Monthly Reports
- Institution of Mental Disease (IMD) Services Report
- Grievance and Appeal Report: Member Issue Log (Open) Revised 08/29/2023
- Grievance and Appeal Report: Member Issue Log (Closed) Revised 09/23/2021
- Health Plan Hospital Services Reporting
Quarterly Reports
- Call Center Report Revised: 9/23/2021
- Care Management Member Journey Report
- Care Management Self Report (Pregnancy Only)
- Complaint, Grievance, and Appeal Report: Provider Issues Log Revised: 9/23/2021
- Disease Management Reports
- Disease Management Report Revised: 9/23/2021
- Disease Management Report Summary Revised: 9/23/2021
- Foster Care Population Summary
- Fraud, Waste, and Abuse Activities Report: Case Log
- Improvement Plan Report
- Overpayments Due to Fraud Reporting Template
- Prior Authorization and Denials Log Revised: 9/23/2021
- SMHK Member Journey Report
- Third Party Savings Reports
- Timeliness of Claims Adjudication Report Revised 9/23/2021
Semi-Annual Reports
Annual Reports
- Core Set Reporting Template
- FY2019 EPSDT Self Report Instructions
- FY2020 EPSDT Self Report Instructions
- Exhibit C, Federally Qualified Health Center, Rural Health Clinics, Community Mental Health Centers, Safety Net Hospitals, Family Planning and STD Providers
- Health Care Management Member Survey
- HEDIS Indicators by MO HealthNet Managed Care Health Plans Within Regions, Live Births located
- Overpayments Due to Fraud Reporting Template
- Provider Preventable Conditions
- Subcontractor Oversight Annual Evaluation Report
- Trends in Missouri MO HealthNet Quality Indicators
Healthcare Quality Data Reports
- Healthcare Quality Data Instructions
- Healthcare Quality Data Template - Regional
- Healthcare Quality Data Template - Statewide
Medical Loss Ratio
Quality Assessment and Improvement Evaluation Reports
- Quality Assessment and Improvement Evaluation Report Instructions
- Quality Assessment and Improvement Evaluation Report
Miscellaneous Deliverables
- Federally Qualified Health Clinic and Rural Health Clinic M-1 Instructions and Form Revised 04/2022
- Inpatient Certifications File Specifications
- Interim Performance Withhold Program Report
- Interim Performance Withhold Program Spreadsheet
- MO FWA Referral Form
- Ownership or Controlling Interest Disclosure
- Policies and Procedures Requiring Prior Approval
- Policy Submission Form
- Provider and Subcontractor Disclosure
- Transaction Disclosure