Bayou Health Prepaid Deliverables
| Documentation/Certifications | revision date |
| PF015 A - Key Staffing Organizational Listing - Prepaid | |
| PF016 A - Functional Organizational Chart and Function/Location Listing | |
| PQ066 Q - UM Committee Meeting Minutes | |
| PQ068 A - Utilization Management Medical Record Review Strategy | |
| PQ069 Q - Utilization Management Medical Record Review Report | 11.20.2012 |
| PQ119 Q - QAPI Committee (minutes) | |
| PS139 Q - Member Advisory Council (minutes) | |
| PS141 A - Member Advisory Council | |
| PF145 Q - Fraud and Abuse Activity Report | |
| PI159 Q - Back-up File List | |
| PF163 A - State Audit Exit Interview Yearly Report | |
| PF167 M - Claims Payment Accuracy Report | |
| PF170 A - Form CMS 1513 Ownership and Control Interest Statement | |
| PF183 Q - Claims Processing Interest Payments | |
| PF184 A - Annual Audited Financial Statement | |
| PF185 Q - Quarterly Unaudited Financial Statements | |
| PF186 M - Monthly Financial Statements | |
| PF189 A - SAS 70 Report | |
| Reports | revision date |
| PF019 A - Medical Loss Ratio | |
| PF022 M - Post Payment Recoveries (existence of TPL) | |
| PQ026 Q - EPSDT Report (CMS416) | |
| PQ039 A - Case Management Report | 1.29.2013 |
| PQ042 A - CCMP Reports (Chronic Care Management Program) | 2.22.2013 |
| PI058 A - NCQA PCP-PCMH Recognition Report | |
| PQ072 Q/A - QAPI PCP Profile Reports | 11.26.2012 |
| PI082 Q - PCP Linkages | |
| PS097 M - Initial Member Contact Report | |
| PS107 M - Member Service Call Center | |
| PM109 M - Marketing Plan Update | 2.22.2013 |
| PM110 A - Marketing Activities Annual Review | |
| PS113 M - Grievance, Appeal and Fair Hearing Log | |
| PS114 Q/A - Grievance, Appeal and Fair Hearing Log (Redacted) | |
| PQ127 A - QAPI Performance Reporting Measures (Level I and Level II) | |
| PQ131 A - QAPI Performance Improvements Projects (outcomes) | |
| PS132 A - Member Satisfaction Survey Report | |
| PI133 A - Provider Satisfaction Survey Report | |
| PI173 M - Prepaid Denied Claims Report | |
| PI181 M - Provider Call Center | |
| PI182 M - Provider Complaint & Appeal Summary Report | |
| PI187 A - Electronic Data Processing (EDP) Audit | |
| PQ188 Q/A - PA and Pre-Cert Summary | 11.29.2012 |
| PQ216 A - QAPI Impact and Effectiveness of QAPI Program Evaluation | |
| PI217 M - QAPI Early Warning System Performance Measures | 11.20.2012 |
| PI220 Q - Network Adequacy Review | |
| PI221 Q - Prompt Payment Report | |
| Plans Operational/Strategic | revision date |
| PQ041 A - CCMP Policies and Procedures (program evaluation) | |
| PQ044 A - CCMP Predictive Modeling Specifications | |
| PI053 A - NW Provider Development Management Plan | |
| PI056 A - PCMH Implementation Plan (patient-centered medical home) | |
| PQ121 A - QAPI Program Description and Work Plan | |
| PQ130 A - QAPI Performance Improvement Projects (descriptions) | |
| PI151 A - Systems Refresh Plan | |
| PF157 A - Emergency Management Plan | |
| Electronic Data Submissions | revision date |
| PF203 M - PL Member Report | |
| PI103 W - Network Provider and Subcontractor Registry | |
| PI168 W - encounter Submission File | 2.22.2013 |
| PI174 M - FQHC/RHC Encounter File |
