Common use of UTILIZATION MANAGEMENT REPORTS Clause in Contracts

UTILIZATION MANAGEMENT REPORTS. PHYSICAL HEALTH ------------------------------------------------ Physical health (PH) utilization management reports are required on a semi-annual basis. [Deletion] Refer to Appendix J for the standardized reporting format for each report and detailed instructions for obtaining specific data required in the report. [Deletion] 12.9.1 In addition, data files are due to the TDH External Quality Review Organization five (5) working days following the end of each State Quarter. See Appendix J for submission instructions. The PH utilization report and data file submission instruction may periodically be updated by TDH to facilitate clear communication to the health plan.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical health -------------------------------------------------- Behavioral Health (PHBH) utilization management reports are required on a semi-annual basisbasis [deleted]. [Deletion] Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report. [Deletiondeleted] 12.9.1 12.8.1 In addition, data files are due to the TDH External Quality Review Organization five (5) working days following the end of each State Quarter. See Appendix J H for submission Submission instructions. The PH BH utilization report and data file submission instruction instructions may periodically be updated by TDH to facilitate clear communication to the health planplans.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical -------------------------------------------------- Behavioral health (PHBH) utilization management reports are required on a semi-annual basis. [Deletion] Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report. [Deletion] 12.9.1 12.8.1 In addition, data files are due to the TDH External Quality Review Organization five (5) working days following the end of each State Quarter. See Appendix J H for submission Submission instructions. The PH BH utilization report and data file submission instruction instructions may periodically be updated by TDH to facilitate clear communication to the health planplans.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL HEALTH ------------------------------------------------ Physical health (PH) utilization management reports are required on a semi-annual basisbasis [deleted]. [Deletion] Refer to Appendix J for the standardized reporting format for each report and detailed instructions for obtaining specific data required in the report. [Deletiondeleted] 12.9.1 In addition, data files are due to the TDH External Quality Review Organization five (5) working days following the end of each State Quarter. See Appendix J for submission instructions. The PH utilization report and data file submission instruction may periodically be updated by TDH to facilitate clear communication to the health plan.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical -------------------------------------------------- Behavioral health (PHBH) utilization management reports are required on a semi-annual basisbasis with submission of data files that are, at a minimum, due to TDH or its designee, on a quarterly basis no later than 150 days following the end of the period. [Deletion] Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report. [Deletion] 12.9.1 In addition, report and for data files are due to the TDH External Quality Review Organization five (5) working days following the end of each State Quarter. See Appendix J for file submission instructionsspecifications. The PH BH utilization report and data file submission instruction instructions may periodically be updated by TDH to facilitate clear communication to the health plan.

UTILIZATION MANAGEMENT REPORTS. PHYSICAL BEHAVIORAL HEALTH ------------------------------------------------ Physical -------------------------------------------------- Behavioral health (PHBH) utilization management reports are required on a semi-annual basis. [Deletion] Refer to Appendix J H for the standardized reporting format for each report and detailed instructions for obtaining the specific data required in the report. [Deletion]. 12.9.1 12.8.1 In addition, data files are due to TDH or its designee no later than the TDH External Quality Review Organization five (5) fifth working days day following the end of each State Quartermonth. See Appendix J Utilization Data Transfer Encounter Submission Manual for submission instructions. The PH BH utilization report and data file submission instruction instructions may periodically be updated by TDH to facilitate clear communication to the health planplans.