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MMIS current training course FAQs
Last updated August 6, 2008
What will happen to the MMIS screens I use now when the system goes live?
- Some current MMIS screen will go away, while others will continue to be used in the new version.
Commonly-used MMIS screens that will no longer be used are: ELGR, ELGX, ELGH, ENRC, ENRP, ENRH, KSEL, and MID1.
Screens that are not part of the MMIS will remain in active use. This includes UCMS, PCMS and WEBM FIND.
Here is information on accessing information from screens that will no longer be used in the new MMIS:
ELGR screens
Most information currently on ELGR will be located in the Recipient Information panel and the Benefit Plan panel of the new system.
ELGX screens
ELGX currently provides information about a recipient’s managed care enrollment, exemptions to managed care enrollment, Medical and Disease Case Management (MCM/DCM) enrollment, Medicare coverage, and third party resource information.
- General information on managed care enrollment will display on the Recipient Information panel in Recipient, and the detail managed care enrollment information will be located on the Recipient Case Enrollment panel in Managed Care.
- Managed care exemption information will be located on the MC Special Conditions panel in Recipient.
- Medical and Disease Case Management indicators will display on the Recipient Information panel in Recipient, and the detail information will display on the Recipient Case management panel in Recipient.
- Medicare coverage indicators will display on the Recipient Information panel in Recipient, and the detail information will display on the Medicare A Coverage and Medicare B Coverage panels.
- A third-party resource flag will display on the Recipient Information panel in Recipient, and the detail information will be located on the Base Information and Coverage panels in TPL.
KSEL screens
KSEL functions will also be located in the Recipient Case Enrollment panel in Managed Care.
ENRC, ENRP and ENRH screens
Enrollment using ENRC, ENRP, and ENRH will be done through the Recipient Case Enrollment panel in Managed Care.
A new CM OIS enrollment screen similar to ENRC will interface with the new MMIS in real time. The new screen will be available for CAF-SS and SPD case workers who currently use ENRC for enrollments.
MID1 screens
To produce a temporary ID card (currently done on MID1), access the Temp ID Card panel in Recipient. Users can also use the ID Card Request panel in Recipient to replace a recipient’s ID card.
ELGH screens
ELGH person-specific information will be located in the Recipient Information and Benefit Plan panels in Recipient.
Case-level ELGH information will be located in the Case Information, (Case) Base Information and Case Members panels in Recipient. Users must do a Case Search.
If you have other questions about system screens, email MMIS Training Manager Bob Costa or call 503-947-5213.
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Course # 1 - MMIS Fundamentals (online)
- How long will the fundamentals class be available online at the DHS Learning Center?
The fundamentals class will be available to DHS users indefinitely.
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Course # 2 - Benefit Plans and Assignment Plans
- How will MMIS change my day-to-day responsibilities?
This depends on the work you do. Your manager can tell you what specific changes MMIS will have on your job function.
- Will the system catch and report an error if I enter the wrong specialty for the claim type on the co-pay panel?
No, the system doesn’t have a field edit to catch this type of error.
- Have the Oregon local codes been cross-walked to national codes? Is there a way to view crosswalks on interchange?
There is no crosswalk in the panels. Talk to your manager about the best way to crosswalk between national and local codes.
- What does the “i” preceding numbers on the Reimbursement Rules panel indicate? For example, “search by procedure code 01951 and view rule i93858.”
The “i” shows the rule was “inherited” and is set at a higher level in the procedure code hierarchy. The 93858 rule is set at the CPT level. A rule set at the procedure 01951 level does not have an “i” before it.
- Can we remove Benefit Classification codes using the Recipient Plan panel?
Yes, codes can be changed using the Benefit Classification panel. The standard classification lists them. Others can be updated as needed. Please note that classifications should be set before adding the rules.
- Can co-pay be set at the procedure code level?
No. This is defined on the co-pay panel by claim type, recipient plan and provider specialty. It’s not directly tied to a procedure.
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Course # 3 - HSC List
- What determines the difference between “exempt” and “exclude?” They’re updated in the same panel so it doesn’t look like there’s any difference between the two functions.
The Health Services Commission (HSC) defines “excluded” and “exempted.” The MMIS system recognizes the category numbers according to current business practices.
