Attachment D _ Encounter Data Layout.xlsx

This is an Encounter Data Layout file (Attachment D in Excel format) related to the City of Houston's request for proposals for Third Party Administrator (TPA) and Chronic Disease Management (CDM) services for self-funded medical benefit plans. The file specifies the required data structure and formatting standards that responding firms must use to submit encounter data, which represents claims information and member interactions with healthcare providers. The encounter data layout establishes the technical specifications for how claims data, member demographics, provider information, and service utilization must be organized and transmitted to the City's Human Resources department. This attachment serves as a critical technical requirement for proposing firms to demonstrate their capability to integrate with the City's data systems and meet reporting standards throughout the proposed five-year initial contract term with two one-year renewal options.

The encounter data layout requirements ensure standardized reporting across all proposed solutions and enable the City to effectively monitor plan performance, member outcomes, and the effectiveness of chronic disease management initiatives. Compliant submission of encounter data in the specified format is a mandatory deliverable for any awarded TPA vendor, as it directly supports the City's objectives of improving operational efficiency, enhancing member experience, and achieving better health outcomes for City employees and dependents. This technical specification file indicates the City's commitment to data-driven contract management and vendor accountability throughout the seven-year potential contract period.