Molina Medicaid Solutions - DHHR

Bridging the Rivers ofChange TogetherWest Virginia MMIS Re-ProcurementSolicitation: MED13006TERMCompound DrugComputer TimeConditionConfidentialityContinuity Of OperationsPlanContractContract AffiliationContract AmendmentContract TermContractorContract LifeContract TermContract YearComputer-Based TrainingCorrespondence (Event)Cost AvoidanceCost Based ProviderCost FactorCost Savings (Event)DEFINITIONA medication that is a combination of two or more pharmaceuticalsTime during which the Contractor’s computer system is processing information(“wall” or “clock” time, not “CPU time”).A patient's diagnosis, symptomatology, and/or state of well beingAll reports, files, information, data, tapes and other documents provided to andprepared, developed, or assembled by the Contractor shall be kept confidential inaccordance with federal and state laws, rules and regulations and shall not bemade available to any individual or organization by the Contractor without priorwritten approval of the Department.A plan that incorporates disaster recovery, risk analysis and Contingency Planningto assure continued operation of Fiscal Agent responsibilities in case of a disaster,system failure, work stoppage, or other occurrence. Same as Business ContinuityPlan BCPThe written, signed agreement resulting from, and inclusion of, this RFP, anysubsequent amendments thereto and the Offeror’s proposalRelationship between a provider's pay-to affiliation and contractsAny written alteration in the specifications, delivery point, rate of delivery,Contract period, price, quantity, or other Contract provisions of any existingContract, whether accomplished by unilateral action in accordance with a Contractprovision, or by mutual action of the parties to the Contract; it shall includebilateral actions, such as administrative changes, notices of termination, andnotices of the exercise of a Contract optionA contract is comprised of a set of contract terms, each of which describes theservices that the contract term encompasses, as well as the rules and regulationsthat will dictate how providers will be reimbursedThe successful Offeror (Fiscal Agent/Fiscal Intermediary) with which the Statehas executed a Contract that processes and adjudicates provider claims on behalfof the StateSee Contract Term.The Contract shall be effective as of the date it is duly signed and for the length of time asspecified in the contract.A twelve (12) month period beginning January 1 and ending December 31, duringwhich time this Contract is in effect.Formal course materials delivered thorough an interactive Web-based trainingapplicationCorrespondence events are a type of event used to initiate and trackcorrespondence between the Case Manager and the memberPurpose for requiring the provider to bill and collect or receive a denial fromliable third parties before sending a claim to MedicaidAny hospital, clinic or health care agency enrolled to receive interim paymentsregularly as reimbursement toward costs for services rendered. At year-end, costsettlement is performed to determine actual costs incurred in providing servicesfor Medicaid recipients.A percentage factor which indicates the percent of total charge paid to aninstitutional provider by Medicaid.Type of event to document information regarding negotiations that are performedas part of the case management process, such as setting rates regarding individual,14.14.2-8