Managed Care Plan Report Guide (Effective 12/1/2018)

Managed Care Plan Report Guide (Effective 12/1/2018)
Report Guide [ 303 kB ]
Managed Care Plan Report Guide Templates:
Actual Value Enhanced Payment MPIP Report [ 33.9 kB ] Effective 12/1/18
Adverse and Critical Incident Summary Report [ 16.4 kB ] Effective 12/1/18
ASR Claim Lags Template [ 37.4 kB ] Effective 12/1/18
ASR Dental Claim Lags Template [ 16.5 kB ] Effective 12/1/18
ASR Dental Financial Report [ 691.6 kB ] Effective 12/1/18
ASR Financial Report [ 2 MB ] Effective 12/1/18
Administrative Subcontractors and Affiliates Report [ 647.3 kB ] Effective 12/1/18
Annual Fraud and Abuse Activity Report [ 29.6 kB ] Effective 12/1/18
Appointment Wait Times Report [ 53.4 kB ] Effective 12/1/18
Case Manager Caseload Report [ 92 kB ] Effective 12/1/18
Case Management File Audit Report [ 26.1 kB ] Effective 12/1/18
Case Manager and Provider Training Report [ 20.1 kB ] Effective 12/1/18
Claims Aging Report [ 125.2 kB ] Effective 12/1/18
Critical Incident Individual Report [ 13.9 kB ] Effective 12/1/18
Custody Arrangement Multiple Signature Verification Agreement Form [ 88.9 kB ] Effective 12/1/18
Denial, Reduction, Termination or Suspension of Services Report [ 34.7 kB ] Effective 12/1/18
Denied/Suspended/Terminated Provider Report [ 17.7 kB ] Effective 12/1/18
Enhanced Care Coordination Report [ 175 kB ] Effective 12/1/18
Enrollee Complaints, Grievances and Appeals Report [ 12.1 MB ] Effective 1/16/2019
Enrollee Roster and Facility Residence Report [ 30.3 kB ] Effective 12/1/18
ER Visits without PCP/PDP Appointment Report [ 18.6 kB ] Effective 12/1/18
Estimated Value of Enhanced Reimbursement MPIP Report [ 327.5 kB ] Effective 12/1/18
Health Risk Assessment Report [ 26.2 kB ] Effective 12/1/18
Healthy Behaviors Report [ 24.7 kB ] Effective 12/1/18
Hernandez Settlement Agreement Log - MMA [ 238 kB ] Effective 12/1/18
Hernandez Settlement Agreement Survey - MMA [ 31 kB ] Effective 12/1/18
Hernandez Settlement Survey Requirements [ 89.4 kB ] Effective 12/1/18
HIV/AIDS DM Algorithm (Updated 1/29/2019) [ 53.4 kB ] Effective 12/1/18
HIV/AIDS Performance Measures Attachment [ 20.1 kB ] Effective 12/1/18
IMD Reimbursement Report [ 42.9 kB ] Effective 12/1/18
Insolvency Protection Multiple Signature Verification Agreement Form [ 47 kB ] Effective 12/1/18
Inter-Rater Reliability Report [ 12.1 kB ] Effective 12/1/18
LTC Performance Measure Specifications [ 375.4 kB ] Effective 12/1/2018
MMA Performance Measure Specifications [ 183.7 kB ] Effective 12/1/2018
Marketing Agent Status Report [ 19.6 kB ] Effective 12/1/18
Marketing Public Educational Events Report [ 96.7 kB ] Effective 12/1/18
Missed Services Report [ 37.2 kB ] Effective 12/1/18
Non-Emergency Transportation Missed Trips Report [ 43 kB ] Effective 12/1/18
Non-SNP Financial Report [ 957.4 kB ] Effective 12/1/18
PASRR Report [ 32 kB ] Effective 12/1/18
Patient Responsibility Report [ 16.4 kB ] Effective 12/1/18
Participant Directed Option Roster Report [ 86.3 kB ] Effective 12/1/18
PCP/PDP Appointment Report [ 18.5 kB ] Effective 12/1/18
Performance Measures Report [ 338.5 kB ] Effective 12/1/18
Provider Complaint/Appeal Report [ 12 MB ] Effective 1/16/2019
Provider Network and Qualifications Report [ 61.5 kB ] Effective 12/1/18
Quarterly Fraud and Abuse Activity Report [ 45.2 kB ] Effective 12/1/18
Residential Psychiatric Treatment Report [ 35.1 kB ] Effective 12/1/18
Suspected/Confirmed Waste Reporting [ 16.3 MB ] Effective 12/1/18
Unable to Provide Case Management Report [ 158.6 kB ] Effective 12/1/18
Well Child Visit Report [ 277 kB ] Effective 12/1/18

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Managed Care Plan Report Guide (Effective 12/1/2018)