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 9.1.1.1-42. Member Correspondence. eCAMS enables the display and retrieval of allmember correspondence.BE2.SS.01eCAMS has the capability to receive and process member eligibility, demographic, and authorizationinformation real time using web service framework. Eligibility data received real time is immediatelyposted to the member eligibility database and is available for claim, prior authorization, and eligibilityinquiry processes. Figure 9.1.1.1-43 depicts one of real time eligibility source defined in eCAMS.Figure 9.1.1.1-43. Real Time Eligibility source. eCAMS interface list page showing both batch and realtime interfaces.9.1.1.1 | 48
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsBE2.SS.02eCAMS provides the flexibility to perform mass transactions, including mass enrollment, mass transfer ofmembers from one plan to another, and mass disenrollment. eCAMS also supports mass transactionsubmission requests with its ability to upload mass transaction data files in Excel formatFigure 9.1.1.1-44 identifies the available mass transaction selection criteria in eCAMS. After the selectionis made, a mass transaction batch is submitted for execution. Users also view all the transactions underthe batch and exclude a transaction from the batch.Figure 9.1.1.1-44. Mass Transactions. eCAMS page for initiation of mass enrollment, transfer anddisenrollment batch transactions.BE2.SS.03eCAMS supports secured real time interaction with POS using web service framework to verify membereligibility as directed by IME. Team Noridian has implemented a proven real time POS interface for theeCAMS system servicing the State of Washington. We will modify the interface to meet the needs of IME.BE2.SS.04eCAMS supports the creation and maintenance of unique business rules for each eligibility source,including real time and batch interfaces. Business rule definitions include the interface source and format,data element validation, error thresholds, and escalation procedures.eCAMS reports warning and fatal errors for each eligibility record that is received from systems ofrecord. Error messages are configured based on interface business rules, and can include messages such"possible duplicate - record allowed" or "exact duplicate - record rejected". The member ID is includedwith each reported error.The system also supports tracking of each interface instance through the use of online screens displayingexecution details, such as number of records processed and number of records in error.9.1.1.1 | 49
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Part 4 - Iowa Medicaid Enterprise

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