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{"sheet":"ECM RESPONSE","index":0,"n_rows":1,"n_cols":62,"rows_kept":1,"cut":false,"hidden":false,"merged":[]}
["Primary Payer (MCP) Identifier","MCP Name","Member Client Index Number (CIN)","Member Last Name","Member First Name","Member New Address Indicator","Member Homelessness Indicator","Member Residential Address","Member Residential City","Member Residential State","Member Residential Zip","Member New Phone Number Indicator","Member Primary Phone Number","Member Preferred Language (Spoken)","Member Preferred Language (Written)","Adult - Individuals Experiencing Homelessness","Adult – Families Experiencing Homelessness","Adult – Avoidable Hospital or ED Utilization","Adult – SMH or SUD","Adult – Transitioning from Incarceration","Adult – At Risk for LTC Institutionalization","Adult – NF Transitioning to Community","Adult – Birth Equity","Child – Individuals Experiencing Homelessness","Child – Families Experiencing Homelessness","Child – Avoidable Hospital or ED Utilization","Child – SMH or SUD","Child – CCS/CCS WCM with Additional Needs","Child – Child Welfare","Child – Transitioning from Incarceration","Child – Birth Equity","Status of Member Engagement","Member Acuity Level","ECM Benefit Start Date","ECM Benefit End Date","Date of Latest Care Plan Revision","Date of Most Recent Care Conference","Date Assessment Started","Date of Most Recent Completed Assessment","Date of Most Recent Encounter with Member","ECM Lead Care Manager Name","ECM Lead Care Manager Phone Number","ECM Lead Care Manager Phone Number Extension","ECM Lead Care Manager Email","Recommendation for Discontinuation Date","Discontinuation Reason Code","Discontinuation Reason","In Person","Telephonic/Video","Outreach In Person","Outreach Telephonic/Video","Member Information Return Transmission File Production Date","Member Information File Reporting Period","ECM Provider Name","ECM Provider National Provider Identifier (NPI)","ECM Provider Tax ID Number (TIN)","ECM Provider Phone Number","CLR ID","Referral Status","Date of Referral Status","Reason for Referral Loop Closure","Date Care Plan Created"]

{"sheet":"CountyCodes","index":1,"n_rows":15,"n_cols":2,"rows_kept":15,"cut":false,"hidden":true,"merged":[]}
["Project Code","County Name"]
["150","Sacramento "]
["315","Fresno "]
["316","Kings "]
["317","Madera "]
["352","Los Angeles"]
["353","Tulare "]
["354","San Joaquin "]
["361","Stanislaus "]
["380","Amador"]
["381","Calaveras"]
["382","Inyo"]
["383","Mono"]
["384","Tuolumne"]
["533","Imperial"]

{"sheet":"LoopClosureReasons","index":2,"n_rows":5,"n_cols":1,"rows_kept":5,"cut":false,"hidden":true,"merged":[]}
["(1) Services Received"]
["(2) Service Provider Declined"]
["(3) Unable to Reach Member"]
["(4) Member No Longer Eligible for Services"]
["(5) Member No Longer Needs Services or Declines Services"]

{"sheet":"ColAU","index":3,"n_rows":17,"n_cols":1,"rows_kept":17,"cut":false,"hidden":true,"merged":[]}
["Member has graduated from ECM"]
["Member no longer qualifies for ECM and requires warm handoff to lower level CM"]
["Member no longer wishes to receive ECM"]
["Unable to connect with member"]
["Incarcerated"]
["Declined to participate"]
["Duplicative program"]
["Lost Medi-Cal coverage"]
["Switched health plans"]
["Moved out of the county"]
["Moved out of country"]
["Unsafe behavior or environment"]
["Member not reauthorized for ECM services"]
["Deceased"]
["ECM Provider at Full Capacity"]
["Unable to serve member's Population of Focus"]
["Member does not meet ECM PoF eligibility criteria"]

