SMMC Report Guide (Effective 6/1/14) - Archive

Note:  The SMMC Report Guide is NOT for use with the 2012-15 Medicaid Health Plan Contract.  The Health Plan Report Guide for the 2012-15 Medicaid Health Plan Contract is located at http://ahca.myflorida.com/medicaid/Policy_and_Quality/Policy/Managed_Care_contracting/MHMO/prior_contracts.shtml

SMMC Report Guide [849KB PDF] Effective 6/1/2014

SMMC Report Guide Templates:

ACA PCP Payment Increase Encounter Data File Layout - MMA [17KB MS Excel] Effective 6/1/14

ACA PCP Payment Increase MPA SFTP Instructions - MMA [199KB MS Word] Effective 6/1/14

ACA PCP Payment Increase Summary Information - MMA [27KB MS Excel] Effective 6/1/14

Administrative Subcontractors and Affiliates Report [649KB MS Excel] Effective 6/1/14

Annual Fraud and Abuse Activity Report [27KB MS Excel] Effective 6/1/14

Audited Annual and Unaudited Quarterly Financial Reports [437KB Microsoft Excel] Effective 6/1/2014

Case Manager Caseload Report - LTC [66KB MS Excel] Effective 6/1/14

Case Management File Audit Report - LTC [43KB MS Excel] Effective 6/1/14

Case Manager Monitoring and Evaluation Report - LTC [33KB MS Excel]

Child Health Check-Up- MMA [229KB MS Excel]

Claims Aging Report for SMMC [4.01MB MS Excel] Effective 6/1/14

Claims Aging Supplemental Filing Report for SMMC [2.45MB MS Excel] Effective 6/1/14

Code 15 Report [13KB MS Excel] Effective 6/1/14

Critical Incident Report [13KB MS Excel] Effective 6/1/14

Critical Incident Summary Report [76KB MS Excel] Effective 6/1/14

Denial, Reduction, Termination or Suspension of Services Report - LTC [25KB MS Excel] Effective 6/1/14

Enrollee Complaints, Grievances and Appeals Report [3.78MB MS Excel] Effective 6/1/14

Enrollee Roster and Facility Residence Report - LTC [33KB MS Excel] Effective 6/1/14

Hernandez Settlement Agreement Log - MMA [238KB MS Excel] Effective 6/1/14

Hernandez Settlement Agreement Survey - MMA [31KB MS Excel] Effective 6/1/14

Insolvency Protection Multiple Signature Verification Agreement Form [106KB PDF] Effective 6/1/14

Marketing Agent Termination Report [89KB PDF] Effective 6/1/14

Marketing Outreach Events Notification Logs [MS Excel] Effective 6/1/14

Missed Services Report - LTC [23KB MS Excel] Effective 6/1/14

Nursing Facility Transfer Report - LTC [41KB MS Excel] Updated 10/1/2013

Patient Responsibility Report - LTC [33KB MS Excel] Effective 6/1/14

Participant Directed Option Roster Report - LTC [19KB MS Excel] Effective 6/1/14

Performance Measures Report LTC & MMA [135KB MS Excel] Effective 6/1/14

Provider Complaint Report [865KB MS Excel] Effective 6/1/14

Provider Termination and New Provider Notification Report [123KB MS Excel] Effective 6/1/14

Quarterly and Annual MLR Report - MMA [65KB MS Excel] Effective 6/1/14

Timely Access PCP Wait Times Report - MMA [1.70KB MS Excel] Effective 6/1/14

Utilization Report - LTC [43KB MS Excel] Effective 6/1/14