UTILIZATION MONITORING. The LME/PIHP shall monitor and review service utilization data related to the CONTRACTOR and the LME/PIHP’s Provider Network to ensure that services are being provided in a manner consistent with Controlling Authority and the LME/PIHP’s agreements with the Department.
UTILIZATION MONITORING. Alliance shall monitor and review service utilization data related to the Provider and the Alliance Provider Network to ensure that services are being provided in a manner consistent with Controlling Authority.
UTILIZATION MONITORING. The state will summarize utilization through a review of claims/encounter data for the demonstration population in the subsequent tables. This includes the following:
Table 1. Utilization Monitoring Measures Table 2: Unduplicated Number of Enrollees by Quarter Number of Female Enrollees by Quarter Table 3: Unduplicated Number of Beneficiaries with any Claim by Age Group per Quarter in the Demonstration Year (to date) Number of Females Who Utilize Services by Age and Quarter Table 5: Number Beneficiaries Tested for any STD by Demonstration Year Test Total Tests Table 6: Total Number of Female Beneficiaries who obtained a Cervical Cancer Screening Table 7: Breast Cancer Screening
UTILIZATION MONITORING. CARDINAL INNOVATIONS shall monitor and review service utilization data related to the CONTRACTOR and CARDINAL INNOVATIONS’ Provider Network to insure that services are being provided in a manner consistent with CARDINAL INNOVATIONS’ agreement with the Division of Mental Health, Developmental Disabilities and Substance Abuse Services and the Division of Medical Assistance.
UTILIZATION MONITORING. The BH I/DD Tailored Plan shall monitor and review service utilization data related to the Contractor and the BH I/DD Tailored Plan’s Provider Network to ensure that services are being provided in a manner consistent with Controlling Authority and the BH I/DD Tailored Plan’s Contracts with the Department.
UTILIZATION MONITORING. The LME shall monitor and review service utilization data related to the Contractor and the LME’s Provider Network to insure that services are being provided in a manner consistent with the LME’s agreement with the Division of Mental Health, Developmental Disabilities and Substance Abuse Services and the Division of Medical Assistance.
UTILIZATION MONITORING. The state will summarize utilization through a review of claims/encounter data for the demonstration population in the subsequent tables. This includes the following:
Table 1. Utilization Monitoring Measures Table 2: Unduplicated Number of Enrollees by Quarter Number of Female Enrollees by Quarter Table 3: Unduplicated Number of Beneficiaries with any Claim by Age Group and Gender per Quarter in the Demonstration Year Number of Females Who Utilize Services by Age and Quarter Table 5: Number Beneficiaries Tested for any STD by Demonstration Year Test Female Tests Male Tests Total Tests Table 6: Total Number of Female Beneficiaries who obtained a Cervical Cancer Screening Table 7: Breast Cancer Screening
1. General Outreach and Awareness
a. Provide information on the public outreach and education activities conducted this demonstration year; and,
b. Provide a brief assessment on the effectiveness of these outreach and education activities.
2. Target Outreach Campaign(s) (if applicable)
a. Provide a narrative on the populations targeted for outreach and education campaigns and reasons for targeting; and,
b. Provide a brief assessment on the effectiveness of these targeted outreach and education activities.
