Managed Care Resources

Member Enrollment Report

Report Templates

Contract Section Report

	Attestation for Managed Care Reports
3	Call Center Performance
4	High Cost No Experience Drug	updated
4	Additional Services Impact Report
5	Case Management
6	Provider Network
6	Non-Par Report
7	Manual Maternity Kicker
7	PCMH
7	FQHC/RHC Wrap Detail Data
7	FQHC/RHC Wrap Summary Data
8	Service Authorization
	Service Authorization by Benefit Type Report
9	Member Grievance and Appeal Report Quarterly
9	Member Grievance and Appeal Report Annual
9	Provider Dispute Log
10	TPL Cost Avoidance
10	TPL COB Savings
10	TPL Recoveries
10	TPL Casualty Cases
11	TPL (Medicare) COB Savings
11	TPL (Medicare) Cost Avoidance
11	TPL (Medicare) Recoveries
11	Pharmacy Lock In Member Letter
11	Pharmacy Lock In Member Removal Letter
11	Pharmacy Lock In Pharmacy Letter
12	MCO Material Minimal Change Attestation
13	Claims Payment Accuracy
13	GME Report
13	PRTF
14	Encounter Submission Summary
15	Performance Improvements Projects - Clinical
15	Performance Improvements Projects - Non-clinical
15	Alternative Payment Models
16	Managed Care Question and Answer Grid

Reference Tools

Managed Care Organization Notification forms

Pharmacy

MCO Comprehensive Drug Lists