The chart lists the RBO (provider identification number, name, region, county and reporting period) and whether the RBO has 'met' or 'not met' the five grading criteria (maintained positive working capital at all times; maintained the required cash-to-claims ratio; maintained positive TNE at all times; calculated and documented IBNR; and reimbursed, contested or denied at least 95 percent of its claims within 45 working days). In addition, the Relative Working Capital and TNE ratios are calculated (by the Department) for each RBO.
The RBOs reporting deficiencies in any of the five grading criteria are required to implement, with agreement of its contracting health plans and the approval of the Department, a corrective action plan to remedy the deficiencies.
Financial Surveys Received
The chart below contains the self-reported information from the disclosure statements ('Compliance Statements') received for RBOs with less than 10,000 lives for the quarter ended September 30, 2019 and prior.
Effective October 1, 2019, all organizations, regardless of the number of covered lives assigned, are required to submit a Quarterly Survey Report. The Compliance Statements are no longer allowed.
Compliance Statements Received
The chart lists RBOs that have not filed either a Quarterly Survey or an Annual Survey.
List of Non-Filing RBO's
Summary of Comparative Aggregated Data
The information below allows consumers to assess summarized information on a statewide and region basis.
Summary of Comparative Aggregated Data
Statement of Organization
The chart available below provides certain information set forth in each RBO’s Statement of Organization filed with the Department.
Statement of Organization