Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS Operationsallowing them to stop and later continue working on their applications. The unique reference number alsoallows providers to check on the status of their submitted application.The wizard uses rules engine functions to designate steps dynamically as "required" or "optional,"depending on data supplied by the provider. The wizard also displays validation error messagesthroughout the data entry process. These interactive messages alert the provider to conditions that need tobe corrected ensuring valid and complete data is captured prior to submission.eCAMS supports multiple enrollment types. The wizard validation rules are based on the enrollment typeand provider type and specialty. The rules support validation of such details as the National ProviderIdentifier (NPI), Clinical Laboratory Improvement Act (CLIA), and Drug Enforcement Agency (DEA)numbers. eCAMS supports interface-based credential validation and currently supports Office ofInspector General LEIE provider sanctions, CLIA, and National Plan and Provider Enumeration System(NPPES). eCAMS also supports customizable interfaces for State licensing organizations.The enrollment process captures many details about the provider. All details are captured througheCAMS Provider portal data entry pages and dialogs are triggered by enrollment steps in the wizard.Figure 9.1.2.1-7 shows an example of the wizard for a newly initiated enrollment. Representativeinformation captured includes:• Provider NPI or eCAMS-assigned Atypical Provider ID (API)• Provider name, gender, and date of birth or alternately organization name and the alternate name forthe business (Doing Business As or DBA)• Credentials such as licenses, certifications, training, and education• Provider type and areas of specialization captured as nation standard taxonomies or as locallyassigned taxonomy• Multiple provider addresses and contact details, including office locations, pay to location, andmailing addresses• Claim submission and payment preferences and elections for electronic funds transfer (EFT) andHIPAA transaction submission• Multiple provider identifiers information, such as social security number (SSN), federal employeridentification number (FEIN), DEA, and CLIA numbers, as well as multiple legacy MMIS IDs• Provider associations with other entities, such as owners, billing agents, and servicing providers towhom the provider may submit bills• Federal tax details for identity validation and 1099 preparation9.1.2.1 | 16