Reports
Provider Type
- Participating Physician Groups (PPG)
The following site-level reports are generated monthly by Health Net and sent to participating providers. Consolidated- and physician-level reports are available on request.
Report Option |
Description |
---|---|
Consolidated |
Allows the participating physician group (PPG) and all satellite offices to receive one integrated report. |
Site |
Allows the PPG to have all its satellites receive their own sets of reports. |
Physician |
Allows each primary care physician (PCP) within a PPG to receive an individual report. This option is only available for the Eligibility and Remittance Detail report. |
The following reports are available to PPGs:
Report # |
Name |
Description |
---|---|---|
BRM 11 |
Eligibility Summary by Employer Group Report |
Lists members by employer group. |
BRM 18 |
CMS Monthly Membership Report |
Lists Medicare-specific attributes and premium amounts. |
BRM 20 |
Remittance Detail Report |
Details the capitation and adjustments for each member. |
BRM 25 |
CMS Risk Adjustment Model Output Report |
Lists hierarchical condition category (HCC) codes used by the Centers for Medicare & Medicaid Services (CMS) to determine risk scores. |
BRM 28 |
SB260 Reconciliation Report |
Summarizes eligibility and remittance data. |
BRM 30 (monthly) or BRW 30 (weekly) |
Activity Analysis Report (available weekly or monthly) |
Details all member-related activity during the prior reporting period.
|
BRM 42 |
Expanded Eligibility Report |
Lists all members approved by CMS who receive their Medicare benefits from Health Net. |