Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS Operationsdepending on document type, and from experience, we have determined that 300 dpi works best for blackand white images.CR1.10All hardcopy claims and all scanned images are stored within the system. All images are stamped with thedate and time on their entry in the MMIS. Team Noridian’s document imaging and workflowmanagement solution batches all the hard-copy claims, adjustments, voids, and their associatedattachments and assigns a unique control number. This ensures consistency and integrity of documents.These batches are scanned and the images are indexed and stored in OnBase.CR1.11Team Noridian’s solution groups the input into multiple batches based on a set of predefined criteria. Forexample, all UB04 forms are batched together and sent to a separate workflow than that for CMS 1500forms. Once the batches are identified, each form or attachment is logged into the automated batch controlsystem by Emdeon Transform Suite. This is useful in forwarding the forms to appropriate workflows and,hence, improves traceability.CR1.12eCAMS has a comprehensive monitoringsystem, HealthBeat, which monitors all HIPAAtransactions including claims entry. Theseclaims go through various stages within MMISbefore the final response generation. The datathat the system monitors includes start and endtime for every stage through which a claimpasses, throughput at different times of the day,and the daily volume processed.HealthBeat runs around the clock and providesa real-time view of all claims loading usingvarious kinds of visual displays. These viewshelp identify how the system is performing forvarious transactions with respect to the definedperformance-related service level metrics.Figures 9.1.3.1-11 and 9.1.3.1-12 illustrateclaims loading volume and throughput,respectively.Figure 9.1.3.1-11. Claims Loading Volume atVarious Stages. Claims loading volume at variousphases will provide more insight on the expectedload for the subsequent adjudication, paymentcycle, and remittance advice (RA) processes.9.1.3.1 | 18