Letter to CMS - Medicaid Managed Care Policies - Agency for ...

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- Standard IV - Enrollee Services & Enrollee Rights - Standard V - Provider Credentialing and Recredentialing - Standard VI - Provider Services - Standard VII - Provider Contracting - Standard VIII - Quality Improvement Program - Standard IX - Medical Records - Standard X - Access and Availability - Standard XI - Grievances and Appeals - Standard XII - Administration and Management - Standard XIII - Community Outreach - Standard XIV - Covered Services - Standard XV - Immunizations, Pregnancy, Drugs & Transportation Policy and Procedures Template [10KB PDF] RAMP Manager Information Sheet [1.28MB PDF] Sample Member Handbook [46KB PDF] Sample X12 Transactions How to Become a Licensed HMO in Florida: Review Parts I and III of Chapter 641, Florida Statutes. Download application for a Health Care Provider Certificate from the Agency for Health Care Administration website. Schedule a teleconference or meeting with Division of Health Quality Assurance, Bureau of Managed Health Care at (850) 487-0640, staff to discuss licensure process. It is recommended that the organization schedule a teleconference or meeting with the Office of Insurance Regulation to discuss its process for the issuance of a Certificate of Authority. Download application for a Certificate of Authority from the Office of Insurance Regulation website Page 3 of 3
Appendix B MCO Application Checklist January 2012 Agency for Health Care Administration
Page 3 and 4: Attachment I Special Term and Condi
Page 5 and 6: Attachment II Special Term and Cond
Page 7 and 8: RICK SCOTT GOVERNOR 272 7 Mah an Dr
Page 9 and 10: • Encounter data • Systems issu
Page 11 and 12: Appendix A How to Become a Florida
Page 13: How to Become a Florida Medicaid He
Page 17 and 18: 4 5 6 7 8 9 10 Service Level(s) are
Page 19 and 20: 19 b. Total number of employees; AP
Page 21 and 22: APPLICATION ITEM 25 3. In the past
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Page 25 and 26: APPLICATION ITEM C. Criminal Backgr
Page 27 and 28: APPLICATION ITEM 43 13. For medical
Page 29 and 30: 46 47 APPLICATION ITEM 16. Indicate
Page 31 and 32: 49 APPLICATION ITEM 19. Describe in
Page 33 and 34: 51 52 53 54 55 56 APPLICATION ITEM
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Page 39 and 40: e. Complete a credentialing review
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Page 43 and 44: Compliance Monitoring Tool with Spe
Page 45 and 46: Standard I: Care Management/Continu
Page 51 and 52: Results for Standard I Care Managem
Page 53 and 54: Standarrd II: Utilizatio on Managem
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Standard III: Eligibility, Enrollme
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Standard IV: Enrollee Services & En
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Results for Standard IV Enrollee Se
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Standard V: Provider Credentialing
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Standard VI: Provider Services CONT
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Standard VI: Provider Services CC-
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Standard VI: Provider Services CONT
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Standard VII: Provider Contracting
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AGENCY FOR HEALTHCARE ADMINISTRATIO
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Standard VIII: Quality Improvement
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Results for Standard IX Medical Rec
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Standard X: Access and Availability
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Results for Standard X Access and A
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Standard XI: Grievances and Appeals
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Standard XII: Administration and Ma
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Results for Standard XII Administra
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Standard XIII: Community Outreach C
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Results for Standard XIII Community
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Standard XIV: Covered Services AGEN
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Standard XV: Immunizations, Pregnan
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Vendor Name: Review Period: Date of
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Agency For Health Care Administrati
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File # Case ID # Agency For Health
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File # Case ID # 1 2 3 4 5 6 7 8 9
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13 14 15 Agency For Health Care Adm
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f. Posting of the Agency Summary of
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Name: Review Period: Date of Review
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5. 6. 7. 8. 9. local WIC office to
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14 Agency For Health Care Administr
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8 providers Agency For Health Care
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Medical Loss Ratio The following dr
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RICK SCOTT GOVERNOR Better Health C
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Plan Name: AGENCY FOR HEALTH CARE A
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DRAFT ATTESTATION OF 201_ QUARTER E
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Draft MLR Reporting Schedule Health
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RICK SCOTT GOVERNOR PLAN TYPES: Bet
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Attachment V Special Term and Condi
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RICK SCOTT GOVERNOR Mission to Ensu
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• Obtaining data from the health
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RICK SCOTT GOVERNOR Mission to Ensu
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Attachment VI Special Term and Cond
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RICK SCOTT GOVERNOR Better Health C
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Letter to CMS - Medicaid Managed Care Policies - Agency for ...

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