SMMC Report Guide (Effective 10/1/15) - Archive

Report Guide [687KB 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

ASR Claim Lags Template SMMC [34KB MS Excel] Effective 7/1/15

ASR Financial Report SMMC [2.18MB MS Excel] Effective 7/1/15

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 [458KB MS Excel] Effective 7/1/15

Case Manager Caseload Report - SMMC [39KB MS Excel] Effective 7/1/15

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 [13KB MS Excel] Effective 4/1/15

Critical Incident Summary Report [42KB MS Excel] Effective 10/1/15

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

Enhanced Care Coordination Report [61KB MS Excel] Effective 7/1/15

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

Enrollee Roster and Facility Residence Report - SMMC [26KB MS Excel] Effective 10/1/15

ER Visits without PCP Appointment Report [19KB MS Excel] Effective 7/1/15

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

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

LTC Performance Measure Specifications [59KB MS Word] Effective 7/1/15

MMA Performance Measure Specifications [52KB PDF] Effective 7/1/15

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

Marketing Public Educational Events Report [168KB MS Excel] Effective 10/1/15

Missed Services Report - SMMC [23KB MS Excel] Effective 7/1/15

PASRR Report [12KB MS Excel] Effective 10/1/15

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 [162KB MS Excel] Effective 7/1/15

Provider Complaint Report [1.54MB MS Excel] Effective 7/1/15

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