f. Pending at the time of the report 0 0 0 …………………………………………………………… g. Total (Must = The Total # of Complaints in 1.c.) 78 65 13 ………………………………………… 19. Number of Complaints over 30 days that were Reported to the LME-MCO and Investigated by an Agency 0 0 0 Other Than LME-MCO (e.g. DHSR, DSS, etc.) Section 3 - Special Reporting 20. Total # of Children Currently in PRTFs: All Children Medicaid a. In-state 30 0 30 b. Out-of-State inside 40 mile radius 14 0 14 c. Out-of-State outside of 40 mile radius 0 0 0 d. Total (Must = The Total # of Children Currently in 44 0 44 PRTFs) Section 4 - Update On Information Reported In Prior Quarter(s) (Indicate SFY and Quarter and Reason for Update) Name of Person Completing Report: Mary Kidd ……………………………………………………….. Title: Complaints and Incident Manager Phone: 910-673-7418 Email: SFY2015 Report Submission Schedule LME-MCO Report Data Report SFY / Quarter Quarter Period Submission Date* Same as Jul to Sep November 2015 Q1 Report 2014 15, 2014 Quarter Same as Oct to Dec February 15, 2015 Q2 Report 2014 2015 Quarter Same as Jan to Mar May 15, 2015 Q3 Report 2015 2015 Quarter Same as Apr to Jun August 15, 2015 Q4 Report 2015 2015 Quarter * DMH/DD/SAS Complaint Form and DMA forms
f. Pending at the time of the report …………………………………………………………… 0 0 0 g. Total (Must = The Total # of Complaints in 1.c.) ………………………………………… 78 65 13 19. Number of Complaints over 30 days that were Reported to the LME-MCO and Investigated by an Agency Other Than LME-MCO (e.g. DHSR, DSS, etc.) 0 0 0 Section 3 - Special Reporting 20. Total # of Children Currently in PRTFs: All Children Medicaid a. In-state 30 0 30 b. Out-of-State inside 40 mile radius 14 0 14 c. Out-of-State outside of 40 mile radius 0 0 0 d. Total (Must = The Total # of Children Currently in PRTFs) 44 0 44 Section 4 - Update On Information Reported In Prior Quarter(s) (Indicate SFY and Quarter and Reason for Update) Name of Person Completing Report: ……………………………………………………….. Mary Kidd Title: Complaints and Incident Manager Phone: 910-673-7418 Email: SFY2015 Report Submission Schedule SFY / Quarter Report Quarter Data Period LME-MCO Report Submission Date* 2015 Q1 Jul to Sep 2014 Same as Report Quarter November 15, 2014 2015 Q2 Oct to Dec 2014 Same as Report Quarter February 15, 2015 2015 Q3 Jan to Mar 2015 Same as Report Quarter May 15, 2015 2015 Q4 Apr to Jun 2015 Same as Report Quarter August 15, 2015 * DMH/DD/SAS Complaint Form and DMA forms