We recommend that the Plan develop documented policies and procedures to govern the collection and reporting of MLR data that comply with laws, regulations, and the OPM contract, including: accurate claims reporting, processing, and payment; premium and capitations adjustments; comprehensive record keeping for data used to price claims; and QHI.
Questioned Costs
$0
Funds for Better Use
$0
Recommendation Status
Closed
Source UUID
ce56b9f0-96fc-4b6c-959b-a3a969e994d9-10
Recommendation Number
10
Significant Recommendation
No