Managed Care Contracts - Resources
Reporting Templates – July 2023
Monthly Reports
- Institution of Mental Disease (IMD) Services Report
- Grievance and Appeal Report: Member Issue Log (Open)
- Grievance and Appeal Report: Member Issue Log (Closed)
- Health Plan Hospital Services Reporting
Quarterly Reports
- Private Duty Nursing Quarterly Report Instructions
- PDN Reporting Template
- CCBHO claim data reporting instructions
- CCBHO claim data template
- Call Center Report
- Care Management SFY24 Member Journey Report
- SMHK Care Management Member Journey Report
- Care Management Self Report (Pregnancy Only)
- Complaint, Grievance, and Appeal Report: Provider Issues Log
- Disease Management Report Revised: 12/01/2022
- Disease Management Summary Revised: 12/01/2022
- Fraud, Waste, and Abuse Activities Report: Case Log
- Overpayments Due to Fraud Reporting Template
- IMD Services Report- Specialty Plan
- Prior-Authorizations and Denial Log
- Third Party Savings Reports
- Timeliness of Claims Adjudication Report
Semi-Annual Reports
Annual Reports
- FY2020 EPSDT Self Report Instructions
- Health Care Management Member Survey
- HEDIS Indicators by MO HealthNet Managed Care Health Plans Within Regions, Live Births located
- Parity Compliance Report
- 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
- Quality Assessment and Improvement Evaluation Reports
Miscellaneous Deliverables
- Federally Qualified Health Clinic and Rural Health Clinic M-1 Instructions and Form
- Inpatient Certifications File Specifications
- Ownership or Controlling Interest Disclosure
- Additional Health Benefit Submission
- Member Incentive Template
- Provider Incentive Program Tool
- Provider & Subcontractor Disclosure
- Transaction Disclosure
- Policies and Procedures Requiring Prior Approval
Reporting Requirements – October 2023
Bidder and Vendor Documents – October 2023
- Reporting Schedule
- Managed Care Performance Withhold Technical Specifications
- Additional Health Benefit Listings
- EPSDT Screening Codes by Line Number
- EPSDT Screening Codes and Reporting Methodology
- In Lieu of Service Application
- Member Incentive Template
- MO MAPS Operations Manual
- Travel Distance Standards
- MO HealthNet Managed Care Policy Statements
- Marketing and Member Education Guidelines
- MO HealthNet Managed Care and Related Eligibles Groups
- Delivery (KICK) Payment Policy
- Federally Qualified Health Center and Rural Health Clinic Services
- NICU Payment Policy
- MO HealthNet Quality Improvement Strategy
- MO HealthNet Acronyms
- Managed Care Provider Coordination with Local Public Health Agencies
- MO HealthNet Health Risk Assessment
- Policies and Procedures Requiring Prior Approval
- Policy Submission Form
- Community Mental Health Center Reimbursement
- Waivers Operated by the Department of Mental Health (DMH)
- Health Plan Attestation of Compliance with section 2.7.22