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Managed Care Help Center

The Bureau of Managed Care (BMC) has created a resource account to help answer any questions or resolve any issues with submissions, including reports, applications, and other records required by the laws and regulations.
A print-friendly Managed Care - Resource Account Help Guide is also available. 

Document Submission Process

BMC uses SharePoint and SERFF for collecting documents.  If you do not already have a SharePoint site for submissions, please submit a request to, with “SharePoint Submission Request” in the subject line.

Help by Topic Area

To help us direct your email to the correct office, please use the tables below to locate the topic area of help required.
When submitting an email request for help please be sure to include the specific Subject Line Language provided for your topic area in the subject line of your email.
The regulatory citation for each topic area is also provided for your reference as additional information can be found by referencing the specific citation in Title 28 of the PA Code.

​Help Topics for Companies
Topic Area
Subject Line Language
Regulatory Citation
Annual Reports
Annual Report (insert 4-digit year)

e.g., Annual Report 2021
28 Pa. Code § 9.604(a)
Quarterly ReportsQuarterly Report (insert 4-digit year)-Q(insert quarter #)

e.g., Quarterly Report 2021-Q1
28 Pa. Code § 9.604(b)
Certificate of Authority Application
(includes foreign HMOs)
COA-(insert company name)

e.g., COA-ABC Company
28 Pa. Code §§ 9.631, 9.635
Delegation of HMO operationsHMO-Delegation of Operations-(insert company name)

e.g., HMO-Delegation of Operations-ABC Company
28 Pa. Code § 9.634
Use of subnetworks – Approval RequestHMO-Subnetwork-(insert company name)

e.g., HMO-Subnetwork-ABC Company
28 Pa. Code § 9.653
Annual Quality Assurance Plan
(for information only)
QA Plan-(insert 4-digit year)-(insert company name)

e.g., QA Plan-2021-ABC Company
28 Pa. Code § 9.674(b)(9)
Delegation of Medical Management
(for review and approval)
Med Management Delegation-(insert company name)

e.g., Med Management Delegation-ABC Company
28 Pa. Code § 9.675
Service Area Expansion

Note: Initial network adequacy filings and QHP network adequacy review filings are to be submitted as part of the applications with which they are associated.

Service Area Expansion-(insert company name)

e.g., Service Area Expansion-ABC Company
28 Pa. Code § 9.679
Access for persons with disabilities
(for information only)
ADA Access-(insert company name)

e.g., ADA Access-ABC Company
28 Pa. Code § 9.680
Complaint ProceduresComplaint Procedures-(insert company name)

e.g., Complaint Procedures-ABC Company
28 Pa. Code § 9.702(a)(6)
Grievance ProceduresGrievance Procedures-(insert company name)

e.g., Grievance Procedures-ABC Company
28 Pa. Code § 9.702(a)(6)
External Grievance requestExternal Grievance Request-(insert company name)

e.g., External Grievance Request-ABC Company
28 Pa. Code § 9.707(b)(2)
Expedited External Review request
(in addition to fax or phone as outlined in reg)
EXPEDITED External Review-(insert company name)

e.g., EXPEDITED External Review-ABC Company
28 Pa. Code § 9.709(h)
Provider ContractsProvider Contract-(insert company name)

e.g., Provider Contract-ABC Company
28 Pa. Code § 9.722(a)
Amended Provider ContractsAmended Provider Contract-(insert company name)

e.g., Amended Provider Contract-ABC Company
28 Pa. Code § 9.722(b)
IDS Notification and Contract approvalIDS Notification-(insert company name)

e.g., IDS Notification-ABC Company
28 Pa. Code §§ 9.723(b), 9.724(b) & (c), 9.725
New CRE Application
BMC will create a secure SharePoint site for applicants to upload their applications.

Mail checks for certification fees to the BMC at the address below.

CRE Certification-(insert company name)

e.g., CRE Certification-ABC Company
28 Pa. Code § 9.743 
CRE Renewal

The renewal application should be uploaded to the Company's assigned SharePoint.

Mail checks for certification fees to the BMC at the address below.
CRE Renewal-(insert company name)

e.g., CRE Renewal-ABC Company
28 Pa. Code § 9.748(b)
Credentialing planCredentialing Plan-(insert company name)

e.g., Credentialing Plan-ABC Company
28 Pa. Code § 9.761(b)
PPO CredentialingPPO Application-(insert company name)

e.g., PPO Application-ABC Company
31 Pa. Code Ch. 152 (§§ 152.4 & 152.6)
PPO Annual ReportingPPO Annual Report-(insert year)

e.g., PPO Annual Report-2021
31 Pa. Code § 152.19
NCQA DocumentsNCQA -(insert company name)-(insert doc type)

e.g., NCQA-ABC Company-Final Corrective Action Report

​Help for Consumers
Topic Area
Subject Line language
Regulatory citation
Complaint/Grievance Classification by BMCComplaints/Grievances Classification28 Pa. Code § 9.702(c)(3)
Appeal a complaint decision or additional information for an existing appealAppeal
28 Pa. Code § 9.704

Written Requests

If you would prefer to submit your request for help or additional information via mail, please be sure to include the topic of your request in your cover letter and use the address below.
Bureau of Managed Care
1311 Strawberry Square
Harrisburg, PA 17120