Monthly Statistical Summary Report (MSSR) Tips and Guidelines June 2013

 MSSR Introduction  Submission Guidelines  MSSR (CDA 174 Rev. 02/13)  MSSR Instructions  Examples  Do’s and Don’ts  Additional Assistance June Outline

 Revised form CDA 174 (Rev 02/13) to reflect the transition to Managed Care.  Revised instructions April  Importance of the MSSR  Data is utilized by CDA and DHCS and reported to CMS per California Bridge to Reform 1115(c) Demonstration Waiver.  Data is used to determine (among other things):  County/statewide changes in enrollment/discharges  County/statewide utilization rates  Access to care June MSSR Introduction

 Submission  All CBAS providers are required to submit by the 10 th of each month.  Time sensitive data.  Preferable method of submission is in an Excel format via the CBAS main .  Allows for direct importing in the CDA CBAS database.  CBAS June MSSR Introduction (Cont.)

June CDA 174 (Rev 02/13) Form

CDA 174 (Rev 02/13) June remember …  Do not use any other versions of this form.  Several fields are locked in order to ensure correct data calculations.

MSSR Instructions: Header Information June The Header Information is at the top of the form and should be completed as follows: Center Name and City: Enter the center’s complete legal name and the city in which it is located. NPI: Enter your center’s National Provider Identifier. Report Year: Enter the report year the monthly data report reflects. Weekdays of Center Operation: Check the days of the week the center provides CBAS services. Hours of Service: Enter the center’s CBAS program hours which are defined and posted by the center. License Capacity: Enter the center’s approved licensed capacity.

June Header Information (cont.): Correct Example A correctly completed form includes: Center Name and City: Complete center name and city location. NPI: Correct and completed NPI listed (10 digits). Report Year: Correct year indicated. Weekdays of Operation: Correct days of operation indicated. Note: Due to compatibility issues between different versions of Excel, the check boxes may not function. If you cannot check the days, please submit the Excel version of the form with the days blank. Hours of Service: Correct hours of service (program hours) selected. License Capacity: Correct license capacity indicated.

June Header Information (cont.): Common Mistakes An incorrectly completed form includes: Center Name and City: city information is missing. NPI: NPI does not contain a correct NPI number (Incorrect NPI is less than 10 digits). Hours of Service: the hours of operation are indicated instead of hours of service (program hours). Hours of service are generally shorter than hours of operation that may be reflected on your license.

 Include all Medi-Cal beneficiaries determined CBAS eligible by the managed care plan and/or the Medi-Cal Field Office during the reporting month.  Include any individuals determined eligible through the fair hearing process.  Do NOT include participants reauthorized for services or those previously determined eligible for CBAS for whom no new face-to- face was conducted (e.g., a participant moving from another CBAS center for whom the Plan or DHCS does not conduct another face- to-face). June MSSR Instructions Box 1

Box 1 (cont.): Correct Example June  A correctly completed form includes:  Only participants determined eligible by managed care, Medi-Cal Field Office (FFS), or through their Fair Hearing during this reporting period.

June Box 1 (cont.): Common Mistakes  An incorrectly completed form includes:  All participants attending the center.  Participants reauthorized for services.  Participants transferred from another CBAS center who the Plan authorizes without conducting a face-to-face (F2F) eligibility determination.

 Include all Medi-Cal beneficiaries who have been determined CBAS ineligible by either managed care and/or the Medi-Cal Field Office during the reporting month. June MSSR Instructions (Cont.) Box 2

 Include all participants the center has formally discharged (per the center’s discharge policies and procedures) during the reporting month. June MSSR Instructions (Cont.) Box 3

 Include all eligible participants enrolled at the center and receiving CBAS per their Individual Plans of Care (IPC) or their ADHC plans of care during the reporting month.  Do NOT include:  Participants who are pending eligibility determination; or  Participants who are in the process of being assessed by the center’s multidisciplinary team (MDT). June MSSR Instructions (Cont.) Box 4

June Box 4 Tips  A correctly completed form includes:  All eligible individuals attending the center during the reporting period.  An incorrectly completed form includes:  Individuals pending admission.  Reporting individuals pending admission in this box will produce incorrect data.

 Include all days of attendance by eligible CBAS and ADHC participants enrolled at the center (those individuals identified in Box 4) during the reporting month.  Do NOT include days the participant is initially assessed by the center’s Multidisciplinary Team (MDT). June MSSR Instructions (Cont.) Box 5

June Box 5 Tips  A correctly completed form includes:  Attendance days for all participants reported in Box 4.  An incorrectly completed form includes:  Reporting initial assessment days.

 Include the total number of days of operation the center provided CBAS/ADHC services during the reporting month. June MSSR Instructions (Cont.) Box 6

Do nothing with this box!  Box 7 will calculate automatically by dividing Total Attendance Days by Days of Center Operation. If you are completing the form manually, divide Box 5(d) by Box 6.  Please do NOT alter CDA’s document. June MSSR Instructions (Cont.) Box 7

 Questions related to the MSSR can be answered through review of the MSSR instructions. You may contact your CDA assigned staff for further discussion.  CBAS Main  CBAS Main Telephone Number : (916)  CDA Website: THANK YOU June Still Have Questions?

The End June