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 9.1.3.1-13. eCAMS Trading Partner Screen. The eCAMS Trading Partner screen provides betterunderstanding of the trading partner process to operations/fiscal agent users and submitters.CR1.14All electronic media claims will have placeholders for attachments in accordance with HIPAA X12N4010 and 5010 standards. Providers can use these placeholders to identify claims with attachments andpass the attachment control numbers in the electronic claims. eCAMS uses this attachment controlnumber to link the claims with their associated attachments, which are submitted separately. Once anattachment is received, it is indexed with appropriate information, such as related claim number and PAnumber, and uploaded into OnBase EDMS. Online users have the flexibility to retrieve the attachmentthrough online screens to perform their work functions. Figure 9.1.3.1-14 presents an eCAMS screenshowing a sample claim and the link to its attachments.9.1.3.1 | 20
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsFigure 9.1.3.1-14. Claims Screen Showing a Link to an Attachment. Displaying the attachment along withclaims data in the screens improves user friendliness and increases the productivity of operations andoperations staff in adjudicating a claim.CR1.14.01Team Noridian’s solution provides the ability to link electronic claim to all related images, attachmentsand adjustments.• Linkage between claim and associated paper claim image. Team Noridian's solution uses theEmdeon Transform Suite for Document Imaging and Scanning. The Emdeon Transform suiteproduces an image of the actual claim and will be stored in OnBase EDMS. eCAMS links the paperclaims image and the loaded claim using an internal control number. Department and providers canretrieve the image of the claim while viewing the claims in eCAMS claim retrieval screens. This isimplemented in Washington’s MMIS.• Linkage between claim and associated adjustments. eCAMS has three attributes associatedwith each claim document – TCN, Parent TCN, and Original TCN. When a claim is submitted thefirst time (fresh claim), the claim is populated with all three attributes with the same value (e.g., T1).If a replacement (adjustment/void) is submitted, the TCN value would be T2, but the original andparent TCN values would remain T1. If another replacement is made for TCN T2, the TCN valuewould be T3. The original TCN value would be T1 and the Parent TCN value T2. Figure 9.1.3.1-15show how eCAMS lets users get the original TCN from the inquiry list screen. These TCN's are usedto link claims with their associated adjustments. This is implemented in both Washington andMichigan MMIS.9.1.3.1 | 21
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Part 4 - Iowa Medicaid Enterprise

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