Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsFigure 9.1.2.1-17. Automatic Notification of Newly Submitted Provider Application. eCAMSautomatically produces provider enrollment messages and sends them to the enrollment specialistsassigned to the category of enrolment activity.eCAMS provides specific reports to collect provider enrollment and status information. The reportsinclude the PRV Provider Enrollment Summary report and the PRV Transaction Status By Admin, ByStaff, By Enrollment Type report.• The PRV Provider Enrollment Summary report provides a daily report of the transaction status countsof all applications and data modifications not complete and those completed during the day. Thisreport is sorted by organizational unit, staff member, and enrollment type.• The PRV Transaction Status By Admin, By Staff, By Enrollment Type report provides a monthlyreport of the application processing performance of all organizational units. This report collects dataon a calendar basis beginning in January of each year, with succeeding months being added to build ayear-to-date report, through December.PR1.02.01eCAMS provider enrollment and maintenance business process uses wizard functions to ensure that alldata submitted is complete and accurate. eCAMS wizards use real-time validation and editing to ensurethat each application or maintenance request is accurate and complete. The wizards give the enrollingprovider a roadmap to complete their application successfully. Throughout the enrollment process,eCAMS performs online, real-time, editing and cross-field validations to ensure that the data entered iscorrectly formatted and contains data consistent with the type of application the provider is completing.There are different wizards for each general type of enrollment including:• Individuals (traditional and atypical)• Groups who may bill for multiple individual providers• Facilities, agencies, organizations and institutions• Managed care organizations• Billing agents• Tribal health services providers• Special circumstances providers, such as locum tenens one-time, date limited, and unique situations9.1.2.1 | 34