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. |