Section_J_Attachment_J-5__CDRLs_3-14-13.doc
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- HT9402-12-R-0005
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Defense Health Agency
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Attachment J-5 List of Contract Data Requirements List (CDRLs)
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SECTION J
ATTACHMENT J-5
CONTRACT DATA REQUIREMENTS LIST (CDRL)
DAILY REPORTS
D010 – Payment/Check Issue Report
WEEKLY REPORTS
W010 – Claims Aging Report by Status Location
W020 – Claims Processing Statistics Report
W030 – Incoming Contractor Weekly Status Report
W040 – Outgoing Contractor Weekly Status Report
MONTHLY REPORTS
M010 – Toll-Free Telephone Report
M020 – Beneficiary Contact Data
M030 – Monthly HIPAA Privacy Disclosure Complaint Report
M040 – TRICARE Contractor Cycle Time/Aging Report
M050 – TRICARE Contractor Monthly Workload Report
M060 – Accounts Receivable Summary Report including Supplemental Reports
M070 – Bank Account Reconciliation Report
M080 – Bank Cleared Payment Report
M090 – Bank Account Statement Report
M100 – Internal Quality Management/Quality Improvement Program Report
M110 – Present on Admission (POA) Indicators and Hospital Acquired Conditions (HACs)
M120 – Reserved
M130 – Productivity Report
M140 – Employee Access to DoD/IS Networks
QUARTERLY REPORTS
Q010 – Claims Audit Report
Q020 – Audit Error Correction Report
Q030 – Fraud and Abuse Summary Report
Q040 – Appeals Quality Assessment Report
Q050 – Written Correspondence Quality Assessment Report
Q060 – Telephonic Response Quality Assessment Report
Q070 – Retrospective Review Requirements for Other than DRG Validation Report
Q080 – Reserved
Q090 – Evolving Practices Report
ANNUAL REPORTS
A010 – Third Party Recoveries by FY Report
A020 – Fraud Prevention Savings Report
A030 – Annual Letter of Assurance
A040 – Reserved A050 –Annual Checklist & Certification for Minimum Level of Enhanced
Safeguarding for Unclassified DoD Information
A060 – Annual Risk Assessment & Program Evaluation
C020 – Statement on Standards for Attestation Engagements (SSAE 16)
ANNUAL PLANS
P010 – Internal Quality Management/Quality Improvement Program
P020 – Annual Continuity of Operation Plan (COOP) and Annual Disaster Recovery Test
P030 – Reserved
P040 – Utilization Management Plan
P050 – Education Plan
AS REQUIRED
R010 – TMA Preliminary Incident Report
R020 – Reserved
R030 – Reserved
R040 – Initial Risk Assessment & Program Evaluation
R050 – Start Up Plan
R060 – Privacy Impact Assessment
R070 – Weekly History Updates
R080 – Executed Crossover Agreement with the Medicare Coordination of Benefits Contractor
(COBC)
R090 – MOU with Beneficiary Education & Support (BE&S)
R100 – MOUs with Each MCS Contractor
R110 – Appeals Processing Guidelines, Desk Instructions and Reference Materials
R120 – Reserved
R130 – State Prevailing Annual Update Report
R140 – TQMC Findings Response
R150 – Congressional and Contacts Summary Report
R160 – Automated Response Unit – IVR Messaging
R170 – TQMC Validation Report
HT9402-12-R-0005
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