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All Payer All Claims Data Requests



 

Data Request Overview

The All Payer All Claims (APAC) data request process varies depending on what type of data you are requesting. The flowchart below illustrates the request process for the different types of data available. Review the APAC Data Request Fact Sheet (updates pending) for more information about the data request process. To learn more about the Data Review Committee, view the Data Review Committee page.

APAC Data on Timely Topics

By design, APAC data are generally about 18 months old by the time they are released as final, but they have shed light on a range of important and timely topics, including:

  • Health impacts of wildfires
  • Balance or "surprise" billing
  • Health care costs
  • Emergency department use for mental health issues

Wondering whether APAC data are right for your project? Please contact APAC.Admin@dhsoha.state.or.us for assistance.

APAC Vendor Transition

The APAC Program recently completed the transition to Human Services Research Institute (HSRI). What does this mean for data users? For more information, please consult these documents:

How to Obtain APAC Data

Public Use data set requesters must submit an APAC-2 form. The APAC-2 is reviewed by staff, a Data Use Agreement is executed and then the request is fulfilled. This process generally takes 2-4 weeks.

Limited data set requesters must submit an APAC-3 form. APAC-3 is reviewed by staff, reviewed by the Data Review Committee, a Data Use Agreement is executed, and then the request is fulfilled. This process generally takes 2-4 months.

 

Enhanced APAC Data

All Payer All Claims (APAC) and Oregon death record data are now linked, supporting analyses and research about health care access, services and outcomes. These data are now available for request through a two-part process:

You may submit requests to the APAC program (Part A) and CHS (Part B) concurrently, and APAC and CHS will coordinate approval.

The APAC program highly recommends that you contact us for a discussion and consultation prior to submitting your APAC-Death record linked data request.

Data Request Applications and Forms

Overview of Application Process

Requests for APAC data are subject to the standards and regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and OAR 409-025-0160. Requesters must complete an application and review process to determine:

  • Appropriate use of the data
  • Only minimum necessary data
  • Data use and storage complies with HIPAA and ensures data privacy and security

Consultation with the APAC team prior to request is highly recommended. For more information about review process, estimated timeframes, and costs for data requests, see APAC Data Request Fact Sheet (updates pending) and APAC Data User Guide.

Applications vary by requested data type (see below). Once completed, submit application to apac.admin@dhsoha.state.or.us to begin the review process.

APAC-2: Application for Public Use Data Sets

Public use data sets contain statewide, de-identified claims-level data. Three annual data sets are available by request: medical claims, pharmacy claims, and dental claims.

APAC-3: Application for Limited Use Data Sets

Limited data sets offer a higher level of detail and contain personal health information (PHI), excluding direct identifiers (e.g., patient name or address). Limited data sets may inform activities related to health care operations, treatment, payment, public health, or research as defined in HIPAA.

Oregon State Agency/LPHA Application (Internal Use Only)

This application is only for government official use requests. Processing time will vary depending on request type (public or limited use) and is estimated to take at least three months.

Public Use Data Set Files (Excel)

Reference this document to determine which public use data set(s) suits your needs.

Data Elements Workbook (Excel) Updated 11/15/2021

Complete and attach this workbook to the APAC-3 application.

APAC Data User Guide

Release notes, data limitations, business rules and other tips for interpreting APAC data correctly.

APAC Data Dictionary (Excel) Updated 11/15/2021

Data dictionary organized by data structure.

APAC Release Notes

Release notes posted as they become available. 

Resources for Data Requesters

OHA recommends data requesters review the following documents to fully understand what data are available in APAC, potential data uses and limitations, and the data request process.

APAC Overview
Provides an overview of the APAC database, including what data are collected and released.

APAC Data Issue Log
This is a log of all known issues in APAC data. Requesters should anticipate the effects of these issues on their projects and caveat their analyses accordingly.

APAC Frequently Asked Questions
Answers questions about data collection, management, access and use.

APAC Use Cases 
Showcases previous projects for which APAC data have been approved and used.

Lookup Tables (Excel)
Provides the valid values for certain data elements.

Claim Exclusions version 2018.0.1 (Excel)
Per OAR 407-014-0020, information related to the receipt of substance abuse treatment will not be disclosed without written authorization, unless disclosure is otherwise permitted under 42 CFR part 2. This document contains all diagnosis, procedure and revenue codes that will result in claims line exclusions.

Data Review Committee (DRC)

To learn more about the Data Review Committee, view the Data Review Committee page.

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