2077 Jo MR CH\KAIPERIC@Kaiperm, NCA KAIPERM@KAIPERM \ osisr2008 ont Pa ¢ EEE BEE 2.109 OKAIPER, EEE KAP ERM CK perm, NIN CAKAIPERIAEDKaiperm Subject Fw: PRIVILEGED AND CONFIDENTIAL - Retro-Enrolments/Retra-Terminations | Thote have been wo recent DMHC demands o poy regarding retro enrolment and to termination, One involved claim for a member stunt dependent member who had along nosptalzaton, KE ed been eotied of the cdmassion and wore case managing her hospital stay. Scbsequerty the group rer termed he fo belore te admission dae, The socond cose wes orto envalimant wnere te palin ceived cae aout of plan hospital and thon 10 days afterdischarge his group reo enrolled ign fs day ofthe month of accion, | wil eforword those dedisions to you,Bocaus of those docslone hee was a meoting hold on Ny ti; T/T 1085, legol contracting 99d Special sonics to discuss his typo of siytion and whats KPs responsibilty. The‘ocsion coming out the scsi chal agg as KP _ ing to accept revo enrollment oa tec TEM cases we need to accep te costs of eames tha arise out of thee ig, KNTSTATER That his fe of case comes to special servcssco-S Uiies OTTONM Bie Cases wil aver rare Tcl fcr N95 2K 0 dovolop 2 guideline or algorithm for lniealroviow aged sonicos to follow. Asa follow-up to tho meting on May tat Special Services ond ogo! nave been Gvfering ona case rcase basa on aloppoci fret ermiotons oreo erolment cones, llloes cen prondng guidances on tow the classes of case shoud be pad, A subgroup of vs met again on May tho assure tha we were on ack We clscussed varias scenarios thd wo folow-up actions wore agreed on: 1) Spatial Services vl boinc Keep a manual logo tho cases ned omaodated cosa and 2 tot we mooded to expand the discussion To ncuto lime epresertalve so ican be explored Ihe wanicsiono nose coves could be cocoring Upeteam inthe orignal review process, we Know tom por DMG discussions tal ney wil oxpec sto ake te ight ection ne tl roviw and vot require the mernoor 1 appeal 2) tat ws inalvefhance so thoy could be aware ofthe potent bulge pect, From Finance RN 0.6 mI 210 e019 Our nox! meeting, Please let me know whom you would tke to attend from claims 7 ‘Thanks, NOTICE TO RECIPIENT: Ifyou ar nthe intended ecient of is ema, ou are roiled rom sharing, copying. ofthese uth oon is cafes you Nave "eeshed th esmal insoles ny he sender mmedaely by epy ema and pennanery delete ts e-mail an ary atacnents wiht retin, eran sung tm.