Inland Empire Health Plan Standard Monthly Reports
INLAND EMPIRE HEALTH PLAN STANDARD MONTHLY REPORTS Supplemental to: Board Report #318 July 12, 2021 Inland Empire Health Plan Supplemental to Board Report #318 July 12, 2021 ADMINISTRATION (Jarrod McNaughton) 1. Standard IEHP Monthly Reports a. IEHP Operations Reports 1) Claims Inventory Report 2) Claims Processing Turnaround Time 3) PCP Member Allocation Report 4) Member Services Telephone Activity Report 5) Provider Automated Eligibility Contact Report 6) Member Eligibility Verification Report b. IEHP Provider Reports 1) IPA Consolidated Membership Report 2) Hospital Consolidated Membership Report c. IEHP Marketing Reports 2) Two-county Medi-Cal Market Enrollment Report 2) IEHP’s Medi-Cal Membership by Market Segmentation 3) Two-county Cal MediConnect Market Enrollment Report – 2 Inland Empire Health Plan Supplemental to Board Report #318 July 12, 2021 ADMINISTRATION 1. Review of The Standard IEHP Monthly Reports a. Operations Reports 1) Claims Summary Report Claims Inventory Report Month End May 2021 Claims Beginning Claims Claims Claims Claims Ending Category Inventory Received Paid Denied Capitated Inventory Professional IEHP Responsible 51,813 141,621 100,287 37,213 1,181 54,753 IEHP Direct 166,866 511,146 402,183 54,777 41,179 179,873 Per Diem Hospital Contract 23,049 74,557 65,268 8,962 980 22,396 Vision 4,614 26,495 21,356 572 4 9,177 Pay For Performance (P4P) 431 1,386 1,336 68 - 413 Mental Health 9,760 33,506 30,221 1,373 - 11,672 Member Reimbursement - - - - - Redirected 8,876 33,828 - 31,825 11 10,868 Decaps - - - - - - No
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