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Current BIDM Documentation

 

MECT Checklists

Decision Support System - Data Warehouse Checklist

Federal Reporting Checklist

Managed Care Organization Interfaces Checklist

Reference Data Management Checklist

 

Miscellaneous BIDM Documents

AHRQ Quality Toolkit - qifactsheet

Authorized User Licensing - Estimates 8-14-2013

Childrens LTC

DSS Hardware Environment

E-mail related to CBMS DSS 01 Size

Example of Resource Intensive Update Queries Used in Rate Setting Process

FY 2013-14 Budget Request - Department Description

PI Recovery Officer -RO Spreadsheet Template

Program Integrity Case Management Data

Rules Engine - Business Cases

TPL Files and Data for the BIDM

TPL - COMBO_TORTS_V2

Xerox Data Warehouse Table Sizes 8-5-2013

 

APCD Data Submission

APCD_Data-Submission-Guide-V5 - May 2013

APCD_Data-Submission-Guide-V5-March-2013

APCD_Rules-Governing-Data-Submissions-to-APCD-2011-08-24

APCD-Frequently-Asked-Questions-for-Data-Submitters-2012-01-23

 

CMS-10185 Medicare Pard D Reporting Requirements

CMS-10185 508_CMS-10185_Supporting_Statement_Part_A

CMS-10185 508_CY2014_Part_D_Reporting_Requirements_Draft 1

CMS-10185 508_Summary_of_RR_Changes_from_CY2013_to_CY2014

  

CMS-21 and 21b2 Quarterly Children's Health Insurance (CHIP) Statement of Expenditures for the Title XXI Program

508 CMS-21B 

508_CMS-21 Disclosure Statement

508_CMS-21 Form 83 Part I

508_CMS-21 Form 83 - Part II

508_CMS-21 Supporting Statement

508_CMS21Forms

CMS-21 Disclosure Statement

CMS-21 Form 83 Part I

CMS-21 Form 83 - Part II

CMS-21 Supporting Statement

 

CMS-222 Independent Rural Health Center

2010 RHC-FQHC Form 83 - Part 1 Worksheet

2010 rhcfqhc supporting statement version 3

508_2010 RHC-FQHC Form 83 - Part 1 Worksheet

508_2010rhcfqhcsupporting statementversion 3

508_pr2_2900_to_2910

508_pr2_2990_to_2995

508_pr2_29_toc

508_PRA CMS-222 form SUPPORTING STATEMENT

508_R9p229f

pr2_2900_to_2910

 pr2_29_toc

PRA CMS-222 form SUPPORTING STATEMENT

R9p229f

  

CMS-317 State Medicaid Eligibility Quality Control Sampling Plans

508_CMS-317 Supporting Statement Part A

508_CMS-317 Supporting Statement Part B

508_Medicaid Eligibility Sampling Plan Content

  

CMS-372S Annual Report on Home and Community Based Services Waivers and Supporting Regulations

 CMS-372(s) 83i

CMS-372(s) Supporting Statement

SEC 1915 c of the Act

sm 02 2 2700 6 to 2700 6

 

CMS-416 Annual Early and Periodic Screening, Diagnosis, and Treatment Reports

508CHIPRA CMS-416 Form 03-30-10

508CMS-416 Instructions 03-29-10 clean

508CMS-416 Supporting Statement CHIPRA PRA

508Crosswalk CHIPRA PRA

508Form 83 - Part I Worksheet CHIPRA PRA

508Form 83 - Part II Worksheet CHIPRA

CHIPRA CMS-416 Form 03-30-10

CMS-416 Instructions 03-29-10 clean

CMS-416 Supporting Statement CHIPRA PRA

CMS-416 Crosswalk CHIPRA PRA

Form 83 - Part I Worksheet CHIPRA PRA

Form 83 - Part II Worksheet CHIPRA

 

CMS-R-153 Medicaid Drug Utilization Review (DUR) Annual Report

07-28-10 MEDICAID DRUG UTILIZATION REVIEW FINAL (2)