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Course # 4 - Updating Benefits Reference Data
- Are future claims affected if the end date on the Mass Rate Adjustment (MRA) panel 12/31/2299? If so, is there a maximum amount billed for claims impacted by that rate adjustment?
Yes, future claims will be adjusted if a provider’s MRA has a beginning effective date and an MRA date. On an MRA with an effective end date of 12/31/2299, the new rate will be applied to all future claims with a service date greater than the MRA date.
- Can we use “delete” instead of “cancel” from the drop down menu in the Provider > Related Data > Other > Mass Rate Adjustment panel?
Yes, if your user access allows it.
- How do you decrease and increase rates on the MRA panel?
The Mass Rate Adjustment panel is used to increase and decrease rates.
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Course # 5 - Claims Adjustments and Voids
- Do the effective/end dates and active/inactive dates in the Contract Services panel refer to the group or the contract?
Those dates refer to the grouping.
- What determines the Batch Number entered into the Adjustment Request panel?
The user may choose any batch number between 001 and 999 that isn’t already assigned to another adjustment request on the same date.
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Course # 6 - Claims Resolution
- The 90 or 91 region code must be assigned on a claim by EDMS before performing a forced override. When is the code assigned?
This is subject to normal DHS business policies. Ask your manager for clarification.
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Course # 8 - Claims Resolution
- Will the MMIS error codes be the same as Oregon proprietary codes or HIPAA codes? Where are the crosswalks between proprietary and HIPAA codes on the new MMIS?
This is subject to normal DHS business policies. Ask your manager for clarification.
- Who will work the Service Alert Reports, and who will determine what error codes are reported on them?
Only users with access will work with the Service Alert Reports. DHS will determine the error codes shown in the “Error Disposition” panel under Reference. The online Service Alert Report follows this navigation path: [Home Page] -[Claims] - [Reports] - [Service Alerts Report].
- Will the new MMIS supply the provider claim denial summary? Will there be a batch report on COLD listing denials and claim counts?
There are many batch reports that show error code trends and claims received counts, for instance:
- Daily Exception Summary By Claim Type shows trends in error codes that set on claims.
- Claims Processing Daily Summary shows counts and amounts for claims received, and claim status (Paid, Denied, Suspended).
- Claims Submission Statistics shows claims counts received by type of submission.
- Will the MMIS error codes be the same as Oregon proprietary codes or HIPAA codes? Where are the crosswalks between proprietary and HIPAA codes on the new MMIS?
This is subject to normal DHS business policies. Ask your manager for clarification.
- What is the Link Image panel used for?
The panel links document images from EDMS to a specific claim.
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Course # 10 - Monitoring FFS Claims Processing
- When DSS is implemented, where will DSSURS reports and queries be stored?
Reports for the project will be stored in the Business Objects Production Report Repository. Only users with security access will be able to view and/or run these reports in the production environment.
- Is it possible to print a list of details from the Claim Detail panel?
No, details from the Claim Detail panel cannot be printed. However, users can use Snagit or Paint (in Word) to copy the window to a Word document, then print.
- How long do claims remain in the MMIS system?
The new MMIS system will hold claims data for the duration of a contract and can be expanded to hold more data. If the system reaches maximum capacity, the procedure is to determine what information to archive.
- Will the PAN number be shown on the hard copy RA given to the provider?
Yes, the paper RA includes a field for the patient account number. These reports will be stored in the Business Objects Production Report Repository. Only users with security access will be able to view and/or run the reports in production.
- Can the COLD search results panel be sorted, or are results displayed only in a sequence such as alpha or numeric?
Currently, Cold Application sorts results only by date on the REPORT_RUN_DATE column (<orderbycolumn>REPORT_RUN_DATE desc</orderbycolumn>).
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Course # 11 - Monitoring Pharmacy Claims Processing
- How will compound drugs be processed in the new MMIS system? Will attachments be required? Will each compound drug component be shown as a separate detail on the claim, or will the drug be listed as the only detail on the claim?
Compound Claims are processed as “Claim Type = Q.” Different components of the compound drug will be shown as separate details unless otherwise noted. For example, if one detail is denied, the entire claim will be denied. If one detail requires a PA, the entire claim will require a PA. However, a provider can process a compound drug claim without those restrictions. In this case, there is no attachment.
