Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS Operations• Continually assessing and designing changes and updates to the OnBase workflow system whichresults in increased efficiencies for all IME contractors.• Providing extensive support to the Provider Services unit through knowledge transfer on topics suchas electronic billing, use of the PC-ACE Pro32 billing software, MMIS edits, and frequent billingissues discovered through claims processing. We participate in weekly collaborative meetings withthe Provider Services contractor aimed at identifying issues early to decrease claims processing errorsand increase provider satisfaction.• Noridian's Electronic Data Interchange Support Services (EDISS) works with Iowa providers onbehalf of the Provider Services contractor to help them successfully submit Medicaid electronicmedia claims for payment.• Assisting by producing training documentation and manuals on electronic transactions, PC-ACEPro32, and the Web Portal.• Helping to conduct outreach to Iowa Medicaid providers in an effort to reduce paper claims.• Building a new workflow for the IME Medical Services contractor that, in their words, resultedin the "most advanced project that we have created and the most advanced workflow we have inMedical Services".Noridian's philosophy of creating win-win situations through collaborative work efforts extends to itsother contracts:• CMS has recognized Noridian for excellent performance in its Medicare operations. In the mostrecent award fee determination letter dated July 8, 2011, CMS commented on Noridian’s ability toundertake initiatives that benefit the Medicare program. CMS recognized Noridian’s ability tocollaborate very well with other organizations handling Medicare workload.• Noridian was recently honored with the CMS Provider Customer Service Program (PCSP) of the yearaward. One key reason for achieving this distinction is our focus on proactive collaboration. Noridianhas proactively collaborated with the three other Durable Medical Equipment MedicareAdministrative Contractors (DME MACs) in efforts to improve the overall program.• In Noridian's Medicare operations, we interact with the Program Safeguard Contractor (PSC)responsible for performing post-pay provider reviews, medical reviews, and fraud and abuseinvestigations routinely by way of bi-weekly conference calls and quarterly face-to-face meetings.These meetings have improved the effectiveness of the full program.• We established a relationship with FOX Systems, Inc. (FOX) in support of the National ProviderIdentifier (NPI) Enumeration Operation contract through CMS. For this project, Noridian providedthe infrastructure and technical support along with process support. We were instrumental inestablishing the business processes and the quality management activities that contributed to FOX’sachievement of International Standards Organization (ISO): 9001 certification for the NPIEnumerator Operation contract.• Another present example of a contractual relationship that requires constant communication andcollaboration is our work with the Mandaree Enterprise Company (MEC), a small disadvantagedbusiness. MEC provides critical operational support for Noridian's DME MAC Jurisdiction D contract.• We were the first DME MAC to offer our Comprehensive Error Rate Testing (CERT) score to ourcounterparts to encourage open communications to support development of a uniform process toidentify and address the root causes of CERT errors. As a result, a joint DME MAC CERT Taskforcewas established to develop consistent educational efforts to reduce error rates.Our subcontractor, CNSI, also promotes this same philosophy of improvement through collaboration:• CNSI and the state of Michigan project team have created a highly collaborative work environmentto ensure effective communication at all levels of the project. The Integrated Project ManagementOffice (IPMO) combines the leadership of CNSI and the state of Michigan into a single entity foreffective and expeditious resolution of project issues. The IPMO meets weekly and has established7 | 5