Measure for Adults time and Children How well doctors 0006 CAHPS/NCQA MCO; demographic Comparison to Annual communicate characteristics baseline; composite measure CMS Core Quality trending over Measure for Adults time and Children Customer service 0006 CAHPS/NCQA MCO; demographic Comparison to Annual composite measure characteristics baseline; CMS Core Quality trending over Measure for Adults time and Children Rating of specialist 0006 CAHPS/NCQA MCO; demographic Comparison to Annual seen most often characteristics baseline; CMS Core Quality trending over Measure for Adults time and Children B. Are provider Percentage of clean MCO claims activity Provider type: Comparison to Reported by claims paid claims adjudicated in reports behavioral health, baseline; MCOs accurately and 30/90 days physical health, trending over weekly; on time? I/T/U, specialty pay time evaluator may provider summarize to present annually Percentage of claims MCO claims activity Provider type: Comparison to Reported by denied reports behavioral health, baseline; MCOs physical health, trending over weekly; I/T/U, specialty pay time evaluator may provider summarize to present annually
Measure for Adults and Children time How well doctors communicate composite measure 0006 CAHPS/NCQA CMS Core Quality Measure for Adults and Children MCO; demographic characteristics Comparison to baseline; trending over time Annual Customer service composite measure 0006 CAHPS/NCQA CMS Core Quality Measure for Adults and Children MCO; demographic characteristics Comparison to baseline; trending over time Annual Rating of specialist seen most often 0006 CAHPS/NCQA CMS Core Quality Measure for Adults and Children MCO; demographic characteristics Comparison to baseline; trending over time Annual B. Are provider claims paid accurately and on time? Percentage of clean claims adjudicated in 30/90 days MCO claims activity reports Provider type: behavioral health, physical health, I/T/U, specialty pay provider Comparison to baseline; trending over time Reported by MCOs weekly; evaluator may summarize to present annually Percentage of claims denied MCO claims activity reports Provider type: behavioral health, physical health, I/T/U, specialty pay provider Comparison to baseline; trending over time Reported by MCOs weekly; evaluator may summarize to present annually
Evaluation%20of%20the%20Centennial%20Care%201115%20Demonstration%20Waiver%20-%201463080000006%20.docx