Technical Interface Guidelines


Behavioral Health Interface

Monthly BHS Capitation Summary Report


Introduction The Monthly BHS Capitation Summary is created once a month by AHCCCS. This file contains summary data of AHCCCS eligible members included in the monthly capitation calculation. 
Schedules The following table outlines schedules for the Monthly BHS Capitation Summary Report process.
Processing requirement Schedule
Monthly BHS Capitation Summary Report Run on the third day before the 1st of the next month as part of the Monthly cycle and is available in the /AZ/BHS/PROD/OUT folder

Media Monthly BHS Capitation Summary Report file will be sent to the AHCCCS FTP server.
Reporting This process produces the Monthly BHS Capitation Summary reports of Title XIX, Title XIX with Navajo Nation and Gila River, TXXI, Title XXI with Navajo Nation and Gila River, HIFA II and HIFA II with Navajo Nation and Gila River.  

The reports created in this process will be sent to the AHCCCS FTP server and will be available for download and printed by ADHS.


Reference documents

Monthly BHS Capitation Summary Report
Monthly BHS Capitation Summary Report for Navajo & Gila River Community

Monthly BHS KidsCare Capitation Summary Report
Monthly BHS KidsCare Capitation Summary Report for Navajo & Gila River Community
Monthly HIFA II BHS Capitation Summary Report
Monthly HIFA II BHS Capitation Summary Report for Navajo & Gila River Community
Monthly Capitation Detail File
 

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Monthly BHS Capitation Summary Report

REPORT ID: HP07M274-A                         ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM                              PAGE:   1    
PROGRAM #: HP07L274                             MONTHLY MENTAL HEALTH CAPITATION SUMMARY                                RUN:11/30/03
                                                            AS OF 12/01/03                                                     01:29
PLAN: 079999 DHS BEHAVIORAL HEALTH                                                                                                  
COUNTY: 01 APACHE                                                                                                                   
                      NA CHILDREN       CHILDREN       NA ADULTS        ADULTS                        NA GMH/ADULT     GMH/ADULT    
MEMBER COUNT           0-17 YRS         0-17 YRS       18 & OVER       18 & OVER           TOTAL       18 & OVER       18 & OVER    
__________________ ______________ ______________ ______________ ______________ ______________ ______________ ______________  
TANF                         6,713             719           3,608             454          11,494           3,608             454  
SSI WITH MEDICARE                0               0           1,515             196           1,711           1,515             196  
SSI W/O MEDICARE               446              51           1,953             253           2,703           1,953             253  
SOBRA CHILDREN               3,737             642             390              46           4,815             390              46  
SOBRA MOTHER                    19               5             246              36             306             246              36  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
COUNTY SUB-TOTAL            10,915           1,417           7,712             985          21,029           7,712             985  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION RATE             $31.85          $31.85          $65.91          $65.91                          $26.02          $26.02  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION PAYMENT     $347,642.75      $45,131.45     $508,297.92      $64,921.35     $965,993.47                                  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
GMS SUB-TOTAL                                                                          $226,295.94     $200,666.24      $25,629.70  
                    ============== ============== ============== ============== ============== ============== ==============  
SUB-TOTAL CAPITATION                                                                 $1,192,289.41                                  
FOR CATEGORICAL     ============== ============== ============== ============== ============== ============== ==============  
TANF EXP                       106              23           1,552             272           1,953           1,552             272  
SSI WITH MED EXP                 0               0             213              95             308             213              95  
SSI W/O MED EXP                  0               0               9               1              10               9               1  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
COUNTY SUB-TOTAL               106              23           1,774             368           2,271           1,774             368  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION RATE             $31.85          $31.85          $65.91          $65.91                          $26.02          $26.02  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION PAYMENT       $3,376.10         $732.55     $116,924.34      $24,254.88     $145,287.87                                  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
GMS SUB-TOTAL                                                                           $55,734.84      $46,159.48       $9,575.36  
                    ============== ============== ============== ============== ============== ============== ==============  
SUB-TOTAL CAPITATION                                                                   $201,022.71                                  
FOR CAT LINKED EXP ============== ============== ============== ============== ============== ============== ==============  
 

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Monthly BHS Capitation Summary for Navajo Nation and Gila River Report

REPORT ID: HP07M274-B                         ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM                              PAGE:   1    
PROGRAM #: HP07L274                             MONTHLY MENTAL HEALTH CAPITATION SUMMARY                                RUN:11/30/03
                                                FOR NAVAJO NATION & GILA RIVER COMMUNITY                                            
                                                           