{"sheet":"VALIDATE DATA","index":4,"n_rows":71,"n_cols":5,"rows_kept":71,"cut":false,"hidden":false,"merged":[]}
["RTF Rule Guide"]
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[]
[]
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[]
["Column Name","Column Index","Required?","Sample Data","Notes"]
["Primary Payer (MCP) Identifier","A (1)","⬜ Optional",352,"Member's HCP Plan Code; Please refer to PrimaryPayerMCPIdentifier Xwalk tab"]
["MCP Name","B (2)","⬜ Optional","HEALTH NET","HEALTH NET, CHPIV, CALVIVA HEALTH"]
["CIN","C (3)","✅ Required","99999999A"]
["Member Last Name","D (4)","✅ Required","DOE","The following note applies to all Member Demographic data: \nIf ECM Provider Determines the information is different than what was provided by the Health Plan.  ECM Provider shall contact the member's County to update their system.  Updates will flow downstream to Health Plan."]
["Member First Name","E (5)","✅ Required","JANE"]
["Member New Address Indicator","F (6)","⬜ Optional",1,"1 for Yes; \"0\" for No."]
["Member Homelessness Indicator","G (7)","⬜ Optional",0,"\"1\" for Yes; \"0\" for No, Unknown, or Unconfirmed."]
["Member Residential Address","H (8)","⬜ Optional","706 LARAMIE ST","Update if Member New Address Indicator is a \"1\""]
["Member Residential City","I (9)","⬜ Optional","SALINAS","Update if Member New Address Indicator is a \"1\""]
["Member Residential State","J (10)","⬜ Optional","CA","Update if Member New Address Indicator is a \"1\""]
["Member Residential Zip","K (11)","⬜ Optional",939053018,"Update if Member New Address Indicator is a \"1\""]
["Member New Phone Number Indicator","L (12)","⬜ Optional",1,"1 for Yes; \"0\" for No.\n\nECM Providers may indicate a new phone number for Members after engagement; they are expected to seek and share up-to-date phone numbers, where possible. MCPs may follow-up with Members to verify"]
["Member Primary Phone Number","M (13)","⬜ Optional",2078712411,"Update if Member New Phone Number Indicator "]
["Member Preferred Language (Spoken)","N (14)","⬜ Optional","Farsi"]
["Member Preferred Language (Written)","O (15)","⬜ Optional","Farsi"]
["Adult - Individuals Experiencing Homelessness","P (16)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Adult – Families Experiencing Homelessness","Q (17)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Adult – Avoidable Hospital or ED Utilization","R (18)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Adult – SMH or SUD","S (19)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Adult – Transitioning from Incarceration","T (20)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Adult – At Risk for LTC Institutionalization","U (21)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Adult – NF Transitioning to Community","V (22)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Adult – Birth Equity","W (23)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – Individuals Experiencing Homelessness","X (24)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – Families Experiencing Homelessness","Y (25)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – Avoidable Hospital or ED Utilization","Z (26)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – SMH or SUD","AA (27)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – CCS/CCS WCM with Additional Needs","AB (28)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – Child Welfare","AC (29)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – Transitioning from Incarceration","AD (30)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Child – Birth Equity","AE (31)","⬜ Optional",1,"\"1\" for Yes; \"0\" for No."]
["Status of Member Engagement","AF (32)","✅ Required","1. Pending Outreach","1. Pending Outreach\n2. Currently in Outreach\n3. Enrolled\n4. Declined\n5. Excluded"]
["Member Acuity Level","AG (33)","⬜ Optional","High","Valid Values: Low, Moderate, High"]
["ECM Benefit Start Date","AH (34)","✅ Required if AF = \"3. Enrolled\"","2025-01-01","This is the date that the member enrolled or opted in to ECM. This date should match the ECM providers documentation of a member's verbal &/or written consent into ECM within the ECM Providers care management documentation system."]
["ECM Benefit End Date","AI (35)","✅ Required if AF = \"4. Declined\" or \"5. Excluded\"","2025-01-01","This is the Member Disenrollment Date from ECM. This only applies when member was enrolled at some point in ECM."]
["Date of Latest Care Plan Revision","AJ (36)","⬜ Optional","2025-01-01"]