- Will EDMS report names and numbers be available to DHS staff before implementation?
A list of reports for each subsystem is available through the MMIS “Help” link in the new system. Go to Help - User Manuals, and then choose the appropriate subsystem. A list of reports is available for each area.
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Course # 12 - Updating Claims Reference Data
- How can we see the procedure code limitations on the new system?
You’ll find these on the limitation audit panel under “Reference.”
- Where do I find the link between the diagnosis code and procedure codes?
The diagnosis is shown on the procedure code restriction panel.
- What MMIS screens will replace the HSCX page?
Data found on the current HSCX page will move to the Benefit Plan and HSC List Inquiry panels.
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Course # 13 - Managed Care Contracts
- We were told in training that the due dates and date received on the Deliverables, Milestones and Work Plans panels should be the same. When I tried this in training, an error message that read “Due Date must be less than Received Date” appeared on the screen. Why did this happen?
This is a defect in the training environment that is being corrected. Updates and corrections are applied to the training environment two weeks after they are moved into the UAT environment.
- If two users are trying to perform the same function on the same case at the same time, will the new MMIS notify the other user? If so, will it provide the person’s ID?
The rule is: Two people may try to perform the same function on the same case at the same time. But only the data entered by the first user to successfully “SAVE” will go on the database. The second user will receive a message showing duplicate functions, but may be able to append the previous action, depending on the subsystem.
- Can more than one person change Cap Rates at the same time?
No, but the table behind the panel can be changed by more than one person.
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Course # 14 - DSS Reporting for the Ad Hoc User
- Does an “is like” function appear in Business Objects?
The operator’s list contains two functions, “Matches Pattern” and “Different from Pattern.” Here are three examples of how this functionality will work in Business Objects:
- Match (“Smith”, “Jones”) returns 0 matches.
- Match (“Smith”, “S%”) returns 1 match.
- Match (“Smith”, “St?”) and then “Match Else” returns “No Match.”
- Will there be a cost to run long queries (based on the time it takes to pull the data)?
Yes, the new MMIS database will calculate a cost on each query run, depending on the time it takes to pull the data.
- What formatting is required for the “inlist” function of the DSSNavigator?
According to the Business Objects document, the inlist separator is based on the computer’s Regional Settings on the Control Panel. This is usually set to a comma or semi-colon.
- When creating a new report in DSSNavigator in the new MMIS, how will claims status be reported - at the detail, the header, or both?
The Claims Analysis universe carries only one Claim Status object. It will carry either the detail status code for detail paid claims, or the header status for header paid claims.
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Course # 15 - DSS Reporting for the Power User
- How often does the batch process search for a random sample?
The batch process searches every 15 minutes for a random sample submission.
- How does a user drop tables into their schema?
To insert a table, the user chooses “Drop Table” in the Oracle Drop Table command.
- When setting a date condition for a query, the timestamp shows on the condition in the query view, but does not show in the SQL. This is only true on the training PCs. But the trainer’s PC showed the timestamp in the SQL. Why is this happening?
The timestamp function is in an oracle.prm file that a user sets on their PC when the Business Objects software is loaded. This controls how the date and/or date timestamp is formatted and displayed.
In this case, it doesn’t matter that the training PC displays the information differently, because both PCs will generate the same results. The prm file on the training PC was probably not updated.
To change a setting, users can copy the file below then use it to overlay their current PC setting. In particular, these are the lines that have been changed:
<Parameter Name=“USER_INPUT_DATE_FORMAT”>‘MM-dd-yyyy’</Parameter>
<Parameter Name=“DATABASE_DATE_FORMAT”>MM-DD-YYYY</Parameter>
<Parameter Name=“EPM_DATE”>TO_DATE(‘%1-%4-%6’, ‘MM-DD-YYYY’)</Parameter>
<Parameter Name=“EPM_DATETIME”>TO_DATE(‘%1-%4-%6’, ‘MM-DD-YYYY’)</Parameter>
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Course # 16 - DSSSUR Maintenance
- Will the blue backgrounds on the canned reports show when printed on the new MMIS?
The blue background will appear only when a color printer is used. When it’s printed on a black and white printer, it will appear slightly darker than the non-shaded rows.
