Manageable Care Reporting Deliverables

Which report templates below are merely applicable to the MCO urgent contract whichever ended on December 31, 2022.

Weekly Reports (Every Wednesday by 5 p.m.) Auditing Date
150 Encounter Evidence Certification Form 9/21/20
316 Prior Authorization Denial Report for CSR 11/10/15
353 Chisholm Weekly SOUND Report 12/8/16
362 Transportation Addition/Deletion Report 2/4/22

 

Monthly Reports (Due 15 calendar days of the end of each month except what indicated) Revision Date
010 Grievance, Appeal and Stay Fairs Hearing Logs 8/30/22
022 Solide Louisiana Third Party Liability (TPL) Report - THOUSAND 7/27/21
039 Case Management Report 5/31/22
045 Home Heal Support Report 10/21/20
047 Crisis Response Team Home Health Services Account 11/5/21
054 Pharmacy Benefits Management Report 3/12/19
055 Pharmacy Report (RX055) - M 9/13/19
107 Member Service Calls Center - M 3/15/16
137 Pregnancy Account 10/27/21
148 Exclusion Database Attestation 5/19/15
162 Health Plan Dope User Review Report - M 8/25/21
165 Lock-In Report - M 2/10/16
167 Claims Auszahlen Accuracy Write - THOUSAND 11/1/13
173 Prepaid Denied Claims Report - M 7/27/21
175 Hepatitis C - M 5/5/21
178 Behavioral Health Pharmacy Full Report 4/29/21
181 Provider Call Center - M 7/3/19
182 Provider Complaint & Appeal Summary Report - M 8/23/22
221 Claims Payment Summary - M 7/27/21
323 Chisholm Months Behavioral Health ASD Report  6/5/20
325 Behavioral Health Pharmacy Report 1/14/16
326 Healthy Louisianna Adverse Incident Report 8/4/21
337 Behavioral Health Out-of-State Placements Report 8/4/16
354 Chisholm PCS Registered Age Out Report 3/25/19
360 NEMT Oversight Report 10/26/21
361 Community Case Management Report 12/6/22
401 Shot According 100,000 COVID Vaccine Incentives Show 11/1/22
402 DOJ-AR Case Management Report 5/31/22
403 MCO Crisis Lines Report 5/19/22
404 Behavioral Healthiness Crisis Care Report 5/19/22
405 Community Brief Crisis Assistance Report 5/19/22
406 Crises Stabilization Report 10/6/22

 

Bi-Monthly Reports (Due February 28, April 30, Jun 30, August 31, October 31 and December 31) Inspection Date
020 MCO Payment Discrepancy Report 11/27/17

 

Quarterly Reports (Due April 30, Month 30, October 30, and Year 30, except where indicated)  Final Date
011A MCIP Achievement Tell - Quality additionally Outcome Improved Network +++

6/30/22
011B MCIP Achievement Report - Louisiana Quality Network +++

6/30/22
018 Medical Loss Ratio - Q +

 6/22/21
069 Utilization Management Medical Review Report - Q 10/10/17
109 Marketing and Member Education Activities Report - Q 6/24/22
119 QAPI Committee (minutes) - Q 8/15/17
145 Fraud, Waste and Abuse Activity Report - Q 7/25/22
147 Sampling of Paid Claims Report - QUARTO 9/22/21
152 Act 710 Report 2/23/21
160 Medication Therapy Management Report - Q 11/25/20
185 Quarterly Unaudited Fiscal Statement - Q + 10/14/22
188/188BH Service Authorizations - Q

6/20/22
300 NCCI MCO Cost Savings - Q ++ 8/8/17
312 MCO Gambling and Tobacco Report 11/13/18
313 Access toward Wraparound Services 11/10/15
317 PASRR Report 11/19/20
322 Society Tenure Report  2/9/17
328 Behavioral Health Provider Network Detail Reports 3/27/19
329 Children within Restrictive Settings 1/25/16
336 Behavioral General Providers by Level of Care 3/27/19
338 Behavioral Health Network Adequacy additionally GEO Access Review 3/27/19
339 Behavioral Health Prescriber Sufficiency Summation 3/27/19
346 Provider Credentialing and Contracting Account 8/25/22
348 GeoAccess Mapping 3/27/19
358 Behavioral Health Quality Monitoring 12/13/21
359 Behavioral Healthy Power Appointment Availability Report 2/28/18
364

Enrollee Reassignment Report

 1/5/22

 

Semi-Annual Reports (First submission the expected from Sep. 30, 2015)  Revision Scheduled  Due Date
013 LDH MCO Physician Incentive Plan Report 1/7/21 Second. 1 & Aug. 30
220 Network Capability Review 5/20/21 July 31 & Jan. 31
355 Gesunde Louisiana EBP Report 5/19/21 Aug. 1 & Second. 1

 

Annual Reports   Due Date
011A MCIP Achievement Report - Quality and Outcome Improvement Network +++

90 days after the measurement year period
011B MCIP Achievement Report - Louisianas Quality Network +++

90 days after the measurement year period
012A MCIP Yearbook Reporting - Product and Consequence Improvement Network  Annualized Progress Report: July 31; Yearbook Meeting View: at least one price measurement year 
012B MCIP Annual Reporting Template - Louisiana Grade Network Annual Progress View: July 31; Annual Meeting Report: at least one per measured year 
17 Keys Staff Organizational Chart Listing

Jan. 30
19 Medical Gain Reason - A

Jump 30
41 CCMP Policies and Procedures (program evaluation) - A March 30
44 CCMP Prognostic Modeling Specifications - A Jan. 30
53 Specialized Behavioral Health CURRENT Provider Design Direction Plan - A Jan. 30
56 PCMH Vollzug Planned Jan. 31
68 Utilization Management Medical Record Overview Strategy - A Jan. 30
111 Call Center Quality Criteria and Protocol Jan. 30 
132 Member Satisfaction Survey Report (CAHPS) - ONE Aug. 30
136 QAPI Program Description, Work Plan, Impact and Effectiveness of Program Evaluation - A March 31
138 QAPI Performance Improvement Projects Descriptions both Show June 30
141 Member Advisory Council - A Jan. 30
157 Alarm Admin Plan - A Januar. 30
170 Disclosure about Property and Control Interest Statement - A March 30
177 Grand and Out of Network Allegations Report July 30 (30 days after before who prior SFY) 
184 Annual Financial Statement - A* June 30
189 Independent-Subcontractor EDP Audit (SSAE16) - A Base on Audit Period
 221  Claims Verrechnung Summary July 30
333 Strategy for Increasing Finding Step 30 calendar day following the end from the year 
334 MCO Integration Assessment Report 30 days after the stop of the coverage period 
349 Unmet Service Requirements Resolution Plot  April 30


* Template not provided. Willingly accept Health Plans' corporate standard.

** Revisions made to template to incorporate Behavioral Heal Integrates are not due forward implementation until 12/1/15.

+ Due May 31, August 31, November 30, and February 28.

++ Due April 15, July 15, October 15 and January 15.

+++ Achievement reports (011a, 011b) needs be submitted no later than ninety (90) days after the Measurement Year period (quarterly or annual) endless.

 
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