State Member Cindi Furlough
State Member-
Cindi Furlough replied to the discussion Annual Awards – Employee or Case of the Year in the forum State Only Forum 3 weeks ago
Reply to Annual Awards - Employee or Case of the Year
Hi Melissa,
In Tennessee, we hold an annual Summit (it’s like a mini-NAMPI) where attendees from all of our Managed Care Contractors, MFCD, Attorney General’s Office, and various other State partners. At that Summit, I recognize the MCO with the most referrals accepted by Law Enforcement every year. Throughout the year, I will also take note…
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Cindi Furlough started the discussion Data Mining Initiatives Template in the forum State Only Forum 4 months ago
Data Mining Initiatives Template
Happy Friday!!!
I’m interested if any state has a template they provide to their MCO’s for the MCO to report their data mining initiatives? If so, would you mind sharing so Tennessee can use as a guide when developing our own report for this? It can be sent to me at Cindi.Furlough@tn.gov.
Thank you
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Cindi Furlough posted an update a year ago
Hello fellow Nampians,
Tennessee is trying to develop a list or table that matches the corresponding citation with the names of the
screenings, registries, etc of each category type, the required frequency
(Initial/Monthly/Annually), and who is required to conduct them, for example,
Subcontractors, Contractors, MCO’s, the State, and/or… -
Cindi Furlough replied to the discussion UPIC Final Findings Report (FFR) in the forum State Only Forum 3 years ago
Reply to UPIC Final Findings Report (FFR)
Thank you for the info!
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Cindi Furlough started the discussion UPIC Final Findings Report (FFR) in the forum State Only Forum 3 years ago
UPIC Final Findings Report (FFR)
Has anyone made it to the point of the UPIC submitting an FFR and disagreed with their findings/was not interested in pursuing their identified overpayment? We received an FFR with a lot of technical denials but the physician reviewer mentioned in the exhibit that the member was eligible for services (hospice). Now that the FFR has been…
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Cindi Furlough replied to the discussion MCO Contracts and Program Integrity in the forum State Only Forum 3 years ago
Reply to MCO Contracts and Program Integrity
Hi Mary Kay, Tennessee is actually preparing a presentation on exactly all of what you have listed for the MII Managed Care Symposium on September 7th! If you are unable to attend it, I can send you the presentation when it’s completed to see if it helps any. Also, I will search for your email and send you our Managed Care Program…