508_Supporting Statement Part A 10-6-10

508_Worksheet Part 1

508_Worksheet Part 2

Supporting Statement Part A 10-6-10

Worksheet Part 1

Worksheet Part 2

 

CMS-R-266 Medicaid Disproportionate Share Hospital Annual Reporting Requirements

508_CMS-R-266 - Crosswalk

508_CMS-R-266 -- Supporting Statement part A [rev 6-11]

508_Copy of CMS-R-266_Spreadsheet rev

CMS-R-266 - Crosswalk

CMS-R-266 -- Supporting Statement part A [rev 6-11-201]

 

CMS-R-284 Medicaid Statistical Information System (MSIS)

508_CMS-R-284_-_Supporting_Statement_part_A_[rev_11-29]

508_msisdd7-2010

508_TMSIS DD 508 Compliant 12-21-12

CMS-R-284_-_Supporting_Statement_part_A_[rev_11-29-201]

 

Contractor Reporting

Benefits Management Portal Tab Instructions with images

Benefits Management Report List

CMS-37 Forms - Medical Program Budget Report

CMS-64 Forms - Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program

Medicare Buy-In COLD Reports Currently used 2013-07-31

 

Demonstration Reports

Hospice RCCO Protocol for Subcommittee 09102013

Protocol Home Health and RCCO Subcommittee Recommendation 07092013

Protocol Hospital and RCCO Subcommittee Recommendation 07092013

Written Protocol BHOs and RCCOs Subcommittee Recommendation 07092013

Written Protocol CCBs and RCCOs Subcommittee Recommendation 07092013

Written Protocol SEPs and RCCOs Subcommittee Recommendation 07092013 

 

DSS

DSS Hardware Environment

DSS 01 Size and Estimate

DSS Extract Overview - 21-2 DSS Extract

DSS Mapping - Colorado DSS Data Dictionary

DSS Mapping - DSD for Claims

DSS Mapping - DSD for Client

DSS Mapping - DSD for Prior Authorization

DSS Mapping - DSD for Provider

DSS Mapping - DSD for Reference

DSS Tables, Number of Rows and Sizes

 

SDAC Reports Matrix

De-Identified Reports

ACC Newsletter

All Members Report

Attribution Summary

Care Management Report

Client Tag Documentation

CPCi Attribution File Spec

Enrollment Summary

HD Rp Login Attempts Summary 7 Days

HD Rpt CRM 7 Days

HS Rpt LogIn Attempts 7Days

Impact Analysis Example

KPI Incentive Payment Report

KPI Members List

KPI Trends Report

PCMP Client Audit Report

Pharmacy Contraindicated Report

Pharmacy Utilization

Potentially Prevent Mbrs List

Roster Report

Rx Report Client Utilization Detail

SDAC User Guide 

 

System Interfaces and Data Exchanges

APCD and SDAC File Extract Script

BCCP-Monthly All BCCP Claims to CDPHE File Format

BCCP-Monthly BCCP Clients to CDPHE File Format

CAHPS Record Layout - 2013 CAHPS Helath Plan Data Sub-specs

CDHS - CCAR Form

CDHS - CCAR Manual

CDHS - DACODS - Drug-Alcohol Coordinated Data System

CDHS - MSHIP

CDHS - YSS-F

CDHS - YSS-F Report and Survey Tool

CDPHE - Cancer Registry Documentation

CDPHE Data Exchanges - Sample Timeframes

CDPHE - Health Facilities and Emergency Medical Services Division

CDPHE - Health Facilities and Emergency Medical Services Division - Licensure and Certification

CDPHE - Immunization Registry - Connectivity Instructions

CDPHE - Trauma Registry

CDPHE - Vital Statistics

CHAS - 2008-2009 Data Dictionary PUF

CHAS - 2011 Data Dictionary PUF

CICP Manaual - Data Collection Requirements

CICP Pharmacy Billing File - 330-516 cicppharmacyfy2013(1)

