Part 4 - Iowa Medicaid Enterprise

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RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsThroughout the review process, the provider enrollment specialist can identify situations where additionalinformation is needed from the provider. Team Noridian will configure a new report to list "In Review"applications that are specifically awaiting additional information from the Provider. The report will usea specific status value identifying that the application is pending due to missing information due fromthe provider.PR1.03eCAMS provides notifications to provider applicants for all of the following situations:• Initiation of a new application through a real-time notice• Submission of a completed application ready for IME review through a real-time notice• Approval or rejection of an application through automatically generated correspondenceIn Team Noridian's response in section 9.1.2.1.2, Requirement PR1.02.07, Figure 9.1.2.1-26, TeamNoridian shows an example of the real-time notice eCAMS generates on initiation of a new application.The provider can use the unique application ID to access the application over several days or weeks untilall information is complete.When the provider successfully completes all steps in the application, the provider submits the applicationfor IME review. On submission of the application, the provider receives a real-time notice that theapplication has been successfully submitted and is now in a pending status awaiting IME review. Figure9.1.2.1-34 shows the submission success notice.Figure 9.1.2.1-34. Successful Provider Application Submission. eCAMS gives the provider applicant realtimenotification that the application has been successfully submitted for IME review.Throughout the enrollment application review process, the provider enrollment specialist can place theapplication in a pending status and send notifications to the provider describing the action they must take9.1.2.1 | 48
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS Operationsto release the application from the pending queue. Refer to Team Noridian's response in section 9.1.2.1.2,Requirement PR1.02.08, Figure 9.1.2.1-31 shows an example of a notice generated for a pendingapplication. After the IME provider enrollment specialist completes the review of the application andreaches a decision to approve or reject the application, eCAMS automatically generates correspondenceinforming the provider of the decision. Team Noridian will configure the text of the letters to theDepartment's specifications. When the provider enrollment specialist approves an application, eCAMScopies the approved enrollment information into the enrolled provider database in real-time.PR1.03.01eCAMS automatically generates notices to providers for many different situations, including statuschanges, application approval and denial, maintenance request approval and denial, and licenseexpirations. In Team Noridian's response in section 9.1.2.1.2, Requirement PR1.02.08, we provide adetailed description of some of the notices produced during the enrollment process. In addition to theinitiation, submission, approval, and rejection (denial) notifications, eCAMS can produce notices torequest additional information and to clarify information already submitted.After successful enrollment, the provider may request changes to their provider data, such as a change totheir fax number or a new location where they render care. eCAMS produces notices to inform theprovider of approval or denial of self-service maintenance requests.For enrolled providers, eCAMS performs a nightly sweep of all enrolled provider data to identify pendingexpirations for credentials required for the provider’s taxonomies and associated Department programs.The nightly process reviews the credentialing requirements housed in the eCAMS Credentialing Matrixand identifies any required credential that is pending expiration. eCAMS then automatically preparescorrespondence to the providers whose credentials are nearing expiration. Credentialing requirements areconfigured to the Department's specification as a part of the standard implementation process for eCAMS.PR1.03.02During the enrollment process, the provider specifies their preferred mode of communication. Figure9.1.2.1-35 shows the communication preference dialog in eCAMS. In addition to choices for email andstandard mail, the provider may also choose delivery to their secure eCAMS web portal inbox - the MyInbox feature of eCAMS. For IME, all communication is routed through OnBase. If the provider selectsemail as their preferred delivery method, eCAMS validates that a good email address has been entered.Preferences can be recorded at the general provider level and at the individual Address Type for the officelocation, mailing address, and pay-to address. Team Noridian will develop integration to communicate theprovider's preference to OnBase. The Department will be able to use the OnBase system to override oraugment the provider's default choice of preferred communication method. The Department can choose tooverride the provider's preferences for situations requiring a specific mode of delivery or multiple modesof delivery. Team Noridian will modify eCAMS to allow specification of fax as a preferred delivery,including validation that the otherwise optional fax number has been provided.9.1.2.1 | 49
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