SMMC Report Guide (Effective 10/1/2017)
Report Guide [568KB PDF]
SMMC Report Guides Templates:
Adverse and Critical Incident Summary Report [17KB MS Excel] Effective 10/1/17
ASR Claim Lags Template SMMC [38KB MS Excel] Effective 4/1/17
ASR Financial Report SMMC [2.61MB MS Excel] Effective 4/1/17
Administrative Subcontractors and Affiliates Report [649KB MS Excel] Effective 6/1/14
Annual Fraud and Abuse Activity Report [30KB MS Excel] Effective 4/1/16
Case Manager Caseload Report - SMMC [92KB MS Excel] Effective 10/1/17
Case Management File Audit Report - SMMC [30KB MS Excel] Effective 10/1/16
Case Manager Monitoring and Evaluation Report - SMMC [33KB MS Excel] Effective 6/1/14
Case Manager and Provider Training Report [21KB MS Excel] Effective 10/1/17
Child Health Check-Up - MMA [223KB Microsoft Excel] Effective 10/1/17
Claims Aging Report for SMMC [47KB MS Excel] Effective 4/1/17
Critical Incident Report [15KB MS Excel] Effective 10/1/17
Custody Arrangement Multiple Signature Verification Agreement Form [479KB PDF] Effective 4/1/17
Denial, Reduction, Termination or Suspension of Services Report - SMMC [35KB MS Excel] Effective 10/1/17
Enhanced Care Coordination Report [169KB MS Excel]  Effective 10/1/17
Enrollee Complaints, Grievances and Appeals Report [12.79MB ZIP/MS Excel]  Effective 1/17/2018
Enrollee Roster and Facility Residence Report - SMMC [31KB MS Excel] Effective 4/1/17
ER Visits without PCP Appointment Report [20KB MS Excel] Effective 1/1/16
Healthy Behaviors Report [15KB MS Excel] Effective 7/1/15
Hernandez Settlement Agreement Log - MMA [238KB MS Excel] Effective 6/1/14
Hernandez Settlement Agreement Survey - MMA [31KB MS Excel] Effective 6/1/14
Hernandez Settlement Survey Requirements [90KB PDF] Effective 4/1/17
HIV/AIDS DM Algorithm [53KB MS Excel] Effective 4/1/18
HIV/AIDS Performance Measures Attachment [21KB MS Excel] Effective 7/1/2017
Insolvency Protection Multiple Signature Verification Agreement Form [262KB PDF] Effective 4/1/17
LTC Performance Measure Specifications [66KB MS Word] Effective 7/1/2017
MMA Performance Measure Specifications [36KB PDF] Effective 7/1/2017
Marketing Agent Status Report [38KB MS Excel] Effective 10/1/17
Marketing Public Educational Events Report [172KB MS Excel] Effective 10/1/17
Missed Services Report - SMMC [38KB MS Excel] Effective 10/1/17
PASRR Report [28KB MS Excel] Effective 4/1/17
Patient Responsibility Report - SMMC [33KB MS Excel] Effective 6/1/14
Participant Directed Option Roster Report - SMMC [87KB MS Excel] Effective 4/1/17
PCP Appointment Report [20KB MS Excel] Effective 10/1/17
Performance Measures Report SMMC & MMA [510KB MS Excel] Effective 7/1/17
Provider Complaint Report [11.20MB ZIP/MS Excel] Effective 1/17/2018
Provider Network and Qualifications Report [62KB MS Excel] Effective 10/1/17
Residential Psychiatric Treatment Report – MMA [30KB Microsoft Excel] Effective 10/1/17
Suspected/Confirmed Waste Reporting [16.25MB Microsoft Excel] Effective 10/1/17
Timely Access PCP Wait Times Report - MMA [806KB MS Excel] Effective 10/1/17
Unable to Locate/Contact Enrollee Report [13KB MS Excel] Effective 1/1/15