Parkland Community Health Plan

Parkland Community Health Plan
2777 N. Stemmons Freeway, Suite 1750
Dallas, Texas
SFY 2014 SFQ 1-2
Parkland Quarter 1
Item
#
1
Performance
Remedies
Imposed
CAP
Y/N
Noncompliance
Determination &
Remedy Imposed
Date
Member Hotline - 80% of calls answered within 30
seconds. First Violation.
$40.00
N
8/25/2014
Up to $100 per second per
each percentage point below
standard
Total Q1 Remedies Imposed
Maximum Remedy Action
Allowed
$40.00
Parkland Quarter 2
Item
#
1
2
Performance
All reports/deliverables must be on time, accurate and
complete. The report contained an inaccurate busy signal
rate.
Provider Hotline Report, First Violation.
Member Appeals 98% resolved within 30 days. First
Violation.
Total Q2 Remedies Imposed
Remedies
Imposed
CAP
Y/N
Noncompliance
Determination &
Remedy Imposed
Date
Maximum Remedy Action
Allowed
$25.00
N
8/25/2014
Up to $250 per calendar day
the report is late, inaccurate,
or incomplete
$50.00
N
8/25/2014
Up to $500 per reporting
period
$75.00
1
Parkland Community Health Plan, Inc.
2777 Stemmons Freeway, Suite 1750
Dallas, TX 75207
SFY 2015 SFQ 1
Parkland Quarter 1
Item
#
Performance Standard
Claims Lag Reports submitted on time, accurate and
complete. Plan submitted the report without password
protection.
Total Q1 Remedies Imposed
1
Remedies
Imposed
Corrective
Action Plan
Y/N
$100.00
N
$100.00
2
Date of Remedy &
Final
Maximum Monetary Remedy Allowed
Noncompliance
by Contract
Finding
7/6/15
Up to $1,000 per reporting period
Parkland Community Health Plan, Inc.
2777 Stemmons Freeway, Suite 1750
Dallas, TX 75207
SFY 2015 SFQ 1
Parkland, 1er trimestre
Ítem
#
Estándar de rendimiento
Los reportes de retraso de solicitudes de pago se
presentaron a tiempo, correctos y completos. El plan
presentó el reporte sin protección de contraseña.
Total de sanciones impuestas en el 1er trimestre
1
Sanciones
impuestas
Plan de
acción
correctiva
Sí/No
Fecha de la
sanción y
determinación
final de
incumplimiento
$100.00
No
7/6/15
$100.00
3
Máxima sanción monetaria permitida
por el contrato
Hasta $1,000 por periodo de reporte