Q-2 Enrollee and Provider Incentives Notification Ad-Hoc Q-3 CAHPS Report (Submission of full CAHPS Report) Annual Q-4 External Research Project Notification Ad-Hoc Q-5 External Audit/Accreditation Ad-Hoc Q-6 HEDIS IDSS Annual D. Behavioral Health Reports ACO Name of Report Deliverable Contract Frequency Exhibit Number BH-1 Behavioral Health Reportable Adverse Incidents and Roster of Notification: Reportable Adverse Incidents-Daily Incident Delivery Report Same Day BH-2 Behavioral Health Adverse Incident Summary Report Annual BH-3 Behavioral Health Readmission Rates Annual BH-4 Behavioral Health Ambulatory Continuing Care Rates Annual BH-5 Inpatient/CBAT Cases Awaiting Resolution and Discharge (CARD) Monthly Census Report BH-7 Use of CANS During Diagnostic Evaluations Monthly BH-9 Intensive Care Coordination Claims-Based Indicators Monthly BH-10 CBHI Cost and Utilization Reports Based on paid claims or Intensive Monthly Home and Community Based Services for Youth and Youth Mobile Crisis Intervention Services BH-11 Behavioral Health Medical Records Review Report Annual BH-12 Annual Submission of (updated) Behavioral Health Performance Annual Specifications and Clinical Criteria BH-13 Behavioral Health Clinical Operations/Inpatient & Acute Service Quarterly Authorization, Diversions, Modification and Denial Report BH-14 Psychotropic Drugs Report Quarterly BH-15 Behavioral Health Utilization and Cost Report Quarterly BH-17 Department of Mental Health (DMH) Daily Admissions Notification: Same Day Provider Network Access and Availability BH-18 Annual Behavioral Health Telephone Statistics BH-19 Annual Behavioral Health BH-20 Behavioral Health Significant Changes in Provider Network Notification: Notification Same Day BH-21 Intensive Clinical Management Referrals Semi-Annual Behavioral Health BH-22 Inquiries, Grievances, Internal Appeals and Annual Behavioral Health BOH BH-24 CANS Compliance. This report is required when CANS data is made Quarterly available through the Virtual Gateway to the ACO. BH-25 Behavioral Health Mobile Crisis Intervention Length of Stay Report Quarterly BH-26 Members Boarding in Emergency Departments or on Daily Administratively Necessary Days (AND) Status
Q-2 Enrollee and Provider Incentives Notification Ad-Hoc Q-3 CAHPS Report (Submission of full CAHPS Report) Annual Q-4 External Research Project Notification Ad-Hoc Q-5 External Audit/Accreditation Ad-Hoc Q-6 HEDIS IDSS Annual D. Behavioral Health Reports ACO Contract Exhibit Number Name of Report Deliverable Frequency BH-1 Behavioral Health Reportable Adverse Incidents and Roster of Reportable Adverse Incidents-Daily Incident Delivery Report Notification: Same Day BH-2 Behavioral Health Adverse Incident Summary Report Annual BH-3 Behavioral Health Readmission Rates Annual BH-4 Behavioral Health Ambulatory Continuing Care Rates Annual BH-5 Inpatient/CBAT Cases Awaiting Resolution and Discharge (CARD) Census Report Monthly BH-7 Use of CANS During Diagnostic Evaluations Monthly BH-9 Intensive Care Coordination Claims-Based Indicators Monthly BH-10 CBHI Cost and Utilization Reports Based on paid claims or Intensive Home and Community Based Services for Youth and Youth Mobile Crisis Intervention Services Monthly BH-11 Behavioral Health Medical Records Review Report Annual BH-12 Annual Submission of (updated) Behavioral Health Performance Specifications and Clinical Criteria Annual BH-13 Behavioral Health Clinical Operations/Inpatient & Acute Service Authorization, Diversions, Modification and Denial Report Quarterly BH-14 Psychotropic Drugs Report Quarterly BH-15 Behavioral Health Utilization and Cost Report Quarterly BH-17 Department of Mental Health (DMH) Daily Admissions Notification: Same Day BH-18 Behavioral Health Provider Network Access and Availability Annual BH-19 Behavioral Health Telephone Statistics Annual BH-20 Behavioral Health Significant Changes in Provider Network Notification Notification: Same Day BH-21 Behavioral Health Intensive Clinical Management Referrals Semi-Annual BH-22 Behavioral Health Inquiries, Grievances, Internal Appeals and BOH Annual BH-24 CANS Compliance. This report is required when CANS data is made available through the Virtual Gateway to the ACO. Quarterly BH-25 Behavioral Health Mobile Crisis Intervention Length of Stay Report Quarterly BH-26 Members Boarding in Emergency Departments or on Administratively Necessary Days (AND) Status Daily