Attachment_J.3-H_LOE_by_Case_Type_and_Case_Volume.xlsx

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Beneficiary and Family Centered Care (BFCC) Quality Improvement Organization (QIO) (BFCC-QIO)
Solicitation number
75FCMC18R0034
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J.3-H LOE by Case Type and Case Volume

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Est. LOE by Case

BFCC-QIO ESTIMATED LEVEL OF EFFORT (LOE) PER CASE

CASE
TYPEQuality of Care Review Hours for IGCE per caseBIPA Appeal Hours for IGCE per caseEMTALA 5-Day Hours for IGCE per caseEMTALA 60-Day Hours for IGCE per caseFocused Study Hours for IGCE per caseGrijalva Appeal Hours for IGCE per caseHWDRG Review Hours for IGCE per caseImmediate Advocacy Hours for IGCE per caseNotice of Non-Coverage Review Hours for IGCE per caseReferred Quality of Care Review Hours for IGCE per caseSanction Hours for IGCE per caseShort Stay Review Hours for IGCE per caseWeichardt Appeal Hours for IGCE per caseNon-Review Activities (i.e. all required activities that are not specifically case review)
Total Hours17.561.834.9912.472.431.692.031.901.7619.49213.372.432.0165% of Total Review Costs

Volume Projection

Case Review Task Order
Year 1Year 2Year 3Year 4Year 5
Region 1 Total8,9739,58710,24510,94811,700
Beneficiary Complaint QOC Reviews310332355380407
BIPA Appeals3,3353,5683,8184,0854,371
EMTALA 5-Day Cases1011121313
EMTALA 60-Day Cases44455
Focus Study200200200200200
Grijalva Appeals3,0593,2733,5033,7484,010
Immediate Advocacy121130139149159
Intensified Reviews00000
Notice of Non-Coverage Reviews259277296317339
Referred QOC Reviews95102109117125
Sanction00011
Weichardt Appeals1,5791,6901,8081,9352,070
Region 2 Total24,09525,76827,55829,47331,522
Beneficiary Complaint QOC Reviews669716766820877
BIPA Appeals6,9827,4717,9948,5539,152
EMTALA 5-Day Cases4751545862
EMTALA 60-Day Cases00000
Focus Study200200200200200
Grijalva Appeals8,5699,1699,81110,49811,232
Immediate Advocacy443474507542580
Intensified Reviews00000
Notice of Non-Coverage Reviews1,0471,1201,1981,2821,372
Referred QOC Reviews166178190204218
Sanction00011
Weichardt Appeals5,9726,3906,8377,3167,828
Region 3 Total30,44632,56334,82937,25339,846
Beneficiary Complaint QOC Reviews685733784839898
BIPA Appeals7,0607,5558,0838,6499,255
EMTALA 5-Day Cases44555
EMTALA 60-Day Cases00011
Focus Study200200200200200
Grijalva Appeals17,35918,57419,87421,26522,754
Immediate Advocacy254272291312333
Intensified Reviews3638414447
Notice of Non-Coverage Reviews165177189202216
Referred QOC Reviews117125134144154
Sanction33444
Weichardt Appeals4,5614,8815,2225,5885,979
Region 4 Total31,79034,00136,36838,89941,608
Beneficiary Complaint QOC Reviews1,6041,7161,8361,9652,103
BIPA Appeals5,3245,6976,0966,5236,979
EMTALA 5-Day Cases280299320343367
EMTALA 60-Day Cases145155166177189
Focus Study200200200200200
Grijalva Appeals14,99216,04217,16518,36619,652
Immediate Advocacy488522559598640
Intensified Reviews143153164176188
Notice of Non-Coverage Reviews342366391419448
Referred QOC Reviews216231247265283
Sanction1617192021
Weichardt Appeals8,0408,6029,2049,84910,538
Region 5 Total36,69439,24841,98244,90648,036
Beneficiary Complaint QOC Reviews9109741,0421,1151,193
BIPA Appeals6,9857,4747,9978,5579,156
EMTALA 5-Day Cases100107114122131
EMTALA 60-Day Cases33444
Focus Study200200200200200
Grijalva Appeals24,71526,44528,29630,27732,396
Immediate Advocacy331354379406434
Intensified Reviews4649525660
Notice of Non-Coverage Reviews2527293133
Referred QOC Reviews131140150161172
Sanction8891010
Weichardt Appeals3,2403,4673,7093,9694,247
Region 6 Total9,57910,23610,93811,69012,494
Beneficiary Complaint QOC Reviews743795851910974
BIPA Appeals1,2931,3841,4811,5841,695
EMTALA 5-Day Cases104111119128136
EMTALA 60-Day Cases11122
Focus Study200200200200200
Grijalva Appeals4,7735,1075,4645,8476,256
Immediate Advocacy196210225241257
Intensified Reviews1920222325
Notice of Non-Coverage Reviews2224262829
Referred QOC Reviews76818793100
Sanction55666
Weichardt Appeals2,1462,2972,4572,6292,813
Region 7 Total4,8025,1255,4695,8386,233
Beneficiary Complaint QOC Reviews250267286306327
BIPA Appeals1,4091,5081,6131,7261,847
EMTALA 5-Day Cases78849096103
EMTALA 60-Day Cases55666
Focus Study200200200200200
Grijalva Appeals1,9422,0782,2242,3792,546
Immediate Advocacy6064687378
Intensified Reviews2021232526
Notice of Non-Coverage Reviews56677
Referred QOC Reviews3538404346
Sanction00000
Weichardt Appeals7988549149781,046
Region 8 Total2,9913,1863,3953,6193,858
Beneficiary Complaint QOC Reviews194207222237254
BIPA Appeals747800856915980
EMTALA 5-Day Cases3841444750
EMTALA 60-Day Cases00000
Focus Study200200200200200
Grijalva Appeals1,3781,4741,5771,6881,806
Immediate Advocacy3335374043
Intensified Reviews44555
Notice of Non-Coverage Reviews910101112
Referred QOC Reviews99101111
Sanction22222
Weichardt Appeals378404432463495
Region 9 Total28,56130,54632,67034,94337,375
Beneficiary Complaint QOC Reviews1,3931,4911,5951,7071,826
BIPA Appeals5,4465,8276,2356,6717,138
EMTALA 5-Day Cases9197104112119
EMTALA 60-Day Cases44455
Focus Study200200200200200
Grijalva Appeals10,85211,61212,42513,29414,225
Immediate Advocacy663709759812869
Intensified Reviews00000
Notice of Non-Coverage Reviews7479849096
Referred QOC Reviews122131140150160
Sanction00000
Weichardt Appeals9,71710,39711,12511,90312,737
Region 10 Total4,5574,8635,1895,5385,912
Beneficiary Complaint QOC Reviews285305326349374
BIPA Appeals1,0811,1571,2381,3251,417
EMTALA 5-Day Cases1314151718
EMTALA 60-Day Cases00011
Focus Study200200200200200
Grijalva Appeals1,9242,0582,2022,3572,522
Immediate Advocacy8794100107115
Intensified Reviews00000
Notice of Non-Coverage Reviews788910
Referred QOC Reviews3133353840
Sanction00000
Weichardt Appeals9289931,0631,1371,217
Grand Total182,489195,124208,642223,107238,585

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