patients are doing this through BCDA would give the information needed to go to providers and have them re-educate patients on need to stay for full 4 hours.

On Wednesday, May 20, 2026 at 4:52:42 PM UTC-4 Beneficiary Claims Data API (BCDA) Community wrote:

[Beneficiary Claims Data API (BCDA) Community]

Hi Derrick,

Yes, partially adjudicated claims are only available to REACH ACOs today via BCDA v2.

When BCDA v3 is released, partially adjudicated claims will also be available to KCEs and ACOs in the Medicare Shared Savings Program. Participants in REACH, MSSP, and KCC will be able to access partially adjudicated claims using BCDA v3. This will not change their availability in v2.

Thanks for the additional details about how valuable treatment time will be. We'll evaluate whether it can be included in claims data from BCDA v3.

The BCDA Team

[Derrick P]

When is V3 expected?