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OLTL External Quality Review

     2021 Statewide Medicaid Managed Care Annual Report

• CHC-MCO Technical Report for Pennsylvania Health and Wellness (PHW)
• January-December 2021
  
• January-December 2020
  
• January-December 2019
  
• CHC-MCO Technical Report for Vista Health Plan, Inc. known as Amerihealth Caritas 
  
• January-December 2021 (ACP)
  
• January-December 2021 (KF)
  
• January-December 2020
  
• January-December 2019
  
• CHC-MCO Technical Report for UPMC Health Plan, 
• January-December 2021
  
• January-December 2020
  
• January-December 2019
  

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Provider Information

Benefits Information

• CHC Benefits Guide
  
• Adults Benefits Package 
• Continuity of Care —  Southwest Zone  //  Southeast Zone  //  Lehigh/Capital, Northeast & Northwest Zones
  
• End of Continuity of Care — Southwest Zone  //  Southeast Zone  //  Lehigh/Capital, Northeast, & Northwest Zones
  
• Service Coordination | Service Coordination Online Course

Billing Information

• CHC-Provider Relationship
  
• CHC Medicare Billing
  
• Third-Party Liability
  

Provider Fact Sheets

• Behavioral Health Provider Update
  
• Complaints and Grievances
  
• Eligibility for CHC
  
• Eligibility Verification System (EVS)
  
• Coordination of Medicare
  
• Office of Developmental Programs Providers & CHC
  
• Populations Served by CHC
  
• Waiver Transitions Flowchart
  
• Understanding Community HealthChoices vs. HealthChoices 
• Transportation
  

Other Resources

• Medical Assistance Quality Strategy for Pennsylvania  
• Protective Services in A Community HealthChoices Managed Care Environment | Webinar 
  

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Managed Care Operations Memorandums

• Community HealthChoices Operations Memorandums
  

CHC-MCO Independent Audits

Year Ended December 31, 2019

• Pennsylvania Health & Wellness
• Keystone Family Health Plan
• UPMC For You