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 9.1.3.1-18. eCAMS Screen Showing Bar Code. eCAMS generates bar codes for several attributeson the claim to guarantee an accurate association.Bar codes are used to automatically link the attachments with the claims on receipt of these attachmentsinto MMIS. Team Noridian has successfully implemented the Bar Code functionality in WashingtonMMIS.CR1.14.03Team Noridian’s solution accepts EDI transactions and loads attachments indicators in accordance withHIPAA X12N 4010A and 5010 standards. Providers can use these indicators to identify claims withattachments and pass the attachment control numbers in the electronic claims. The attachment controlnumber is loaded along with other claim information as part of the eCAMS loading process. eCAMS usesthis attachment control number to link the claims with their associated attachments, which are submittedseparately. Once an attachment is received, it is indexed with appropriate information, such as relatedclaim number and PA number, and uploaded into OnBase EDMS. Online users have the flexibility toretrieve the attachment through online screens to perform their work functions. Figure 9.1.3.1-19 presentsan eCAMS screen showing a sample claim and the link to its attachments.9.1.3.1 | 24
RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS OperationsFigure 9.1.3.1-19. eCAMS Claims Screen Showing a Link to an Attachment. Displaying the attachmentalong with claims data in the screens improves user friendliness and increases the productivity ofoperations and fiscal agent personnel in adjudicating a claim.CR1.16Team Noridian will use TOB for trading partner registration and testing management for initial EDItransaction testing. Iowa providers and their trading partners are presently using TOB for registrationtoday; access to trading partner data will simplify the transition process as trading partners will not berequired to re-register or re-test at the outset of the operations phase for this contract. Trading partnershave expressed their satisfaction with this tool as it has dramatically simplified the process of tradingpartner registration, improving what used to be a largely manual process taking up to 15 days to anautomated process now taking three days or fewer. Providers or their trading partners are not allowed tosubmit production transactions until they have been fully tested and their transactions approved. Figure9.1.3.1-20 shows that TOB maintains a record of how many HIPAA transactions have been tested foreach NPI for which a trading partner has tested and been granted production status.9.1.3.1 | 25
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Part 4 - Iowa Medicaid Enterprise

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