Provider Service Network (PSN)
Policy Transmittals and Plan Letters
2012
2011
- PSN and HMO 11-01: Third Party Liability Reporting Changes
- PSN and HMO 11-02: Reporting Form for Perinatal Hepatitis B [135KB]
- PSN and HMO 11-03: Change in Coverage for Multi-Visceral/Intestinal Transplants [115KB]
- PSN and HMO 11-04: Pharmacy Utilization Management Protocols [80KB]
- PSN 11-05: FFS PSN Conversion to Capitation [65KB]
2010
- PSN and HMO 10-01: Third Party Liability Changes in Reporting
- PSN 10-02: Updated Paper Claims Submission Information [63KB]
- PSN 10-03 and HMO 10-02: Updated Medicare Third Party Liability Reporting Information and Carrier Code List [40KB]
- PSN 10-04 and HMO 10-03: Discontinuation of Minority Participation Report [35KB]
- PSN 10-05: Reform FFS PSN Conversion to Capitation [60KB]
2009
- PSN and HMO 09-01: Year Three Performance Measures [1.84MB]
- PSN and HMO 09-02: 2009 H1N1 Vaccine [589KB]
- PSN 09-03: Guidelines for Comp Plan for Transitioning from FFS to Capitated
2008
- PSN 08-01: Contract Amendment for Increased Enrollment Levels [33KB]
- PSN 08-02 and HMO 08-01: Medicaid Redetermination Date File Use
- Letter [46KB]
- Attachment 1 - Medicaid Redetermination Date File Usage [26KB]
- Attachment 2 - Health Plan Medicaid Review Reminder [9KB]
- Attachment 3 - ACS File Layout for Medicaid Redetermination Date Ad Hoc Report [9KB]
- Attachment 4 - Quarterly Medicaid Redetermination Notice Summary Report Template [11KB]
- PSN 08-03:
Comprehensive Hemophilia Disease Management Program [35KB]
- Letter [74KB]
- PSN 08-04: Medicaid Redetermination Date File Use
- PSN 08-05 and HMO 08-02: Health Plan Performance Measures
- Letter [79KB]
- Attachment 1 - Specifications for Year Two Agency-Defined Measures [42KB]
- Medicaid Reform Performance Measures [116KB]
HMO Attachment II, Section XII, I, Table 21
PSNs Attachment II, Section XII, I. , Table 16
- PSN 08-06 and HMO 08-07: Behavioral Health Medical Records and Staffing Report Requirements
- PSN 08-07: Notice of Discontinuation of Provider Default ID Usage in Provider Network File [33KB]
- PSN 08-08 and HMO 08-08: Unborn Activation Process
- Letter to Health Plans [98KB]
- Attachment 1 [128KB]
- Attachment 1 - A [99KB]
- Attachment 1 - B [99KB]
- Attachment 2 [517KB]
- Attachment 3 [514KB]
2007
- PSN 07-01: Third Party Liability [40 KB]
- PSN 07-02: Disease Management Patient and Provider Satisfaction Surveys [61KB]
- PSN 07-03: Paper Claims [101KB]
- PSN 07-04: Marketing Representative Agent Licensure [40KB]
- PSN 07-05: Payment for PSN Inpatient Claims that Have Denied for Edit 503 or 669 [74KB]
- PSN 07-06: Reimbursement Guidelines for Out-of-State Non-Emergency Covered Services [42KB]
- PSN 07-07: Guidelines for Comp Plan for Transitioning from FFS to Capitated [81 KB]
- PSN 07-08: Performance Measure Reporting [45KB]
2006
- Policy Transmittal 06-06: Performance Measures
- Letter[493 KB]
- Attachments [1.88MB]
- PSN 06-01: Requesting Involuntary Disenrollments [978KB]
- PSN 06-02: Unborn Activation and Newborn Enrollment [915KB]
Dear Health Plan Letters
- Health Plan Performance Measures Reform Letter 11/26/08 [73KB]
- Medicaid Reform Health Plans Specifications for Year 3 Performance Measures [161KB]
- List of Medicaid Pilot Year 3 Performance Measures [74KB]
- Health Plan Performance Measures Non-Reform Letter 11/26/08 [70KB]
- Medicaid Non-Reform Health Plans Specifications for Year 3 Performance Measures [112KB]
- Health Plan Letter 5/1/09 - Resume Collection of Encounter Data through the Current Fiscal Agent on or About July 1, 2009 [452KB]
- National Health Reform - MEDS 4/28/10 [40KB]
- Plan Letter 7/8/10 - MediKids & Vaccine Encounter Data [51KB]
- Health Plan Letter 9/1/10 – Annual Fraud & Abuse Report [134KB]
- Health Plan Letter 10/22/10 – Choice Counseling FTP Site Change [47KB]
- Health Plan Letter 11/4/10 – Pharmacy Encounter Reporting [341KB]
- Health Plan Letter 5/10/11 – Ineligible Providers [355KB]