["Date of Most Recent Care Conference","AK (37)","⬜ Optional","2025-01-01"]
["Date Assessment Started","AL (38)","⬜ Optional","2025-01-01"]
["Date of Most Recent Completed Assessment","AM (39)","⬜ Optional","2025-01-01"]
["Date of Most Recent Encounter with Member","AN (40)","⬜ Optional","2025-01-01"]
["ECM Lead Care Manager Name","AO (41)","✅ Required if AF = \"3. Enrolled\"","Harry Potter"]
["ECM Lead Care Manager Phone Number","AP (42)","✅ Required if AF = \"3. Enrolled\"",1234567890,"Enter the direct business line telephone number to the care facility where the ECM LCM practices. Do not include personal cell phone number"]
["ECM Lead Care Manager Phone Number Extension","AQ (43)","⬜ Optional",12345,"Enter the direct business line telephone extension to the ECM LCM at the care facility. Add \"x\" before extension number."]
["ECM Lead Care Manager Email","AR (44)","⬜ Optional","ABCDEFG@HEALTHNET.COM"]
["Recommendation for Discontinuation Date ","AS (45)","✅ Required if AF = \"4. Declined\" or \"5. Excluded\"","2025-01-01","This date is only populated when member is discontinued from further outreach. This only applies when member has never enrolled in ECM. "]
["Discontinuation Reason Code","AT (46)","✅ Required if AF = \"4. Declined\" or \"5. Excluded\"",1,"Valid Reason Codes: 1. The Member has met all care plan goals; 2. The Member is ready to transition to a lower level of care; 3. The Member no longer wishes to receive ECM; 4. The ECM Provider has not been able to connect with the Member after multiple attempts; 5. Incarcerated; 6. Declined to participate; 7. Duplicative program; 8. Lost Medi-Cal coverage; 9. Switched health plans; 10. Moved out of the county; 11. Moved out of country; 12. Unsafe behavior or environment; 13. Member not reauthorized for ECM services; 14. Deceased; 15.Other."]
["Discontinuation Reason","AU (47)","✅ Required if AF = \"4. Declined\" or \"5. Excluded\"","Member has graduated from ECM","Health plans recommend if \"15=Other\" is identified for Discontinuation Code, Discontinuation reason is recommended to be one of the following:\n-ECM Prov at Full Capacity\n-Member does not meet ECM PoF eligibility criteria\n-Unable to serve member's Population of Focus"]
["In Person","AV (48)","✅ Required - When Available",1,"Number of in-person encounters Member received during the reporting period. "]
["Telephonic/Video","AW (49)","✅ Required - When Available",10,"Number of Telephonic/Video encounters member received during the reporting period."]
["Outreach In Person","AX (50)","✅ Required - When Available",2,"Number of in-person outreach attempts enrolled member received during the reporting period."]
["Outreach Telephonic/Video","AY (51)","✅ Required - When Available",1,"Number of in-person outreach attempts enrolled member received during the reporting period. "]
["Member Information Return Transmission File Production Date ","AZ (52)","⬜ Optional","2021-01-01","Date file was submitted to the Health Plan."]
["Member Information File Reporting Period","BA (53)","⬜ Optional","01/01/2021.01/31/2021","Start and end dates reported as two sets of numbers separated by a period delimiter (e.g., MM/DD/YYYY.MM/DD/YYYY)."]
["ECM Provider Name","BB (54)","✅ Required","ABC ECM PROVIDER"]
["ECM Provider National Provider Identifier (NPI)","BC (55)","✅ Required",1234597890]
["ECM Provider Tax ID Number (TIN)","BD (56)","✅ Required",123456789]
["ECM Provider Phone Number","BE (57)","⬜ Optional",2078712411,"Health Plan's Contact Number"]
["CLR ID","BF (58)","⬜ Optional","XYZ12345AZ55"]
["Referral Status","BG (59)","✅ Situational - Refer to CLR Field Mapping tab","(5) Referral Loop Closed","(1) Accepted\n(3) Pending\n(4) Outreach Initiated\n(5) Referral Loop Closed\n\nReport the latest referral status. After the referral has been closed, leave this field blank."]
["Date of Referral Status","BH (60)","✅ Required","2025-01-01","Report the date that corresponds to the member's Referral Status as recorded in the file. Once the referral loop has been closed, leave this field blank."]
["Reason for Referral Loop Closure","BI (61)","✅ Situational - Refer to CLR Field Mapping tab","(1) Services Received","(1) Services Received\n(2) Service Provider Declined\n(3) Unable to Reach Member\n(4) Member No Longer Eligible for Services\n(5) Member No Longer Needs Services or Declines Services"]
["Date Care Plan Created","BJ (62)","✅ Situational","2025-01-01","Enter the date the ECM LCM created the care plan with the member. Date should not change"]

