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

SMMC Report Guide [1.22MB PDF] Effective 1/1/2014

Summary of SMMC Report Guide Revisions [423KB PDF] Effective 1/1/2014

SMMC Report Guide Transmittal [45KB PDF] Effective 10/1/2013

SMMC Report Guide [1.22MB PDF] Effective 4/17/2013

SMMC Report Guide Templates:

Administrative Subcontractors and Affiliates Report [2.18MB MS Excel] Updated 10/17/2013

Audited Annual and Unaudited Quarterly Financial Reports [267KB MS Excel] Updated 10/31/2013

Case Management File Audit Report [43KB MS Excel]

Case Manager Caseload Report Template [37KB MS Excel] New 10/1/2013

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

Claims Aging Report FFS [2.02MB MS Excel] Updated 10/1/2013

Claims Aging Report & Supplemental Filing Report - Capitated Health Plans [2.45MB MS Excel] Updated 10/1/2013

Critical Incident Report [31KB MS Excel]

Critical Incident Summary Report [32KB MS Excel]

Denial, Reduction, Termination of Services Report [42KB MS Excel] Updated 10/1/2013

Enrollee Complaints, Grievances, and Appeals Report [43KB MS Excel] Updated 10/1/2013

Enrollee & Nursing Facility Residence Report [45KB MS Excel] Updated 10/1/2013

Missed Services Report [32KB MS Excel] Updated 10/1/2013

MPI Annual Fraud and Abuse Activity Report (AFAAR) [65KB MS Excel] Updated 10/1/2013

Multiple Signature Verification Agreement [37KB MS Word]

Nursing Facility Transfer Report [46KB MS Excel] Updated 10/1/2013

Participant Direction Option (PDO) Report [35KB MS Excel]

Patient Responsibility Report [27KB MS Excel]

Provider Complaint Report [34KB MS Excel] Updated 10/1/2013

Provider Network File Specifications [865KB PDF] Updated 10/1/2013

Provider Termination & New Provider Notification Report [74KB MS Excel] Updated 10/31/2013

Utilization Reporting [43KB MS Excel]

SMMC Report Guide Archive

Community Outreach Health Fairs Public Events Notification [147KB MS Excel]

Community Outreach Representative Report [50KB MS Excel]

MPI Quarterly Fraud Abuse Activity Report [213KB MS Word]

MPI Suspected Confirmed Fraud and Abuse Report [60KB MS Word]

Performance Measure Specifications [43KB MS Word]

Performance Measures Report [35KB MS Excel]