328x Filetype XLS File size 0.19 MB Source: files.nc.gov
Area NCTracks Report Legacy Report DMH LME Name
Number Number Needed? Needed?
Prior Authorization AR0500-R0440 Y Y PA Eligibility Pending Report
Prior Authorization AR0500-R0790 IPKR1202 Y Y Prior Approval Eligibility Pending over 21 Days
Prior Authorization AR0500-R0800 IPPR0751 Y N PA Units/Dollars of Expended vs. Authorized
Prior Authorization AR0500-R0810 IPKR1201 Y Y Prior Approval Pending Beyond Alert Date
Prior Authorization AR0500-R0820 IPKR7021 Y Y Active Exhausted Prior Approval Report
Prior Authorization AR0500-R0830 IPKR9961 Y Y Prior Approval Expenditure Tracking Report
Prior Authorization AR0500-R0840 IPKR7101 Y Y Overlapping Prior Approval Alert Report
Prior Authorization AR0500-R0850 IPKR7081 Y Y Active Prior Approval Report Issuing
IPKR7082 Provider/Benefit Plan
Prior Authorization AR0500-R0870 IPKR7911 Y Y Prior Approval Extension File Listing by Benefit Plan
Report
Prior Authorization AR0500-R0880 IPKR7001 Y Y Audit Reports for Post Payment Review
Prior Authorization AR0500-R0980 IPKR1203 Y N PA Eligibility Pending Name Mismatch Report
Recipient BM10200-R0010 IPKR0201 Y N DMH Recipient Eligibility Receipt Summary
Recipient BR10201-R0010 IPKR1971 Y Y DMH Recipient Edit Error Report
Recipient BR12001-R0010 Y Y DMH Recipient Eligibility Cross-Reference Update
Report
Recipient BR12002-R0010 IPKR1951 Y Y DMH Cross-Reference Updates Without Eligibility
Recipient BR12003-R0010 IPKR9001 Y Y DMH Recipient Eligibility Error Report
Recipient BR12004-R0010 IPKR9002 Y Y DMH Recipient Eligibility Update Report
Recipient BR12005-R0010 Y N DMH Recipient - CNDS Error Report
Recipient BR12006-R0010 IPKR1060 Y Y DMH Recipient Discrepancy Demographic Data
Report
Recipient BR12008-R0010 IPKR3731 Y Y Recipient Count per Eligibility Program Report
Recipient BR12008-R0011 IPKR3841 Y Y Active Recipient Enrollment Report
Recipient BR12009-R0010 IPKR3801 Y Y Client Eligibility Expiration Alert by Attending
Provider Report
Recipient BR12010-R0010 IPKR3751 Y Y Client Eligibility Expiration Alert Report
Recipient BR20505-R0010 IPKR1501 Y Y DMH Eligibility Combine Report
Recipient BR60900-R0010 IPKR1801 Y Y Suspect Medicaid Client Eligibility Report
Claims CR10001-R0064 IPDR0611 Y N Retroactive Rate Change Forecast
Claims CR20011-R0077 IPCR1851 Y Y Claims Suspended for Recipient Eligibility Report
Claims CR60020-R0010 New Y N Separated Claims Report
Claims CR80026-R0100 Y N Exception Report For Edits
Claims CR80031-R0105 Y N Claims Processing Adjudication Summary
Claims CR80032-R0106 Y N Edit Summary
Claims CR80036-R0109 IPBR3201 Y N Edit Detail Report
Claims CR80036-R0110 Y N Claim Submission Report By Taxonomy
Claims CR80036-R0111 Y N Error Analysis
Claims CR80037-R0003 Y N Financial Aged Adjustment Claims Analysis
Claims CR80037-R0004 Y N Financial Aged Claims Analysis
Claims CR80037-R0006 IPDR2831 Y N DHM PRIOR SFY CLAIMS WITH FINAL
ADJUDICATION IN CURRENT SFY
Financial FR10000-R0010 IPDR4331 Y N MHBG UCR Budget Expenditure Report by
Attending Provider
Financial FR10000-R0020 IPDR4321 Y N SAPTBG Budget Expenditure Report by ISAT ID
Financial FR10000-R0030 IPDR4411 Y Y SAPTBG Budget Expenditure Report by Attending
IPDR4431 Provider (LME Version)
Financial FR10000-R0040 IPDR4451 Y Y MHBG UCR Budget Expenditure Report by
Attending Provider (LME Version)
Financial FR10000-R0080 IPER3801 Y Y Detail Expenditure By Attending Provider - All
Services
Financial FR10000-R0110 IPGR7501 Y Y Utilization Report By LME/Attending
Provider/Benefit Plan - Annual Version
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