{"sheet":"Error Log","index":5,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}

{"sheet":"CLR Field Mapping - NEW!!","index":6,"n_rows":20,"n_cols":7,"rows_kept":20,"cut":false,"hidden":false,"merged":[]}
["User Guide Matrix for ECM RESPONSE Validation - Closed Loop Referral (CLR) Fields"]
[]
["AF (Status of Member Engagement)","AT (Discontinuation Reason Code)","Discontinuation Reason Text (AU)","Referral Status (BG)","Date of Referral  (BH)","Reason for Referral Loop Closure (BI)","Validation Rule"]
["1. Pending Outreach",null,null,"(3) Pending or (1) Accepted","Must be populated",null,"Column BG is auto-populated with (3) Pending when left blank"]
["2. Currently in Outreach",null,null,"(4) Outreach Initiated","Must be populated",null,"Column BG is auto-populated"]
["3. Enrolled",null,null,"(5) Referral Loop Closed","Must be populated","(1) Services Received","Column BG is auto populated with (1) Services Received is left blank"]
["5. Excluded",1,"Member has graduated from ECM",null,"Must be populated",null,"Columns BG and BI must be blank."]
["5. Excluded",2,"Member no longer qualifies for ECM and requires warm handoff to lower level CM",null,"Must be populated",null,"Columns BG and BI must be blank."]
["4. Declined",3,"Member no longer wishes to receive ECM ",null,"Must be populated",null,"Columns BG and BI must be blank."]
["5. Excluded",4,"Unable to connect with member","(5) Referral Loop Closed","Must be populated","(3) Unable to Reach Member","Columns BG and BI are autopuplated."]
["5. Excluded",5,"Incarcerated","(5) Referral Loop Closed","Must be populated","(4) Member No Longer Eligible for Services","Columns BG and BI are autopuplated."]
["4. Declined",6,"Declined to participate","(5) Referral Loop Closed","Must be populated","(5) Member No Longer Needs Services or Declines Services","Columns BG and BI are autopuplated."]
["5. Excluded",6,"Declined to participate","(5) Referral Loop Closed","Must be populated","(5) Member No Longer Needs Services or Declines Services","Columns BG and BI are autopuplated."]
["5. Excluded",11,"Moved out of country","(5) Referral Loop Closed","Must be populated","(4) Member No Longer Eligible for Services","Columns BG and BI are autopuplated."]
["5. Excluded",12,"Unsafe behavior or environment","(5) Referral Loop Closed","Must be populated","(2) Service Provider Declined","Columns BG and BI are autopuplated."]
["5. Excluded",13,"Member not reauthorized for ECM services","(5) Referral Loop Closed","Must be populated","(4) Member No Longer Eligible for Services","Columns BG and BI are autopuplated."]
["5. Excluded",14,"Deceased","(5) Referral Loop Closed","Must be populated","(4) Member No Longer Eligible for Services","Columns BG and BI are autopuplated."]
["5. Excluded",15,"ECM Provider at Full Capacity","(5) Referral Loop Closed","Must be populated","(2) Service Provider Declined","Columns BG and BI are autopuplated."]
["5. Excluded",15,"Unable to serve member's Population of Focus","(5) Referral Loop Closed","Must be populated","(2) Service Provider Declined","Columns BG and BI are autopuplated."]
["5. Excluded",15,"Member does not meet ECM PoF eligibility criteria","(5) Referral Loop Closed","Must be populated","(4) Member No Longer Eligible for Services","Columns BG and BI are autopuplated."]

{"sheet":"PrimaryPayerMCPIdentifier Xwalk","index":7,"n_rows":15,"n_cols":3,"rows_kept":15,"cut":false,"hidden":false,"merged":[]}
["Primary Payer (MCP) Identifier","County Name","MCP Name"]
["380","Amador ","HEALTH NET"]
["381","Calaveras","HEALTH NET"]
["382","Inyo","HEALTH NET"]
["383","Mono","HEALTH NET"]
["384","Tuolumne","HEALTH NET"]
["533","Imperial","CHPIV"]
["150","Sacramento ","HEALTH NET"]
["315","Fresno ","CALVIVA HEALTH"]
["316","Kings ","CALVIVA HEALTH"]
["317","Madera ","CALVIVA HEALTH"]
["352","Los Angeles","HEALTH NET"]
["353","Tulare ","HEALTH NET"]
["354","San Joaquin ","HEALTH NET"]
["361","Stanislaus ","HEALTH NET"]