Molina Medicaid Solutions - DHHR

Bridging the Rivers ofChange TogetherWest Virginia MMIS Re-ProcurementSolicitation: MED13006Req #OM5.1OM5.23. Operations Management (OM)OM5. Payment Information ManagementYESwithoutDescription of Requirementcustomization1. Manage Payment InformationAbility to provide a Payment Data Repository to track andXmaintain all payment detail, including:OM5.3 Claims and adjudication history (including payment) XOM5.4 Premium and capitation payment history XOM5.5 HCBS claims and payment history XOM5.6 Other as identified by BMS during DDI and accepted via Xformal change controlOM5.7 2. Inquire Payment StatusOM5.8 Ability to receive claim status inquiries in a variety of medium, Xincluding:OM5.9 X12 276 and 277 Transactions through portal and in batch file XprocessOM5.10 Mail XOM5.11 Phone (Agent) XOM5.12 Fax XOM5.13 Phone (AVRS) XOM5.14 Provider Enrollment Tracking System (PETS) XOM5.15OM5.16Other as identified by BMS during DDI and accepted viaformal change controlAbility to automatically assign a unique control (or identificationor tracking) number to each Payment Status Request to trackrequests, from time of receipt to disposition.OM5.17 Ability to respond to claim status inquiries in a variety of medium, Xincluding:OM5.18 X12 276 and 277 Transactions through portal and in batch file XprocessOM5.19 Mail XOM5.20 Phone (Agent) XOM5.21 Fax XOM5.22 Phone (AVRS) XOM5.23OM5.24OM5.25Other as identified by BMS during DDI and accepted viaformal change controlAbility to provide payment inquiry response in conformance withBMS, State, and Federal policies.Ability to deny requests not in compliance with BMS'sinformation access/privacy policies and HIPAA guidelines.XXXXXYeswithcustomizationNOunabletoprovide14.2-45