Molina Medicaid Solutions - DHHR

Bridging the Rivers ofChange TogetherWest Virginia MMIS Re-ProcurementSolicitation: MED13006Req #GT.185GT.186GT.187GT.188GT.189GT.190GT.191GT.192GT.193GT.194GT.195GT.196GT.197GT.198GT.199GT.200GT.201GT.202GT.203GT.2047. General and Technical (GT)Description of RequirementAbility to include balancing control information when required bythe BMS. The BMS is to approve the format along with the filelayout, media, naming conventions, trailer records and otherinterface processing details.Ability to generate load statistics which include the number ofrecords, time taken, successes and failures, and exceptions. Thesestatistics are to be saved to the system for reporting purposes.Ability to generate exception files, when necessary, for manualedits, error corrections, and additions to the interface records byVendor or BMS/State users, prior to being loaded within theMMIS.The Vendor is to implement edits, processes and reporting toeliminate undesired duplication of records and transactions,including:Automatically edit fields for reasonableness, validity, formatand consistency with other data present in update transaction.Transaction reconciliation reporting for file/data reconciliationwith external data sources (e.g., totals and detail information,difference reports, change reports).Ability to generate error reports at the summary and detail levelsthat include all data necessary to resolve errors.Ability to reload or resend records if they have not been appliedcorrectly to the appropriate data repository.Ability to detect duplicate files or records and isolate them formanual review and further processing.Ability to incorporate a method to view and edit interface files forinvestigation and further processing.Ability to provide a method to "roll back" data to a pre-interfacestatus.Ability to create messages that accurately describe errors receivedas a result of a data transfer.Ability to provide ad-hoc query capability against interface sourcefiles.Ability to export records identified by BMS, when required by theBMS.The system is to create and retain an audit trail of all interfaceactivity in accordance with BMS Data Retention Policy.11. Workflow ManagementAbility to include comprehensive workflow managementfunctionality that supports:Definition, and possibly modeling, of workflow processes andtheir constituent activities.Run-time control functions concerned with managing theworkflow process in the Medicaid environment and sequencingthe various activities to be handled as part of each process.Run-time interactions with users and Information Technology(IT) application tools for processing the various activity steps.YESwithoutcustomizationXXXXXXXXXXXXXXXXXXXYESwithcustomizationNOunabletoprovide14.2-97