Health Plan Reporting Schedule and Templates

Monthly Reports

• Federally Qualified Health Center & Rural Health Clinic M-1 Instructions and Form
• Lead Poisoning Prevention Report
• Special Health Care Needs Report

Quarterly Reports

• Call Center Report
• Care Management Log
• Complaint, Grievances, and Appeals Reports
  • Complaint, Grievance, and Appeal Report: Member Issues Log
  • Complaint, Grievances, and Appeals Reports: Provider Issues Log
• Disease Management Reports
  • Disease Management Report: Detailed Log
  • Disease Management Report Summary Log
• Fraud, Waste, and Abuse Activities Reports
  • Fraud, Waste and Abuse Activities Report: Case Log
  • Fraud, Waste and Abuse Activities Report: Events Log
• Prior Authorization and Denials Log
• Third Party Savings Reports
• Timeliness of Claims Adjudication Report

Annual Reports

• Behavioral Health Case Management Survey Instructions
• Federally Qualified Health Center, Rural Health Clinics, Community Mental Health Centers, Safety Net Hospitals, Family Planning and STD Providers
• Healthcare Quality Data
  • Healthcare Quality Data Instructions *Revised*
  • Healthcare Quality Data Template *Revised*
• Health Plan Encounter Data Questionnaire
• HEDIS Indicators by MO HealthNet Managed Care Health Plans Within Regions, Live Births located
• Quality Assessment and Improvement Evaluation Report
  • Quality Assessment and Improvement Evaluation Report Instructions
  • Quality Assessment and Improvement Evaluation Report
• Subcontractor Oversight Annual Evaluation Report
  • Subcontractor Oversight Annual Evaluation Report Instructions
  • Subcontractor Oversight Annual Evaluation Report
• Trends in Missouri MO HealthNet Quality Indicators

Miscellaneous Deliverables

• Federally Qualified Health Center and Rural Health Clinic M-2 Instructions & Form
• Local Community Care Coordination Activities and Expenditures Reports
  • LCCCP Sample Reports
  • LCCCP Program Sample Reports
  • Sample LCCCP Quarterly Survey
• Ownership or Controlling Interest Disclosure
• Policies and Procedures Requiring Prior Approval
• Policy Submission Form
• Provider and Subcontractor Disclosure
• Transaction Disclosure