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Admatch K4649 Amendment 1
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12. December
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2022-12-20 10:00 AM - Commissioners' Agenda
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Admatch K4649 Amendment 1
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Last modified
12/15/2022 12:19:18 PM
Creation date
12/15/2022 12:16:48 PM
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Meeting
Date
12/20/2022
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve Amendment 1 to the Health Care Authority-Medicaid Admatch
Order
7
Placement
Consent Agenda
Row ID
97382
Type
Agreement
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DocuSign Envelope ID; 262ABAl8-53544F41-9508-91313C8ACBA6D <br />must be maintained within the System. This includes, but is not limited to: calendaring, <br />Staff/Participant lists, salary and benefits, direct charges or other claimed costs, indirect <br />rate, MER, and any other data used to generate a claim to HCA for reimbursement. <br />1.7. Verify all data that is determined necessary to be stored electronically within the System <br />or other associated websites, or databases as described in the CAP, Manual and this <br />Agreement is physically entered and stored according to the SOS Retention Schedule. <br />This data includes, but is not limited to: calendaring, Staff/Participant lists, salary and <br />benefits, direct charges or other claimed costs, indirect rate, MER, and any other data <br />used to generate a claim to HCA for reimbursement. <br />1.8. Prepare an annual MER proposal to include the MER calculation and formula, the data <br />sources used to determine the MER, the data collection process, the Contractor's <br />monitoring process to ensure accuracy of the MER and any other relevant information. <br />1.8.1. The proposal must be submitted to HCA no later than December first of each <br />year. <br />1.8.2. The proposal must be updated and re -submitted if the data source or <br />collection, calculations, or monitoring changes thirty (30) business days prior <br />to the change. <br />1.9. Submit a quarterly CPE certification identifying the revenue account codes as found in <br />the BARS manual with each invoice validating the accuracy of the CPE. <br />1.10. Submit an annual certificate of indirect costs that certifies the accuracy of indirect cost <br />rate proposal submitted to their Cognizant Agency each January, <br />1.11. Certify the accuracy of all data used to determine a quarterly MAC reimbursement by <br />signing the A19 by an Authorized Representative. This certification extends to all RMTS <br />data, MER data and financial data. <br />1.12. Complete a one hundred percent (100%) code review of all RMTS moments to ensure <br />the code and narrative correlate, within forty five (45) calendar days after the end of the <br />quarter. <br />1.13. Finalize and certify the accuracy of the 10% quality assurance review no more than 10 <br />(ten) calendar days after the 10% review is received. <br />1.14. Monitor the RMTS non response rate, identify and take corrective action to resolve any <br />deficiencies in staff responses. <br />Corrective action must: <br />1.14.1. Be implemented within ten (10) business days; and <br />1.14.2. Be documented and available to HCA upon request <br />1.15. Use a System that is statistically valid and in compliance with all state, and federal laws <br />and Regulations whether through a third -party or other means as stated in the CAP. <br />1.16. Not participate in a time study or claiming process for the HCA MAC program with any <br />entity that does not have an executed agreement with HCA. <br />Washington State Page 38 of 53 HCA IAA K4649 <br />Health Care Authority Revised 10/2020 <br />
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