Schedule Q RFI Report Template.xlsx
XLSX spreadsheet 24 KB Posted
- Attached to
- HMO Services for MPSERS
- Solicitation number
- RFP 171 230000003226 2
- Issued by
- Michigan
About this file
This is a Schedule Q RFI Report Template associated with RFP No. 230000003226, designed to track and manage Request for Information (RFI) responses related to what appears to be a benefits or health insurance claims processing application. The template provides a standardized format for documenting applicant information and RFI status tracking across multiple submission cycles. The document includes data fields for applicant identification, demographic information (including name, gender, date of birth, Social Security number, and contact details), and application processing metrics. The RFI report tracks application receipt dates, election status, RFI denial dates, and application status outcomes including incomplete, in process, final denied, and rejected classifications.
The template serves as an administrative tool for managing the RFI process workflow and documenting reasons for application failures or RFI denials. It captures both initial application status information and subsequent RFI status determinations, enabling tracking of applicant communications and processing outcomes. The structured format allows for systematic review of applications that require additional information or documentation before final determination. No specific pricing terms, set-asides, incumbent information, funding sources, or contract award details are evident in this administrative tracking template.
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Other files
| File | Type | Posted |
|---|---|---|
| Schedule B Pricing.xlsx | XLSX spreadsheet | |
| Schedule I2 PPO Medicare Summary of Benefits.pdf | ||
| Schedule I4 Medicare Prescription Drug Summary of Benefits.pdf | ||
| Schedule F Definitions.docx | DOCX document | |
| Schedule G - Contractor Performance Evaluation Survey.doc | DOC document | |
| Schedule I1 PPO Non Medicare Summary of Benefits.pdf | ||
| Schedule J Dependent Coverage.pdf | ||
| Schedule P TRR Report Template.xlsx | XLSX spreadsheet | |
| Schedule L Benefit Comparison and Actuarial Attestation.xlsx | XLSX spreadsheet | |
| Schedule H HMO Benefits Summary and Claims Paid Data.xlsx | XLSX spreadsheet | |
| Schedule K 834 Use Case and Example.docx | DOCX document | |
| Schedule M HMO Census Data REVISED.xlsx | XLSX spreadsheet | |
| Schedule I3 Non-Medicare Prescription Drug Summary of Benefits.pdf | ||
| 230000003226 HMO Services RFP.docx | DOCX document | |
| Schedule N Section 2 Solutions Table.xlsx | XLSX spreadsheet | |
| 230000003226 Questions Answers.pdf | ||
| Schedule R Payment Discrepancy Report Template.xlsx | XLSX spreadsheet |
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Text version
RFI Complete
| Schedule Q RFI Report Template |
| RFP No. 230000003226 |
MBI LastName FirstName Claims_SubscriberID AppReceiveDate ElectionStatus AppFailedReason RFIComments
Incomplete In Process
| Schedule Q RFI Report Template |
| RFP No. 230000003226 |
Firstname MName LastName MBI Gender DOB SSN HomePhone Address1 Address2 Address3 City State County Zip AppStatus AppStatusFailedReason AppReceivedDate RFIDenialDate
Incomplete Final Denied
| Schedule Q RFI Report Template |
| RFP No. 230000003226 |
Firstname MName LastName MBI Gender DOB SSN HomePhone Address1 Address2 Address3 City State County Zip AppStatus AppStatusFailedReason AppReceivedDate RFIDenialDate
Rejected
| Schedule Q RFI Report Template |
| RFP No. 230000003226 |
Firstname MName LastName MBI Gender DOB SSN HomePhone Address1 Address2 Address3 City State County Zip AppStatus AppStatusFailedReason AppReceivedDate RFIDenialDate
File details come from the government source that posted it. Updated .