Bayou Health Transparency Report

Bayou Health Transparency Report - Data Response

Bayou Health Transparency Report
Section 1

• CCN Name and Service Area

Section 2

Total Providers by Plan, GSA and Specialty

• Specialty
  • GSA A
  • GSA B
  • GSA C
• Provider Type
  • GSA A
  • GSA B
  • GSA C

Section 3

•  Total and Monthly Average Number of Members Enrolled in Each Network by Eligibility Group

Section 4

•  Continuous Phone Access Provided by PCPs 

Section 5

• Percentage of Regular and Expedited Service Authorization Requests 

Section 6

• Percentage of Clean Claims Paid for Providers and Average Number of Days to Pay

Section 7

• Number of Claims Denied or Reduced by Each Coordinated Care Network by Reason

Section 8

• Number and Dollar Value of Claims Paid to Non-Network Providers by Type

Section 9

• Number of Members Who Chose Their Network Versus Auto-Enrolled Members

Section 10

• Total Payments and Average Per Member Per Month for Each CCN 

Section 11

Medical Loss Ratios for Coordinated Care Networks and Related Refunds

• Amerigroup Louisiana
• AmeriHealth Caritas Louisiana
• Louisiana Healthcare Connections

Section 12

• Comparison of Health Outcomes - Health Plan Rates

Section 13

• Comparison of Health Outcomes - Pre Bayou Health Quality Measures

Section 14

Member and Provider Satisfaction Surveys for Each Bayou Health Plan

Provider Satisfaction Surveys

• Amerigroup Louisiana Part 1, Part 2
• AmeriHealth Caritas Louisiana
• Louisiana Healthcare Connections
• Community Health Solutions of Louisiana
• UnitedHealthcare Community Plan of Louisiana

Member Satisfaction Surveys

• Amerigroup Louisiana: Adult and Children
• AmeriHealth Caritas Louisiana: Adult and Children
• Louisiana Healthcare Connections: Adult and Children
• Community health Solutions of Louisiana: Adult and Children
• UnitedHealthcare Community Plan of Louisiana: Adult and Children

Section 15

Annual Audited Financial Statements for Coordinated Care Networks 

• Amerigroup Louisiana
  • Schedule Y - Parent Audit
  • Schedule Z - Agreed Upon Procedures
• AmeriHealth Caritas Louisiana
  • Schedule Y - Parent Audit
  • Schedule Z - Louisiana Agreed Upon Procedures
• Louisiana Healthcare Connections
  • Schedule Y - Parent Audit
  • Schedule Z - Agreed Upon Procedures
• Community Health Solutions of Louisiana
  • Schedule W - Parent Audit
  • Schedule X - Louisiana Audit
• UnitedHealthcare Community Plan of Louisiana
  • Schedule W - Parent Audit
  • Schedule X - Louisiana Audit 1
  • Schedule X - Louisiana Audit 2
  • Schedule AB - DOI Annual Filing

Section 16

Total Savings to The State for Each Shared-Savings Coordinated Care Network

Section 17

Narrative of Sanctions Levied by LDH against a Coordinated Care Network

Section 18

Grievances, Appeals, State Fair Hearings

Section 19

Recipients Receiving Services by Provider Type, Specialty and Place of Service

• Provider Type
• Specialty
• Place of Service

Section 20

The number of members who received unduplicated outpatient emergency service

Section 21

The number of total inpatient Medicaid days

Section 22

Emergency Services Claims, by CCN

Section 23

Pharmacy Benefit Claims