Process question - How to investigate patients on attribution files but not in CCLF/BCDA data

[Maddy Blakeslee]

Hey all,

When we get questions about why medicare patients with active primary care relationships aren't in the CCLF and BCDA data but they are in our attribution files who should I work with?

Background: We have a report from one of our practices that we don't have claims for all of the MSSP patients that they see at their office. They've sent me examples for the patients with DOS in 2023. I looked and these patients are NOT in any of our CCLF files so I don't expect BCDA to send them. The patients ARE in our MSSP Q0 attribution file and are attributed and assignable. 

[Maddy Blakeslee]

Also the attribution files says that the patients have primary care services with a NPI and TIN. 

[Beneficiary Claims Data API (BCDA) Community]

Hi Maddy,

We've shared your question with the ACOMS team and they've asked you reach out through their help desk; either via email to SharedSavi...@cms.hhs.gov or by clicking the help desk icon from your ACOMS account.

Your expectation matches the intended behavior of BCDA as the API uses CCLF8 files to determine attribution. Minor differences between BCDA and CCLF8 will occur as BCDA supplements the CCLF8 information with Medicare enrollees' data sharing preferences, which are processed daily.

Thanks,
The BCDA Team