AS OF 12/01/03                                                     01:45
PLAN: 079999 DHS BEHAVIORAL HEALTH                                                                                                  
COUNTY: 01 APACHE                                                                                                                   
                      NA CHILDREN       CHILDREN       NA ADULTS        ADULTS                        NA GMH/ADULT     GMH/ADULT    
MEMBER COUNT           0-17 YRS         0-17 YRS       18 & OVER       18 & OVER           TOTAL       18 & OVER       18 & OVER    
__________________ ______________ ______________ ______________ ______________ ______________ ______________ ______________  
TANF                         6,571               0           3,535               0          10,106           3,535               0  
SSI WITH MEDICARE                0               0           1,507               0           1,507           1,507               0  
SSI W/O MEDICARE               431               0           1,939               0           2,370           1,939               0  
SOBRA CHILDREN               3,643               0             381               0           4,024             381               0  
SOBRA MOTHER                    17               0             241               0             258             241               0  
           
        -------------- -------------- -------------- -------------- -------------- -------------- --------------  
COUNTY SUB-TOTAL            10,662               0           7,603               0          18,265           7,603               0  
 
                  -------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION RATE             $31.85          $31.85          $65.91          $65.91                          $26.02          $26.02  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION PAYMENT     $339,584.70            $.00     $501,113.73            $.00     $840,698.43                                  
                    -------------- -------------- -------------- -------------- -------------- -------------- --------------  
GMS SUB-TOTAL                                                                          $197,830.06     $197,830.06            $.00  
                    ============== ============== ============== ============== ============== ============== ==============  
SUB-TOTAL CAPITATION                                                                 $1,038,528.49                                  
FOR CATEGORICAL     ============== ============== ============== ============== ============== ============== ==============  
TANF EXP                       105               0           1,516               0           1,621           1,516               0  
SSI WITH MED EXP                 0               0             209               0             209             209               0  
SSI W/O MED EXP                  0               0               9               0               9               9               0  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
COUNTY SUB-TOTAL               105               0           1,734               0           1,839           1,734               0  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION RATE             $31.85          $31.85          $65.91          $65.91                          $26.02          $26.02  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION PAYMENT       $3,344.25            $.00     $114,287.94            $.00     $117,632.19                                  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
GMS SUB-TOTAL                                                                           $45,118.68      $45,118.68            $.00  
                   
============== ============== ============== ============== ============== ============== ==============  
SUB-TOTAL CAPITATION                                                                   $162,750.87                                  
FOR CAT LINKED EXP ============== ============== ============== ============== ============== ============== ==============  
 
 

 
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Monthly BHS KidsCare Capitation Summary Report

REPORT ID: HP07M274-C                         ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM                              PAGE:   1    
PROGRAM #: HP07L274                             MONTHLY MEN. HLTH. KIDSCARE CAP. SUMMARY                                RUN:11/30/03
                                                            AS OF 12/01/03                                                     01:54
PLAN: 079999 DHS BEHAVIORAL HEALTH                                                                                                  
COUNTY: 01 APACHE                                                                                                                   
                      NA CHILDREN       CHILDREN       NA ADULTS        ADULTS                                                      
MEMBER COUNT           0-17 YRS         0-17 YRS          18              18               TOTAL                                    
__________________ ______________ ______________  ______________ ______________ ______________                                  
KIDSCARE                       656             133              27               9             825                                  
                   
-------------- -------------- -------------- -------------- --------------                                  
COUNTY TOTAL                 656             133              27               9             825                                  
                    -------------- -------------- -------------- -------------- --------------                                  
CAPITATION RATE             $13.34          $13.34          $26.54          $26.54                                                  
                    -------------- -------------- -------------- -------------- --------------                                  
CAPITATION PAYMENT       $8,751.04       $1,774.22         $716.58         $238.86      $11,480.70                                  
          
         -------------- -------------- -------------- -------------- --------------                                  
TOTAL CAPITATION                                                                        $11,480.70                                  
                    ============== ============== ============== ============== ==============                                  
 

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Monthly BHS KidsCare Capitation Summary for Navajo Nation and Gila River Report

REPORT ID: HP07M274-D                         ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM                              PAGE:   1    
PROGRAM #: HP07L274                             MONTHLY MEN. HLTH. KIDSCARE CAP. SUMMARY                                RUN:11/30/03
                                                FOR NAVAJO NATION & GILA RIVER COMMUNITY                                            
                                                           
AS OF 12/01/03                                                     01:59
PLAN: 079999 DHS BEHAVIORAL HEALTH                                                                                                  
COUNTY: 01 APACHE                                                                                                                   
                     
NA CHILDREN       CHILDREN       NA ADULTS        ADULTS                                                      
MEMBER COUNT           0-17 YRS         0-17 YRS          18              18               TOTAL                                    
__________________ ______________ ______________ ______________ ______________ ______________                                  
KIDSCARE                       643               0              27               0             670                                  
                    -------------- -------------- -------------- -------------- --------------                                  
COUNTY TOTAL                 643               0              27               0             670                                  
                    -------------- -------------- -------------- -------------- --------------                                  
CAPITATION RATE             $13.34          $13.34          $26.54          $26.54                                                  
                    -------------- -------------- -------------- -------------- --------------                                  
CAPITATION PAYMENT       $8,577.62            $.00         $716.58            $.00       $9,294.20                                  
                    -------------- -------------- -------------- -------------- --------------                                  
TOTAL CAPITATION                                                                         $9,294.20                                  
                   
