Common use of UTILIZATION MANAGEMENT REPORTS Clause in Contracts

UTILIZATION MANAGEMENT REPORTS. PHYSICAL HEALTH ------------------------------------------------ Physical health (PH) utilization management reports are required on a semi-annual basis with submission of data files that are, at a minimum, due to TDH or its designee on a quarterly basis no later than 150 days following the end of the period. Refer to Appendix J for the standardized reporting format for each report and detailed instructions for obtaining specific data required in the report and for data file submission specifications. The PH Utilization Management Report and data file submission instructions may periodically be updated by TDH to facilitate clear communication to the health plan.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical health -------------------------------------------------- Behavioral Health (PHBH) utilization management reports are required on a semi-annual basis with submission of data files that are, at a minimum, due to TDH or its designee on a quarterly basis no later than 150 days following the end of the period[deleted]. Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report and report. [deleted] 12.8.1 In addition, files are due to the TDH External Quality Review Organization five (5) working days following the end of each State Quarter. See Appendix H for data file submission specificationsSubmission instructions. The PH Utilization Management Report BH utilization report and data file submission instructions may periodically be updated by TDH to facilitate clear communication to the health planplans.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical Behavioral health (PHBH) utilization management reports are required on a semi-annual basis with submission of data files that are, at a minimum, due to TDH or its designee designee, on a quarterly basis no later than 150 days following the end of the period. Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report and for data file submission specifications. The PH Utilization Management Report BH utilization report and data file submission instructions may periodically be updated by TDH to facilitate clear communication to the health plan.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical -------------------------------------------------- Behavioral health (PHBH) utilization management reports are required on a semi-annual basis with submission of data files that are, at a minimum, due to TDH or its designee on a quarterly basis no later than 150 days following the end of the periodbasis. [Deletion] Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report and report. [Deletion] 12.8.1 In addition, files are due to the TDH External Quality Review Organization five (5) working days following the end of each State Quarter. See Appendix H for data file submission specificationsSubmission instructions. The PH Utilization Management Report BH utilization report and data file submission instructions may periodically be updated by TDH to facilitate clear communication to the health planplans.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical -------------------------------------------------- Behavioral health (PHBH) utilization management reports are required on a semi-annual basis with submission of data files that are, at a minimum, due to TDH or its designee designee, on a quarterly basis no later than 150 days following the end of the period. Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report and for data file submission specifications. The PH Utilization Management Report BH utilization report and data file submission instructions may periodically be updated by TDH to facilitate clear communication to the health plan.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical -------------------------------------------------- Behavioral health (PHBH) utilization management reports are required on a semi-annual basis with submission of data files that are, at a minimum, due to TDH or its designee on a quarterly basis no later than 150 days following the end of the periodbasis. Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report and report. 12.8.1 In addition, data files are due to TDH or its designee no later than the fifth working day following the end of each month. See Utilization Data Transfer Encounter Submission Manual for data file submission specificationsinstructions. The PH Utilization Management Report BH utilization report and data file submission instructions may periodically be updated by TDH to facilitate clear communication to the health planplans.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical -------------------------------------------------- Behavioral health (PHBH) utilization management reports are required on a semi-annual basis with submission of data files that are, at a minimum, due to TDH or its designee designee, on a quarterly basis no later than 150 days following the end of the period. Refer to Appendix J H for the standardized reporting format for each report and detailed instructions instructions, for obtaining the specific data required in the report and for data file submission specifications. The PH Utilization Management Report BH utilization report and data file submission instructions may periodically be updated by TDH to facilitate clear communication to the health plan.