SMMC Report Guide (Effective 4/1/15) - Archive

SMMC Report Guide [614KB PDF]

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 [28KB MS Excel] Effective 4/1/15

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

Case Manager Caseload Report - SMMC [66KB MS Excel] Effective 4/1/15

Case Management File Audit Report - SMMC [39KB MS Excel] Effective 10/1/14

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

Child Health Check-Up - MMA [234KB Microsoft Excel] Effective 4/1/15

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 4/1/15

Critical Incident Report [14KB MS Excel] Effective 4/1/15

Critical Incident Summary Report [47KB MS Excel] Effective 4/1/15

Denial, Reduction, Termination or Suspension of Services Report - SMMC [25KB MS Excel] Effective 4/1/15

Enrollee Complaints, Grievances and Appeals Report [1.90MB MS Excel] Effective 4/1/15

Enrollee Roster and Facility Residence Report - SMMC [20KB MS Excel] Effective 4/1/15

ER Visits without PCP Appointment Report [19KB MS Excel] Effective 1/1/15

Freedom of Choice Certification Report [55KB MS Excel] Effective 4/1/15

Healthy Behaviors Report [16KB MS Excel] Effective 1/1/15

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

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

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

Marketing Agent Status Report [37KB MS Excel] Effective 4/1/15

Marketing Public Educational Events Report [175KB MS Excel] Effective 4/1/15

Missed Services Report - SMMC [24KB MS Excel] Effective 4/1/15

PASRR Report [14KB MS Excel] Effective 4/1/15

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

Participant Directed Option Roster Report - SMMC [19KB MS Excel] Effective 4/1/15

Performance Measures Report SMMC & 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

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

Unable to Locate/Contact Enrollee Report [13KB MS Excel] Effective 1/1/15