============== ============== ============== ============== ==============                                  
 
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Monthly BHS HIFA II Capitation Summary Report

REPORT ID: HP07M274-E                         ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM                              PAGE:   1    
PROGRAM #: HP07L274                             MONTHLY HIFA II                  SUMMARY                                RUN:11/30/03
                                                            AS OF 12/01/03                                                     02:00
PLAN: 079999 DHS BEHAVIORAL HEALTH                                                                                                  
COUNTY: 01 APACHE                                                                                                                   
                      NA CHILDREN       CHILDREN       NA ADULTS        ADULTS                        NA GMH/ADULT     GMH/ADULT    
MEMBER COUNT           0-17 YRS         0-17 YRS       18 & OVER       18 & OVER           TOTAL       18 & OVER       18 & OVER    
__________________ ______________ ______________ ______________ ______________ ______________ ______________ ______________  
HIFA II                          0               0             179              34             213             179              34  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
 
COUNTY TOTAL                   0               0             179              34             213             179              34  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION RATE              $0.00           $0.00          $27.13          $27.13                          $11.02          $11.02  
                   
-------------- --------------  -------------- -------------- -------------- -------------- --------------  
CAPITATION PAYMENT            $.00            $.00       $4,856.27         $922.42       $5,778.69       $1,972.58         $374.68  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
                                                                                        
$2,347.26       $1,972.58         $374.68  
                    ============== ============== ============== ============== ============== ============== ==============  
TOTAL CAPITATION                                                                         $8,125.95                                  
                    ============== ============== ============== ============== ============== ============== ==============  
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Monthly BHS HIFA II Capitation Summary for Navajo Nation and Gila River Report

REPORT ID: HP07M274-F                         ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM                              PAGE:   1    
PROGRAM #: HP07L274                             MONTHLY HIFA II                  SUMMARY                                RUN:11/30/03
                                                FOR NAVAJO NATION & GILA RIVER COMMUNITY                                            
                                                           
AS OF 12/01/03                                                     02:01
PLAN: 079999 DHS BEHAVIORAL HEALTH                                                                                                  
COUNTY: 01 APACHE                                                                                                                   
                      NA CHILDREN       CHILDREN       NA ADULTS        ADULTS                        NA GMH/ADULT     GMH/ADULT    
MEMBER COUNT           0-17 YRS         0-17 YRS       18 & OVER       18 & OVER           TOTAL       18 & OVER       18 & OVER    
__________________ ______________ ______________ ______________ ______________ ______________ ______________ ______________  
HIFA II                          0               0             173               0             173             173               0  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
 
COUNTY TOTAL                   0               0             173               0             173             173               0  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION RATE              $0.00           $0.00          $27.13          $27.13                          $11.02          $11.02  
                    -------------- -------------- -------------- -------------- -------------- -------------- --------------  
CAPITATION PAYMENT            $.00            $.00       $4,693.49            $.00       $4,693.49       $1,906.46            $.00  
                   
-------------- -------------- -------------- -------------- -------------- -------------- --------------  
                                                                                         $1,906.46       $1,906.46            $.00  
                   
============== ============== ============== ============== ============== ============== ==============  
TOTAL CAPITATION                                                                         $6,599.95                                  
                    ============== ============== ============== ============== ============== ============== ==============  
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Monthly BHS Capitation Detail File

FIELD NAME TYPE SIZE REMARKS
HP-ID X 6 HEALTH PLAN ID
CTRT-TYP X 1 CONTRACT TYPE
CTY-SER-AREA-CD X 2 COUNTY CODE
AHCCCS-ID X 9 AHCCCS ID
RP-NAME X 34 NAME
ELG-KEY-CD X 3 ELIGIBILITY KEY CODE
RP-ZIP X 9 ZIP CODE
RP-SEX X 1 GENDER
RP-DAT-OF-BIR X 8 DATE OF BIRTH (CCYYMMDD)
PMT-DAT X 8 PAYMENT DATE (CCYYMMDD)
ACT-TYP X 1 NATIVE AMERICAN (Y OR N)
CASE-ID X 9 CASE ID
ACUTE-HP-ID X 6 ACUTE MEDICAL HP ID
TRIBE-CD X 2 RACE
MH-CATEGORY X 1 BHS CATEGORY
ACUTE-RATE-CD X 4 ACUTE MEDICAL RATE CODE
LANGUAGE X 1 LANGUAGE
FILLER X 15 FILLER

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