Fiscal Employer Agent (Fea): Reports

01. Account Summary Statements. This report provides an overview of each participant account and includes the services accessed and the remaining dollar amount in the budget as well as information on how to rea d the report. In addition to providing this monthly report, a participant may request this report for a specifie d timeframe. Each month, the provider must at the participant’s preference mail a hard copy of the report to eac h participant or make the report available on a secure website. The provider must generate the report after every payrol l and post it on a secure SFTP site for the Department to access. This SFTP site must have a user name and passwor d protection. (7-1-25) a. Report Format: Microsoft Excel. (7-1-25) b. Report Due Date: The 10th day of each month. (7-1-25) 02. Medicaid Billing Report. This report provides a detailed breakdown of CSW services rendered by service date per employee, per employer. Each line on this report must provide the following information: employe e name and ID number, hours worked, period start, and period end, pay rate, service date, check number and date, participant’s name, participant’s date of birth, participant’s ID number, service code, taxes, and billing amount. This report collects information based on the timeframe specified by the user. The provider must generate the report afte r every payroll and post it on a secure SFTP site for the Department to access. (7-1-25) a. Report Format: Microsoft Excel. (7-1-25) b. The 10th day of each month. (7-1-25) 03. Demographic Report. This report provides general client demographics in the region and th e employee count per participant for each participant in the database. The provider must generate the report after ever y payroll and post it on a secure SFTP site for the Department to access. (7-1-25) a. Report Format: Microsoft Excel. (7-1-25) b. Report Due Date: The 10th day of each month. (7-1-25) 04. Background Check Report. This report provides a breakdown, by participant, of whic h employees the participant waived the background check, which employees passed or failed the background check, th e background check reference number, and the date the background check was submitted. This report does not includ e SBs. The provider must generate the report after every payroll and post it on a secure SFTP site for the Department t o access. (7-1-25) a. Report Format: Microsoft Word, Microsoft Excel, or PDF. (7-1-25) b. Report Due Date: The 10th day of each month. (7-1-25) 05. Medicaid Billing Report. This report provides a list and count of the unduplicated participants an d expenditures by services code based on the time frame specified by the user. The provider must generate the repor t after every payroll and post it on a SFTP site. Additionally, the provider must provide a quarterly Medicaid Billin g Report that can been reconciled quarterly and work with the Department to reconcile the annual report. (3-17-22) a. Report Format: Microsoft Excel. (7-1-25) b. Report Due Date: The 10th day of each month. (7-1-25) 06. Complaint and Resolution Summary Report. The provider must analyze complaints received o n a quarterly basis to determine the quality of services to participants and identify any corrective actions and progra m improvements needed and implemented. The provider must post the report on a secure SFTP site for Departmen t review. (3-17-22) a. Report Format: Microsoft Word, Microsoft Excel, or PDF. (7-1-25) b. Report Due Date: The 10th day of the month following the end of each annual quarter. (7-1-25) 07. Customer Satisfaction Survey Report. The provider must provide a comprehensive repor t summarizing the results of the customer satisfaction survey completed by each participant. (3-17-22) a. Report Format: Microsoft Word, Microsoft Excel, or PDF. (7-1-25) b. Report Due Date: December 1st of each year. (7-1-25) 08. Quarterly Financial Statements. The provider must provide the Department a quarterly balanc e sheet and income statement that shows the provider’s quarterly financial status and cash management plan cas h reserve. (3-17-22) a. Report Format: Microsoft Word, Microsoft Excel, or PDF. (7-1-25) b. Report Due Date: The 25th day of the month following the end of each annual quarter. (7-1-25)