Part 4 - Iowa Medicaid Enterprise

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RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsFigure 9.1.1.1-26. eCAMS Medicare List Page. Detail records for all Part A, B, C and D coverage areavailable in a single list page.BE1.SS.08eCAMS maintains an indicator for members with dual Medicare/ Medicaid coverage. The eCAMSEXACT interface framework supports extracting member dual Medicare and Medicaid coverageinformation on a monthly basis for distribution to Medicare and coordination-of-benefit carriers as wellas to CMS.BE1.SS.09eCAMS has the capability to archive member records based on the eligibility time period or based onclaims adjudication status. eCAMS facilitates the archive option through both the interface and thedatabase archival process through which data is archived based on data partitions. This can be configuredto archive member records based on criteria approved by IME.BE1.SS.10eCAMS stores member detail information received via batch, real-time, or DDE through screenfunctionality. This member record information will be retained as long as it is used for claims processingand will be archived based on IME defined details.eCAMS supports online updates of member information including end-dating or voiding eligibility databy authorized users.Records are never truly deleted from eCAMS. Rather, the system uses a concept of "soft deleting", wherea record is inactivated and it is never displayed to the user or used by any process.BE1.SS.11eCAMS processes member records information received via interface, real-time, or DDE screenfunctionality and will generate error report for any records which will error out. This report can be usedfor analysis and to resend error records with updated information so that it can be processed into eCAMS.Figure 9.1.1.1-27 depicts the reconciliation report within eCAMS which can be used to accurately matchthe records processed into the system.9.1.1.1 | 34
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsFigure 9.1.1.1-27. Reconciliation Report. eCAMS provides member reports with record details that canbe used for reconciliation.BE1.SS.12eCAMS maintains detailed Medicare Part A, B, C and D data at the member level. The system is capableof extracting this Medicare data and distributing it via the EXACT interface framework to the Medicareclaims processor for use in processing crossover claims.BE1.SS.13eCAMS stores different addresses received from eligibility files to be used for letter generation or forprior authorization determinations. eCAMS also has the flexibility for users to set the address type fordifferent letter generations or for generating outbound files to external vendors.Figure 9.1.1.1-28 depicts different address types maintained in eCAMS and can be used for letter generations.9.1.1.1 | 35
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Part 4 - Iowa Medicaid Enterprise

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