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 HealthCheck
Reporting
What
the MCOs Report to MAA
MCOs
must report the following to MAA:
- Monthly,
quarterly and annual enrollment reports using client encounter
data
- Feedback
on operational issues, including system problems
and overall enrollment problems
What
MAA Reports to the Federal Government
MAA must report
to CMS, by April 1 of each year, health screening information
using
Form
CMS
416 (pdf) for children participating in the managed care
and fee-for service programs for the year ending September 30
of
the previous
year.
See Form
416 Annual EPSDT Participation Report for 2003 for published
national data.
This data allows
the federal government to analyze and compare the delivery of
EPSDT services in the states.
The
Role of the Primary Care Physician in the Reporting Process
The PCP must report certain data to
the MCO to enable it to make required
reports to MAA.
DC's fiscal
agent is responsible for reporting fee-for-service
provider EPSDT procedure code data
on or
before March
1 of each
year for inclusion in the annual
CMS 416 Report.
The
role of the PCP in documenting and reporting EPSDT
services
is crucial!
Electronic
Medical Records
As recordkeeping
evolves from paper-based to data-based, documentation must adapt
to electronic medical record (EMR) systems. Current challenges
include cost, compatibility, and standardization of EMR systems.
The box below lists some online resources for providers who are
exploring the use of EMRs.
| Resource
for Providers: Electronic Medical Records |
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