Laserfiche WebLink
DocuSign Envelope ID: 262ABAl8-5354-4F41-9508-9B13C8ACBA6D <br />4.8.3. The above data from all patient encounter forms, except Client Name/ID <br />Information, must be transferred onto a single spreadsheet that is searchable <br />and sortable must be available upon request. When requested, the data will <br />be provided in a readable, usable, mutually agreed upon format. <br />4.8.4. The invoice must report a summary for each Interpretation Service contract <br />including the names of the interpreting staff, the total amount of time spent <br />performing allowable MAC activities, and total dollar amount claimed for <br />reimbursement. <br />4.8.5. The Contractor is prohibited from altering the information on the patient <br />encounter forms and certifies the accuracy of the data entered into the <br />spreadsheet and the System by signing the A19 by an Authorized <br />Representative. <br />4.9. Calculation and Application of the Pertinent MER <br />4.9.1. All MERs must be calculated quarterly and match the methodology outlined in <br />the contractor's annual MER proposal. <br />4:9.2. All MERs must be based on the quarter claimed. <br />4.9.3. All MAC activities that benefit the Contractors Clients directly and are <br />performed within a program that identifies Clients may use a Client -based <br />MER as described in the CAP and Manual. <br />4.9.4. All MAC activities that benefit the Contractors Clients directly and are <br />performed within a program that operates a primary care or specialty clinic <br />may use a clinic -based MER as described in the CAP and Manual. <br />4.9.5. All MAC activities that benefit a larger population in the geographical region <br />served by the Contractor, or in programs that do not identify Clients or collect <br />demographic data may use the modified county -wide MER. <br />4.9.6. The Contractor is required to collect and maintain demographic data used to <br />determine Medicaid enrollment for all Clients served within budget units <br />whose costs are included in the FFP reimbursement. The Contractor is <br />prohibited from including clients from any budget unit that is not allowable <br />within the MAC program. <br />4.10. Demographic Data Requirements for the Client MER: <br />4.10.1. All data related to Medicaid enrollment and the MER must be maintained <br />according to the SOS records retention schedule. <br />4.10.2. The information collected must be sufficiently detailed to determine Medicaid <br />enrollment through HCA's ProviderOne System. <br />4.10.3. The information must be entered in the Contractor's Client information System <br />or data base. <br />4.10.4. The Contractor must produce a single electronic list of all unduplicated Clients <br />served over the quarter within thirty (30) business days of the end of the <br />quarter. <br />Washington State Page 44 of 53 HCA IAA K4649 <br />Health Care Authority Revised 10/2020 <br />