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Course # 17 - ODM Incoming
- Why can’t I delete a line item from Prior Authorization? In ODM, many applications use the “Enter” button to navigate the system. When I use the “Enter” button in the new MMIS, another panel is added and cannot be deleted, so I have to start over. Is it possible to have a delete key added?
The new MMIS does not utilize the “Enter” button to navigate. However, modifications to the system may occur in the future.
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Course # 18 - Recipient Eligibility Data
- Security access allows a user to view only certain functions. Are the links they’re not permitted to see “grayed out” (have gray bars over the information)?
Yes. Links that the user is not permitted to view will be grayed out or invisible, depending on the security profile applied.
- Where is the alternate prime number found?
If an alternate prime number is displayed, it will appear below the recipient’s “Active” indicator (Linked ID). The value will only be displayed on the inactive recipient panel, showing the person linked to the old ID. The Link History panel of the active recipient user will show the recipients linked to the active ID.
- Will the new MMIS automatically identify a recipient who was issued a prime number as a child, then issued a new number as an adult?
The new MMIS performs this function only when the user requests a link request. This will be manual process. The system doesn’t make assumptions about recipients, or associations based on assumptions.
- What is the purpose of the Population Lock-in Panel? Is it used for Managed Care out-of-area exceptions?
Yes, the panel is used for Managed Care exceptions.
- When will DHS begin using the new semi-permanent recipient ID cards?
The ID cards will be issued from the new MMIS as soon as possible. However, old ID cards will continue to be produced from the Legacy MMIS for up to a month after go live. This will allow DHS to continue to issue cards while resolving any unforeseen issues.
- Will the name of the Managed Care program display on the Care Oregon panel? Why is the Managed Care program name field different than the information on the Enrollment and PCM/MCO panels?
The Managed Care program and code will be displayed on the Recipient Information panel; this is consistent with the recipient’s eligibility information. The Recipient Information panel is independent of other Managed Care panels.
- If a case is closed, will the drop-down menu still display in the Case Certification field on the Recipient Information Panel?
Yes. This field will list all cases, both past and current, which a recipient has been a part of.
- How will we look up begin and end dates for eligibility? How will we determine if the recipient is covered in MMIS?
The dates the benefit plan falls under are the recipient’s eligibility begin and end dates. If the recipient is eligible, an active benefit plan will be shown in the Benefit Plan panel.
- Are the updates made between CMS and MMIS done in real time?
Yes.
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Course # 19 - Managed Care Enrollment/Disenrollment
- Does DHS enroll a recipient who lives in an area without a Medicaid provider into a program outside their area or an “open” program?
A special condition must be attached to a recipient living in an area without a Medicaid provider. This is done on the Recipient Managed Care Special Conditions panel. Batch processing will then allow an out of area assignment. However, the new MMIS cannot enroll a recipient in an out of area MC program.
- The “enrollment” column in the Recipient Case Enrollment panel shows that a recipient is still enrolled even though the panel reads “end dated.” Why does this display as “active” under the status column when it has end dated?
This is a system defect that is being corrected.
- If a date is changed to 12/31/2299 on the Capitation Rate adjustment panel, will that date remain until someone manually changes it, or will someone need to update the record with a new end date every month?
That is currently how the date field works. Someone would need to manually change the date.
- How will an “out-of-area” enrollment be processed in the new MMIS?
If it’s determined that a change like this should be made to Managed Care, one solution would be to attach a “special condition” to the recipient’s plan. This can be done through the Recipient Managed Care Special Conditions panel. Then, since an exception has been attached, the batch processing function would ignore the standard rules for region assignments and allow an out of area assignment. From a panel perspective, a full solution to enrolling a recipient in the out of area Managed Care program is still being developed.
- Is a wild card name search available in Recipient search panel? If so, how is it done?
Yes, this feature is available through a soundex feature on the Recipient Search panel. To utilize this, enter the last name “SMITH,” set soundex = “Y”, then records like SMITH will be returned.
- No results are returned when the last name and first initial of the first name are entered. Is that the intended functionality?
No, this is not how the new system will function. However, the user will still be able to use all first, last, and middle initials in a search.
- How will the user determine if a Managed Care Plan is open to any previous clients within 30, 60 or 90 days when the plan indicates it’s closed to new clients?
