Bidder's Library
Acute RFP YH-09 Bidder's Library

Refer to the following material for general coverage information.

General

• CYE ’09 Acute Care Request for Proposal
• Milestone Dates
  (Updated: March 28, 2007)

Any questions related to this solicitation must be submitted as specified in Section I: Instructions to Offerors, in MS-Word format found in the following link:

• Offeror Question & Answer Template
• Bidder’s Conference Presentation [MS-PowerPoint]
  (Posted February 12, 2008)
• Bidder’s Conference Technical Interface Presentation [MS-PowerPoint]
  (Posted February 12, 2008)

Data Supplement for Offerors

• Section A - Data Supplement Instructions and Overview  (PDF, 18Kb)

• Section B - Program Changes                                      (PDF, 27Kb)
  (Revised: February 27, 2008)

• Section C - Data Book Information             

• Section D - Service Matrix/Selection Criteria

• Section E - AHCCCS Category of Service, Form Types, Provider Type List of Codes and Descriptions

• Section F - Bid Submission Information

• Section G - Crosswalk from Service Matrix to CCFR Layout

• Section H - Enrollment Information

• Section I - Rate Code to Risk Group Matrix

• Section J - Financial Information for Prospective Members

• Section K - Capitation Rates

• Section L - Birth/Member Month Analysis - Summary by County

• Section M - Reinsurance Payments

• Section N - Reinsurance Offsets

• Section O - Hospital Rate Overview

• Section P - Health Plan Audited Financial Statements

• Section Q - Hospice Report

• Section R - Maternity Care and Delivery Reports

• Section S - Delivery Supplement Payment Rates

• Section T - SOBRA Family Planning Service Reports

• Section U - SOBRA Family Planning Capitation Rates

• Section V - Prospective MED Capitation Rates

List of Data Supplement Reports and Files Available on CD

Section C -Utilization and Cost Text File
Section C - Member Month Text File
Section C - Utilization Summary Report
Section C - Member Month Summary Report
Section H - H-1-Acute Enrollment by County by Health Plan
Section H - H-2-Acute Enrollment Mix by GSA
Section H - H-3-Enrollment by Quarter
Section H - H-4-Member Growth Projections
Section H - H-5-Acute Enrollment Activity
Section H - H-6-Enrollment by Zip Code
Section J - Financial Information
Section L - Birth/Member Month Analysis
Section P - Audited Financial Information
Section Q - Hospice Report
Section R - Maternity Care and Delivery Reports
Section T - SOBRA Family Planning Service Reports

Policies

AHCCCS Contractor Operations Manual (ACOM)

The policies listed below either do not appear in the current version of the ACOM, available above, or are revisions to a current ACOM policy. All policies in this list will go into effect on October 1, 2008, unless otherwise specified in the document.

AHCCCS Medical Policy Manual (AMPM)
(Posted: December, 2007)

The policies listed below are revisions to the policies in the AMPM above and will be effective October 1, 2008, unless otherwise specified in the document.

Rules

• Arizona Administrative Code R9-22
• Arizona Administrative Code R9-31
• Arizona Administrative Code R9-34
  (All three: Posted October 30, 2007)

Reporting Guidelines/Manuals

• AHCCCS Reporting Guide for Acute Health Care Contractors

The information in the Reporting Guide that appears below is a revision to the current AHCCCS Reporting Guide for Acute Health Care Contractors that appears above and is effective October 1, 2008.

• Revised - Reporting Guide for Acute Health Care
  Appendices A - F
• Claims Dashboard Reporting Guide
• Data Validation User Manual
  (Posted: December 11, 2007)
• Encounter Reporting User Manual
• Grievance System Reporting Guide
  (All three - Posted: October 30, 2007)
• HIPAA Companion Documents
• Provider Affiliation Transmission (PAT) Manual
• Reinsurance Processing Manual

The Reinsurance Processing Manual found above is the current version. The link below is the final revised version that will go into effect on October 1, 2008.

• Revised - Reinsurance Processing Manual
• Technical Interface Guidelines (TIG)
  (All three - Posted: December 6, 2007)

Forms

• Letter of Intent Template for Prospective Subcontractors (PDF)
  (Posted: December 4, 2007)
• Network Attestation (PDF, 31Kb)
  (Revised: March 11, 2008)
• Minimum Network Standards Spreadsheet Instructions (PDF, 41Kb)
• Minimum Network Standards Spreadsheet Template (MS-Excel, 26Kb)

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