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 9.1.2.1-43. Managed Care Program Capacity. The eCAMS Managed Care Capacity feature showsthe service area and the associated capacityTeam Noridian will build a new on-demand report to address provider/recipient ratios by geographicregion. Geographic region parameters will include town, county, zip code, and/or census-designated place(CDP) for unincorporated areas. To request the report, the authorized user must provide the member'slocation parameter. The user then selects either a specific set of taxonomies or indicates all providersshould be included. The user specifies whether only summary data is needed or a detailed listing ofproviders. The report provides a summary of the request parameters, the number of members found, andthe number of providers found as total numbers and as a ratio. If the user chooses a detailed list, the list ofproviders appears after the summary data.eCAMS already has a rich set of capabilities to support actions performed to determine the adequacy ofthe Medicaid provider network. eCAMS provides the user with the ability to perform both ad hoc andrepetitive inquiries using multiple filter sets. The Provider Management business process area has threeprimary filters and one secondary filter, as shown in Figure 9.1.2.1-44. In this figure, the three primaryfilters are labeled “1,” “2,” and “3,” and the secondary filter is labeled “4.”9.1.2.1 | 58
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsFigure 9.1.2.1-44. Provider List Page Showing Filter Capability. This screen highlights the three majorfilters (1, 2, and 3), the secondary filter (4), the Save this Filter and My Filter retrievals (5), and Save toXLS (6) features.Used in combination, the filters shown in Figure 9.1.2.1-44 allow the user to perform sophisticatedsearches, including taxonomy by city, by county, or by zip code within the city or county. Searches can beperformed on full or partial data. In Figure 9.1.2.1-44, the wild card symbol “%” has been used to requesta list of providers with NPIs that begin with “1.” The user has the ability to save favorite search criteriaby selecting the Save This Filter button (5 in Figure 9.1.2.1-44). Saved filters are retrieved under the MyFilter dropdown. The list retrieved may be exported to Excel (6 in Figure 9.1.2.1-44) for additionalanalysis using the Save to XLS button.As currently implemented, eCAMS has primary filters for:• Contract number• Business status• Date as an individual date value or as a from-to date range• Group code• Indicator type• License or Certification type• State• Town• NPI• Organization detail• Name• Taxonomy components for:• Provider type• Specialty• Subspecialty• System assigned provider number• SSN/FEIN• Administration/program• Specialization end reason• Universal business ID• W-9 organization type9.1.2.1 | 59
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Part 4 - Iowa Medicaid Enterprise

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