a Sub-assurance: The State provides evidence that claims are coded and paid for in accordance with the reimbursement methodology specified in the approved waiver and only for services rendered. (Performance measures in this sub-assurance include all Appendix I performance measures for waiver actions submitted before June 1, 2014.) a.i. Performance Measures For each performance measure the State will use to assess compliance with the statutory assurance complete the following. Where possible, include numerator/denominator. For each performance measure, provide information on the aggregated data that will enable the State to analyze and assess progress toward the performance measure. In this section provide information on the method by which each source of data is analyzed statistically/deductively or inductively, how themes are identified or conclusions drawn, and how recommendations are formulated, where appropriate. Service . % of claims submitted to and paid by MMIS will be monitored Performance and reported using remittance advices. (Approved and paid MMIS claims/ Measure: Total service claims submitted) Financial Data Source (Select one) (Several options are listed in the on-line application): records (including expenditures) If is selected, specify: ‘Other’ Responsible Party for Frequency of data Sampling Approach data collection/generation: (check each that collection/generation (check each that applies) (check each that applies) applies) State Medicaid Agency Weekly 100% Review Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Annually Specify: Continuously and Stratified: Describe Ongoing Group: Other Specify: Other Specify: Add another Data Source for this performance measure Data Aggregation and Analysis Responsible Party for Frequency of data data aggregation and aggregation and
a Sub-assurance: The State provides evidence that claims are coded and paid for in accordance with the reimbursement methodology specified in the approved waiver and only for services rendered. (Performance measures in this sub-assurance include all Appendix I performance measures for waiver actions submitted before June 1, 2014.) a.i. Performance Measures For each performance measure the State will use to assess compliance with the statutory assurance complete the following. Where possible, include numerator/denominator. For each performance measure, provide information on the aggregated data that will enable the State to analyze and assess progress toward the performance measure. In this section provide information on the method by which each source of data is analyzed statistically/deductively or inductively, how themes are identified or conclusions drawn, and how recommendations are formulated, where appropriate. Performance Measure: Service . % of claims submitted to and paid by MMIS will be monitored and reported using remittance advices. (Approved and paid MMIS claims/ Total service claims submitted) Data Source (Select one) (Several options are listed in the on-line application): Financial records (including expenditures) If ‘Other’ is selected, specify: Responsible Party for data collection/generation (check each that applies) Frequency of data collection/generation: (check each that applies) Sampling Approach (check each that applies) State Medicaid Agency Weekly 100% Review Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Specify: Annually Continuously and Ongoing Stratified: Describe Group: Other Specify: Other Specify: Add another Data Source for this performance measure Data Aggregation and Analysis Responsible Party for data aggregation and Frequency of data aggregation and
ABI-RH%20Renewal%20Application-Redlined%20draft-October%202017.docx