Integrated Appeals and Grievances Process Reporting Requirements. The following appeals and grievances reporting requirements shall be submitted within 15 business days of the close of each quarter: A quarterly summary of integrated appeals including: • The reason for appeal; • The coverage type of appeals (Medicaid only, Medicare only or Medicaid and Medicare); • The status of appeals; • The number of appeals late to Office of Temporary and Disability Assistance (OTDA); • The appeal overturn/reversal rate; and • The auto-forward rate to OTDA.
Appears in 4 contracts
Samples: State Medicaid Agency Contract, State Medicaid Agency Contract, State Medicaid Agency Contract
