Part 4 - Iowa Medicaid Enterprise

RFP MED-12-001 | Technical ProposalIowa Medicaid Enterprise System Service Procurement | MMIS and Core MMIS Operations• Other Interfaces. These are data exchanges that are established to support communication withother federal, state, and non-government agencies for specific data needs. Team Noridian's newMMIS uses the publish model approach for outbound data feeds that are tailored by EXACT'sOrchestration Services and based on the trading partner profile, or pushed directly to the tradingpartner for transformation.Figure 8-21. EXACT SOA Framework. The EXACT SOA framework prepares the Department to supportpresently identified interfaces inside the agency, across other agency partners, and outside the agency,while preparing a framework to accommodate new interfaces into the future.Each of these categories can be further divided into inbound data feeds (data consumed by the MMISsystem) or outbound data flows (data published from the MMIS system). The exchange of data withbilling providers, clearinghouses, and trading partners using HIPAA transactions is not listed in thesecategories since EDI exchange is handled through the eCAMS gateway service, which also leverages theEXACT framework.Electronic Data Interchange (EDI)Team Noridian has experience collecting and processing state, government and commercial health careclaims since prior to the inception of HIPAA. We have been involved since the beginning in developing,maintaining and operating HIPAA-compliant claims processing systems and have safeguards in placewithin our systems and operations areas to secure protected health information.Team Noridian’s solution accepts electronic transactions mandated under HIPAA in the approvedelectronic format. Team Noridian’s solution architecture is modularized and can be modified with ease toaccept new HIPAA requirements as they are mandated and released.Our HIPAA-compliant solution to process electronic health care transactions is eCAMS. eCAMS is arobust, comprehensive, and configurable solution to accept, track, and retrieve all current X12 version4010 and 5010 HIPAA transactions. eCAMS is presently modified to implement X12 5010 transactionsfor the Department of Washington and the Department of Michigan. Team Noridian will leverage this8 | 33