6. Attachment E - Reporting and Deliverables.pdf
PDF 94 KB Posted
- Attached to
- RFP No. DMS-2425-312 MAPD
- Solicitation number
- RFP-12976
- Issued by
- Leon County, Florida
About this file
Attachment E is a detailed Reporting and Deliverables document for RFP No. DMS-24/25-312, outlining comprehensive reporting requirements for what appears to be a Medicare-related health services contract. The document specifies 22 distinct reports with varying frequencies (weekly, monthly, quarterly, and annually), each with specific due dates and required file formats. Reports include critical healthcare-related deliverables such as Reject Records Reports, Duplicate Records Reports, Background Checks, Paid Claims Files, Medicare Membership Reports, Performance Guarantee Reports, Formulary Changes, Trend Analysis Reports, and Annual Plan Reports.
The reporting schedule is rigorous, with most reports requiring submission within 2-45 calendar days of a specific period's end, predominantly using department-prescribed formats. Notable requirements include monthly enrollee invoices in Excel format with detailed member enrollment information, quarterly clinical and performance reports, and annual submissions like the Renewal Report (due May 1, 2028) and Participant Member Satisfaction Survey Report. Special attention is given to Medicare-related reporting, with specific reports like Part C and Part D Medicare Membership report and Model Output Report to be submitted within 45 calendar days of receipt from CMS, indicating a complex healthcare services engagement likely involving Medicare plan management or administration.
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Text version
RFP No.: DMS-24/25-312 Attachment E: Reporting and Deliverables Page 1 of 3
ATTACHMENT E: REPORTING AND DELIVERABLES
FREQUENCY REPORT
NUMBER REPORT NAME DUE DATE FILE LAYOUT
Weekly 1 Reject Records Report w/in 2 Business
Days starting w/ 1st full day file is available
Department-prescribed format.
2 Duplicate Records Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
3 Address Errors Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
4 System Generated Subscriber Drop Report w/in 2 Business Days starting w/ 1st full day file is available
Department-prescribed format.
Monthly 5 Background
Checks/Persons with Disqualifying Offenses
15th of following month
6 Paid Claims File - to Dept/HIMIS
7 Paid Claims Summary Report
8 Part C and Part D Medicare Membership report (MMR) w/in 15 Calendar Days of receipt from CMS
As received from CMS – provide data key as needed
Attachment E: Reporting and Deliverables Page 2 of 3
9 Enrollee Invoice 15th of following month
Excel format, tab 1. Must include enrollment file Member detail matching invoiced amount on subsequent tab(s)
Quarterly
10 Performance Guarantee Report w/in 45 Calendar Days of quarter end
Department-prescribed format.
11 Formulary Changes w/in 45 Calendar Days of quarter end
Department-prescribed format.
12 Key Metric Cost w/in 45 Calendar Days of quarter end
Department-prescribed format.
13 Utilizatin Report w/in 45 Calendar Days of quarter end
14 Trend Analysis Report w/in 45 Calendar end
Department-prescribed format.
15 Network Provider Add / Delete Report w/in 45 Calendar
16 Trend Analysis Report w/in 45 Calendar
17 Clinical Program Report w/in 45 Calendar Days of quarter end
Department-prescribed format.
Annually 18 Renewal Report May 1, 2028, and annually thereafter Department-prescribed format.
19 Participant Member
Satisfaction Survey Report w/in 45 Calendar Days of year end
19 Performance Bond By December 31 of each Plan Year
Attachment E: Reporting and Deliverables Page 3 of 3
20 Insurance Certificates By December 31 of each Plan Year
21 Part C and Part D Model Output Report
(MOR)
w/in 45 Calendar Days of receipt from CMS
As received from CMS – provide data key as needed
22 Annual Plan Report within 60 Calendar Days of the end of the Plan reporting year
File details come from the government source that posted it. Updated .