Care Management Status File. The care management status file should be submitted as a CSV file. The care management status file name has the following format: MMCxxxmmyy.CM99 Position Symbol Description 1-3 MMC MMC= Medicaid Managed Care 4-6 xxx xxx= Submitter ID 7-10 mmyy mm= Month of submission yy= Year of submission 11-15 .CM99 CM= Care Management 99= Number of monthly file submission Note: The first file submission of the month should be denoted as “00.” This number should increase by 1 with each new file submission. Example: File name for the first care management status file submission for January 2018: MMCxxx0118.CM00
Care Management Status File. The care management status file should be submitted as a comma separated value (CSV) file. The care management status file name has the format presented in Table 1: Table 1: Care Management Status File Name Format: MCOxxxmmyy.CM99 Position Symbol Description 1-3 MCO MCO = MyCare Ohio 4-6 xxx xxx = Submitter ID 7-10 mmyy mm = Month of submission yy = Year of submission 11-15 .CM99 CM = Care management 99 = Number of monthly file submission Note: The first file submission of the month should be denoted as “00.” This number should increase by 1 with each new file submission. MCOxxx0720.CM00 For example, the file name of the Population Stream file submission for January 2020 would be: MCOxxx0120.CM00 Data Field Definitions and Submission Specifications The fields in Table 2 must be reported on the full replacement file. Table 2: Data Field Definitions and Submission Specifications Data Field Definition Submission Field Medicaid ID Member’s 12-digit Medicaid ID number N/A Character Care Management Status Start Date The care management status start date is the first calendar date the member is assigned to a particular care management status. The initial care management status start date must be on or after the member’s enrollment effective date. Eight-digit date format: mm/dd/yyyy Date Care Management Status End Date The care management status end date is the last calendar date the member is assigned to a particular care management status. For a member who is still assigned to the current care management status at the time of data submission, enter 12/31/2299 to indicate an active care management status span. For a member who dis-enrolls from the MCOP, the disenrollment effective date is the care management status end date. Eight-digit date format: mm/dd/yyyy Date Outreach and Coordina- tion This indicator is used when the MCOP performs one or more of the following activities for a member: Conducts outreach Educates the member Makes referrals for physical, behavioral, or social services Provides service coordination (defined as a planned, active interaction between the MCOP and any provider involved with the member). Place a 1 in the column if the member is assigned to the outreach and coordination care management status. Place a 0 in the column if the member is assigned to an alternate care management status. Character Engaged A member is classified as engaged after the MCOP completes an assessment and develops an individualized care plan. Ongoing, the ...
