Annual Beneficiary Grievance And Appeal Report (ABGAR) by US Government | Healthcare

About this Dataset

Annual Beneficiary Grievance And Appeal Report (ABGAR)

The Annual Beneficiary Grievance and Appeal Report Statewide Summary includes aggregate and county-specific totals of Specialty Mental Health Services (SMHS) Medi-Cal beneficiary grievances, appeals, expedited appeals by category, and Notices of Adverse Benefit Determinations (NOABD) issued by County Mental Health Plans (MHP). The report was compiled from data reported by each MHP that are used to compile the statewide summary.
Organization: State of California
Last updated: 2023-08-12T12:19:29.253594
Tags: abgar, california-department-of-health-care-services, dhcs, mph, smhs

Tables

Appeal Type – County And Statewide

@usgov.ca_gov_annual_beneficiary_grievance_and_appeal_report__449e8be8.appeal_type_county_and_statewide

9.56 KB
1710 rows
7 columns


CREATE TABLE appeal_type_county_and_statewide (
  "report_year" VARCHAR,
  "geography" VARCHAR,
  "notice_of_adverse_benefit_determination_category" VARCHAR,
  "appeal_count" BIGINT,
  "unresolved_as_of_june_30" BIGINT,
  "decision_upheld" BIGINT,
  "decision_overturned" BIGINT
);

Expedited Appeal Type – County And Statewide

@usgov.ca_gov_annual_beneficiary_grievance_and_appeal_report__449e8be8.expedited_appeal_type_county_and_statewide

7.64 KB
1710 rows
7 columns


CREATE TABLE expedited_appeal_type_county_and_statewide (
  "report_year" VARCHAR,
  "geography" VARCHAR,
  "notice_of_adverse_benefit_determination_category" VARCHAR,
  "expedited_appeal_count" BIGINT,
  "unresolved_as_of_june_30" BIGINT,
  "decision_upheld" BIGINT,
  "decision_overturned" DOUBLE
);

Grievance Type – County And Statewide

@usgov.ca_gov_annual_beneficiary_grievance_and_appeal_report__449e8be8.grievance_type_county_and_statewide

22.53 KB
4104 rows
14 columns


CREATE TABLE grievance_type_county_and_statewide (
  "report_year" VARCHAR,
  "geography" VARCHAR,
  "grievance_category" VARCHAR,
  "grievance_type" VARCHAR,
  "grievance_count" BIGINT,
  "exempt_grievance_count" BIGINT,
  "unresolved_as_of_june_30" BIGINT,
  "resolved" BIGINT,
  "referred" BIGINT,
  "unnamed_9" VARCHAR,
  "unnamed_10" VARCHAR,
  "unnamed_11" VARCHAR,
  "unnamed_12" VARCHAR,
  "unnamed_13" VARCHAR
);

Notice Of Adverse Benefit Determination (NOABD) Type – County And Statewide

@usgov.ca_gov_annual_beneficiary_grievance_and_appeal_report__449e8be8.notice_of_adverse_benefit_determination_noabd_type_cou_bef5e806

8.75 KB
1710 rows
4 columns


CREATE TABLE notice_of_adverse_benefit_determination_noabd_type_cou_bef5e806 (
  "report_year" VARCHAR,
  "geography" VARCHAR,
  "notice_of_adverse_benefit_determination_noabd_category" VARCHAR,
  "notice_of_adverse_benefit_determination_noabd_issued" BIGINT
);