| 3.6 |
Manual Maternity Kicker |
|
| 3.17 |
Call Center Performance |
|
| 4.2 |
High Cost No Experience Drug |
|
| 4.3 |
Additional Services Form |
updated |
| 4.8 |
Member Incentive Form |
updated |
| 5.4 |
Care Management |
|
| 6.3 |
Provider Network |
|
| 7.3 |
PCMH |
|
| 7.4 |
FQHC/RHC Wrap Detail Data |
|
| 7.4 |
FQHC/RHC Wrap Summary Data |
|
| 9.1 |
Member Grievance and Appeal Report Quarterly |
|
| 9.1 |
Member Grievance and Appeal Report Annual |
|
| 9.2 |
Provider Dispute Log |
|
| 10.9 |
TPL Cost Avoidance |
|
| 10.9 |
TPL COB Savings |
|
| 10.9 |
TPL Recoveries |
|
| 10.9 |
TPL Casualty Cases |
|
| 11.1 |
PI Fraud and Abuse Definitions |
|
| 11.1 |
PI Rules for Share Point Suspension Termination Exclusion |
|
| 11.1 |
PI Instructions-Use of SharePoint Suspension Termination Exclusion |
|
| 11.10 |
Pharmacy Lock In Member Letter |
|
| 11.10 |
Pharmacy Lock In Member Instructions |
|
| 11.10 |
Pharmacy Lock In Member Removal Letter |
|
| 11.10 |
Pharmacy Lock In Pharmacy Letter |
|
| 13.1 |
Claims Payment Accuracy |
|
| 13.1 |
GME Report |
|
| 13.1 |
PRTF |
|
| 14.6 |
Encounter Submission Summary |
|
| 15.5 |
Alternative Payment Models |
updated |
| 16.3 |
Managed Care Question and Answer Grid |
|
