Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsWhen the system processes member batch eligibility information via interface it tracks error recordswhich will be reported via email for authorized users. The system tracks records posted to eCAMS whichcan be used to generate reports.Figure 9.1.1.1-12 shows different file directory locations that will be used to store error files, inboundfiles, archived files, and outbound files.Figure 9.1.1.1-12. Error Records. eCAMS offers different file directory locations to store error files,inbound files, archived files, and outbound files.BE1.04In eCAMS, the entire interface orchestration is automated and currently includes notification by e-mailfor both completed and in-error interfaces. When information is received from an external source, theinterface monitors pick up this information and automatically uploads the file, thus obviating the need fora manual start. Once the eligibility details processed successfully into the system interface generatesautomatic email notification for the completion of the file load.BE1.05eCAMS receives and processes member eligibility information from SSA or Integrated Eligibility System(IME) via the EXACT interface bus and matches incoming member records to members present in thesystem to apply relevant eligibility, demographic, address and other details. If the incoming memberrecord is not present in eCAMS, new eligibility details will be created in the system. If the memberalready exists in eCAMS, the member's data will be updated with the new information. The member'sexisting eligibility records will be inactivated for historical purpose.The Team Noridian interface team will use the eCAMS interface run-instances screen to identify thestatus of the interfaces. The Department will be notified of failed interfaces along with the reasons for thefailure at the record level. If a failure is system related, authorized users will identify the cause and rerunthe interface for the failed records. If the error is related to an external source system, authorized userswill escalate the issue in a timely manner to the external source staff. Using Department defined businessrules, e-mail notifications of such errors can be sent directly to the external system staff contact. Interfacecontrol reports are available to authorized Department and contractor staff and reconciliation files ofchanged records are provided to the originating source.9.1.1.1 | 21