Download DentaQuest 11044 Research Blvd, Bld D. Suite 400 Austin, Texas

DentaQuest
11044 Research Blvd, Bld D. Suite 400
Austin, Texas 78759
SFY 2014 SFQ 1-2
DentaQuest Quarter 1
Performance
Remedies
Imposed
CAP
Y/N
1
Failure to perform an Administrative Service. Failure to
send English/Spanish member letters.
Noncompliance
Determination &
Remedy Imposed
Date
$10,000.00
Y
9/4/2014
2
Member complaints - 98% resolved within 30 days.
$250.00
Y
9/4/2014
CAP
Y/N
Noncompliance
Determination &
Remedy Imposed
Date
Item
#
Total Q1 Remedies Imposed
Maximum Remedy Action
Allowed
Up to $5,000 per calendar
day per incident
Up to $250 per reporting
period
$10,250.00
DentaQuest Quarter 2
Item
#
Performance
Remedies
Imposed
1
Failure to perform an Administrative Service. Contractor
inappropriately authorized then discontinued orthodontic
care to CHIP members without verifying previous Medicaid
eligibility history.
$5,000.00
Y
9/4/2014
2
Provider Complaints - 98% resolved within 30 days.
$250.00
Y
9/4/2014
3
Member Complaints - 98% resolved within 30 days.
$250.00
Y
9/4/2014
Total Q2 Remedies Imposed
$5,500.00
1
Maximum Remedy Action
Allowed
Up to $5,000 per calendar
day per incident
Up to $250 per reporting
period
Up to $250 per reporting
period
DentaQuest
11044 Research Blvd, Bld D. Suite 400
Austin, Texas 78759
SFY 2014 SFQ 3
DentaQuest Quarter 3
Performance Standard
Remedy
Imposed
Corrective
Action Plan
Y/N
Date of Remedy &
Final
Noncompliance
Finding
1
Failure to Perform an Administrative Service. Security
Incident.
$20,000.00
Y
12/17/14
Up to $5,000 per day for each
incident
2
Provider Complaints 98% resolved within 30 days.
$250.00
N
12/17/14
Up to $250 per reporting period
Item
#
Total Q3 Remedies Imposed
$20,250.00
2
Maximum Monetary Remedy
Allowed by Contract
DentaQuest
11044 Research Blvd, Bld D. Suite 400
Austin, Texas 78759
SFY 2014 SFQ 3
DentaQuest, 3er trimestre
Ítem
1
2
Rendimiento
No se llevó a cabo un servicio administrativo. Incidente de
seguridad.
El 98% de las quejas de los proveedores fueron resueltas
dentro de 30 días.
Total de sanciones impuestas en el 3er trimestre
Fecha de
determinación de
Sanción máxima permitida
incumplimiento y
sanción impuesta
Sanciones
impuestas
CAP
Sí/No
$20,000.00
Sí
12/17/14
$250.00
No
12/17/14
$20,250.00
3
Hasta $5,000 por día por cada
incidente
Hasta $250 por periodo de
reporte
DentaQuest
11044 Research Blvd, Bld D. Suite 400
Austin, Texas 78759
SFY 2014 SFQ 4
DentaQuest Quarter 4
Item
#
Performance Standard
Member complaints 98% resolved within 30 days.
1
Total Q4 Remedies Imposed
Remedies
Imposed
Corrective
Action Plan
Y/N
$500.00
Y
$500.00
4
Date of Remedy &
Final
Maximum Monetary Remedy
Noncompliance
Allowed by Contract
Finding
2/10/15
Up to $250 per reporting period
DentaQuest
11044 Research Blvd, Bld D. Suite 400
Austin, Texas 78759
SFY 2014 SFQ 4
o
DentaQuest, 4 trimestre
Ítem
Estándar de rendimiento
Sanciones
impuestas
Plan de acción
correctiva
Sí/No
1
El 98% de las quejas de los miembros fueron resueltas
dentro de 30 días.
$500.00
Sí
o
Total de sanciones impuestas en el 4 trimestre
$500.00
5
Fecha de la
sanción y
determinación
final de
incumplimiento
2/10/15
Máxima sanción monetaria
permitida por el contrato
Hasta $250 por periodo de reporte