The Managed Care Reporting Maturity Guide
How leading health plans are modernizing compliance operations in the age of AI. A strategic executive guide for C-suite and VP-level leaders.
What's inside:
- ✓How health plans at each maturity level approach reporting differently
- ✓Where AI and automation deliver real compliance value — and where they introduce risk
- ✓A roadmap for building a reporting function that scales with regulatory complexity
Search the Resource Library
Annual Regulatory Reporting Calendar
A comprehensive calendar of Medicaid managed care, MLR, and cost report filing deadlines organized by report type and regulatory body.
MLR Filing Checklist
A step-by-step pre-submission checklist for Medical Loss Ratio reports covering data reconciliation, credibility adjustments, and narrative requirements.
Peer Review Template for Regulatory Reports
A structured Excel template for internal peer review of regulatory filings. Includes quality control checkpoints, reviewer sign-off fields, and issue tracking.
Audit Readiness Scorecard
A self-assessment tool for evaluating your plan's audit readiness across documentation, controls, data integrity, and process maturity dimensions.
SQL Code Library: Regulatory Reporting Validation Queries
Copy-ready SQL queries for common managed care data validation tasks — encounter data completeness, MLR data reconciliation, and financial report checks.
Excel Automation Templates for Reporting Workflows
A collection of Excel workbooks with built-in formulas and macros to automate common regulatory reporting tasks and reduce manual errors.
Regulatory Submission Tracker
A structured Excel tracker for managing multiple regulatory submissions across states and report types, including status, due dates, and reviewer assignments.
Encounter Data Validation Framework
A comprehensive PDF framework for establishing end-to-end encounter data quality controls from submission to reconciliation.
Reporting Team Onboarding Guide
A structured onboarding curriculum for new regulatory reporting team members, covering the full reporting lifecycle, data sources, and quality control practices.