CICP Physician Billing File - 59-367 cicpphysicianfy2013

CICP Provider Data Collection Manual 2013-2014

CICP - Sample Hospital Physician Report

CICP - Sample Hospital Report

CICP - Sample Pharmacy Report

CICP Summary Spreadsheet - 381-847 cicpsummaryspreadsheetfy2013

CMS -COBA Data Exchange Electronic Transmission Form - ETF 05-12-10

CMS Interface Control Document

CMS - MDS - 3.0 CMS Record Layout

CMS-OASIS Record Layout - RIF OASIS C CMS

CO MED-13 - ElectronicCRInstructions

DHHS Interface Control

DHS - Early Childhood Intervention - Memorandum of Understanding Revised May 2011

Drug-Alcohol Coordinate Data Manual DACODS

DUR File Transfer SQL - Client Data File 11Jul2012

DUR File Transfer SQL - Client Eligibility File 11Jul2012

DUR File Transfer SQL - Client Managed Care File 11 Jul 2012

DUR File Transfer SQL - Institutional Claims File 11 Jul 2012

DUR File Transfer SQL - Institutional Other Diagnosis File 11Jul2012

DUR File Transfer SQL - Institutional Other Procedures File 11Jul2012

DUR File Transfer SQL - Institutional Revenue and HCPCS File 11Jul2012

DUR File Transfer SQL - Pharmacy Claims File - 11 Jul 2012

DUR File Transfer SQL - Professional Claims File - 11 Jul 2012

DUR File Transfer SQL - Provider Address File - 11 Jul 2012

DUR File Transfer SQL - Provider Data File - 11 Jul 2012

DUR File Transfer SQL - Provider Specialty File - 11 Jul 2012

DUR File Counts - December 2012

FPL and Dual Eligible Standards - 2013 Federal Poverty level charts

HCRIS Data from PCG

HCRIS CO Provider ID Info (2552-10)

HCRIS CO Provider ID Info (2552-96)

HCRIS CO FY2011 (2552-96) Report Data May 2013 I

HCRIS CO FY2011 (2552-96) Report Data May 2013 II

HCRIS CO FY2011 Report Data May 2013 I

HCRIS CO FY2011 Report Data May 2013 II

Hospital Back Up - Client Sheet Example

Hospital Cost Sheet Example

MED13CostReport

Mediare Part D Clawback- Letter 6 -28-10

Medi-Medi Files July 2013

MHSIP Report and Survey Tool

Money Follows-The-Person - MSIS - Overview and File Layout Finders File

NPPES - Data Dissemination File and Record Layout

NPPES - Data Dissemination File Code Values

Nursing Facility 5615 Form

PARIS - Connect Direct Form

PARIS - federal codes for states 07262013

PARIS - Federal Output Record Format 3F4A

PARIS - Generic Flowchart

PARIS - Interstate Output Record Format NEW

PARIS - Instructions for DMDC electronic file transmission

PARIS - State Input Record Format NEW

PARIS - Veterans Data Dictionary 09182012

PARIS - Veterans Output File Layout 09182012

PASARR Form

PERM - CMS-10184 Supporting Statement - Part A -FINAL 5312013

PERM - CMS-10184 Supporting Statement Part B (2)

PERM - CMS-10184 Crosswalk for condensed forms(1) final

PERM - CMS-10184 Crosswalk for summary findings final

PERM - CMS-10184 PERM Review Summary and Instructions final

PERM - CMS-10184 PETT UserGuide January 2013

PERM - Overview

PERM - Record Request

PERM - Required Documentation

SF-12 Survey - SF12v1 Standard Sample

VARIS - Data Feed Layout for CSR2541 5-31-2012 

 

SANDBOX Load Script

rct clm pd drug li t

rct clm pd drug t

rct clm pd li t

rct clm pd t

rct unload drug

rct unload drug line

rct unload head

rct unload line

 

TCN Database