AHCA Logo
Managed Care Plan Report Guide (Effective 12/1/2018)
Report Guide [303KB MS Word]
Managed Care Plan Report Guide Templates:
Actual Value Enhanced Payment MPIP Report [34KB MS Excel] Effective 12/1/18
Adverse and Critical Incident Summary Report [17KB MS Excel] Effective 12/1/18
ASR Claim Lags Template [38KB MS Excel] Effective 12/1/18
ASR Dental Claim Lags Template [17KB MS Excel] Effective 12/1/18
ASR Dental Financial Report [692KB MS Excel] Effective 12/1/18
ASR Financial Report [2.03MB MS Excel] Effective 12/1/18
Administrative Subcontractors and Affiliates Report [649KB MS Excel] Effective 12/1/18
Annual Fraud and Abuse Activity Report [30KB MS Excel] Effective 12/1/18
Appointment Wait Times Report [54KB MS Excel] Effective 12/1/18
Case Manager Caseload Report [92KB MS Excel] Effective 12/1/18
Case Management File Audit Report [27KB MS Excel] Effective 12/1/18
Case Manager and Provider Training Report [21KB MS Excel] Effective 12/1/18
Claims Aging Report [116KB MS Excel] Effective 12/1/18
Critical Incident Individual Report [14KB MS Excel] Effective 12/1/18
Custody Arrangement Multiple Signature Verification Agreement Form [89KB PDF] Effective 12/1/18
Denial, Reduction, Termination or Suspension of Services Report [35KB MS Excel] Effective 12/1/18
Denied/Suspended/Terminated Provider Report [18KB MS Excel] Effective 12/1/18
Enhanced Care Coordination Report [179KB MS Excel]  Effective 12/1/18
Enrollee Complaints, Grievances and Appeals Report [12.11MB ZIP/MS Excel]  Effective 1/16/2019
Enrollee Roster and Facility Residence Report [31KB MS Excel] Effective 12/1/18
ER Visits without PCP/PDP Appointment Report [19KB MS Excel] Effective 12/1/18
Estimated Value of Enhanced Reimbursement MPIP Report [328KB MS Excel] Effective 12/1/18
Health Risk Assessment Report [27KB MS Excel] Effective 12/1/18
Healthy Behaviors Report [25KB MS Excel] Effective 12/1/18
Hernandez Settlement Agreement Log - MMA [238KB MS Excel] Effective 12/1/18
Hernandez Settlement Agreement Survey - MMA [31KB MS Excel] Effective 12/1/18
Hernandez Settlement Survey Requirements [90KB PDF] Effective 12/1/18
HIV/AIDS DM Algorithm (Updated 1/29/2019) [54KB MS Excel] Effective 12/1/18
HIV/AIDS Performance Measures Attachment [21KB MS Excel] Effective 12/1/18
IMD Reimbursement Report [43KB MS Excel] Effective 12/1/18
Insolvency Protection Multiple Signature Verification Agreement Form [48KB PDF] Effective 12/1/18
Inter-Rater Reliability Report [13KB MS Excel] Effective 12/1/18
LTC Performance Measure Specifications [376KB PDF] Effective 12/1/2018
MMA Performance Measure Specifications [184KB PDF] Effective 12/1/2018
Marketing Agent Status Report [20KB MS Excel] Effective 12/1/18
Marketing Public Educational Events Report [97KB MS Excel] Effective 12/1/18
Missed Services Report [38KB MS Excel] Effective 12/1/18
Non-Emergency Transportation Missed Trips Report [44KB MS Excel] Effective 12/1/18
Non-SNP Financial Report [958KB MS Excel] Effective 12/1/18
PASRR Report [33KB MS Excel] Effective 12/1/18
Patient Responsibility Report [17KB MS Excel] Effective 12/1/18
Participant Directed Option Roster Report [87KB MS Excel] Effective 12/1/18
PCP/PDP Appointment Report [19KB MS Excel] Effective 12/1/18
Performance Measures Report [339KB MS Excel] Effective 12/1/18
Provider Complaint/Appeal Report [12.05MB ZIP/MS Excel] Effective 1/16/2019
Provider Network and Qualifications Report [62KB MS Excel] Effective 12/1/18
Quarterly Fraud and Abuse Activity Report [46KB MS Excel] Effective 12/1/18
Residential Psychiatric Treatment Report [36KB Microsoft Excel] Effective 12/1/18
Suspected/Confirmed Waste Reporting [16.25MB Microsoft Excel] Effective 12/1/18
Unable to Provide Case Management Report [13KB MS Excel] Effective 12/1/18
Well Child Visit Report [277KB MS Excel] Effective 12/1/18