This determination will be done by the “Panel Hold Indicator” field on the Recipient Case Enrollment panel. If the indicator is set to “Y,” then the PMP is not allowing any open enrollments. However, it will allow previous recipients to be enrolled within the 30-, 60-, and 90-day time frame. If the indicator is set to “N,” then there are no holds and anyone can be enrolled in the program.
- If a user retroactively disenrolls a recipient from a Managed Care program, how does the system recoup for already paid claims? And, conversely, if a recipient is retroactively enrolled, how is the system be triggered to pay previous unpaid claims?
If a user retroactively disenrolls a recipient, the MC capitation cycle will automatically adjust the capitation payment to add or subtract money accordingly. However, this may differ based on:
- The retroactive year(s) the process is adjusted for, and
- The capitation categories and rates set for that recipient’s assignment.
These criteria are used to calculate the rates and sends payments to the Financial Unit for further calculations before a final check is created. Then Finance updates the capitation history table to show the date the check is issued.
Note: There are security limitations on these functions, so only authorized users can make these changes.
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Course # 20 - TPL Eligibility (TPR)
- When are Trading Partner Agreements (TPAs) required and how is that done? Is a TPA required when DHS verifies Third Party Liability (TPL) coverage with carriers?
TPAs are required for any outgoing/incoming information on 270/271 eligibility verifications and billing, and the Explanation of Benefits (EOB) 835/837s.
- What panel determines the method of premium payment to the recipient?
The payment panel shows how the payment was made.
To determine if a client has an EFT or EBT account, go to the EFT panel (EBTs are account type 'EBT'). The navigation steps to that panel are: [Financial] - [Related Data] - [Payee] - [EFT Account].
- How will staff see information from Well Partner and First Health on the new system?
Once a carrier is added through the Related Data - Other - Carrier panel, these panels display the carrier added:
- Panel: Employer to Carrier Xref in TPL > Related Data > Other > Employer > carrier xref button
- Panel: Employers By Carrier in TPL > Reports
- Panel: Recipients By Carrier in TPL > Reports
- Panel: HIPP Case Search in TPL > HIPP case
- Panel: AR Search in TPL > AR search
- Panel: TPL Base Information in TPL > Information - This is the only panel that is using the similar search as the TPL - Other - Carrier panel.
- Can MMIS detect if zip code matches the city when entering carrier information in TPL?
A zip code is required, but MMIS does not cross-check to see if it’s for the correct city. The system only validates the length of the zip code.
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Course # 24 - Estate Recovery
- How does the “one time” estate payment process interact with the new MMIS? Will users access the “one time” process through the new MMIS, or must they submit hard copy claims?
MMIS is not connected to the entities that pay the recipient other monetary benefits such as food stamps, energy assistance, etc.
MMIS can locate all claims paid for by a “one time” recipient. To pay the total amount owed by the estate, the user must enter:
- Claims that are too old to be in the system,
- Assistance payments that are not part of MMIS, and
- Any other payments the user wants to include in the estate case.
- Will cash receipts continue to be handled under “Financial” or under Third Party Liability (TPL)? If so, what panels are used?
The financial team will continue to handle receipting, but disposition responsibility is still being determined. Either way, cash receipt will continue to process the checks and the Case Tracking Recovery and Third Party Liability Account Receivables (TPLAR) panels will determine how to disperse the money received.
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Course # 29 - TPR Eligibility and Injury Case Tracking
- Will users be able to read the DMV report before generating letters in MMIS?
DHS determines what DMV data may be viewed. The DMV report cannot be viewed on MMIS. The DMV Data Match Report may be viewed. This report lists the matches between the DMV interface file and currently eligible Medicaid recipients.
- Is there a report that shows just the DMV matches? The TPL-7151-M report includes both matches and variations.
No, there isn’t a report like this available, but it may be available in future modifications to the system.
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Course # 33 - Role Based Security
- What do the prefixes D_I_U and D_I_T in security groups mean?
• D_I_U = DHS Interchange UAT
• D_I_T = DHS Interchange Training
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Course # 34 - Member Call Center
- Will the new MMIS cross-reference alias Recipient ID numbers with the current Recipient ID?
The Recipient ID field or the Provider field panels will compare alias and current numbers. The Search panel shows only exact matches to the Recipient ID entered.
- Will the response code dropdown lists on the notes panel be specific to individual work units? For example, will DMAP have options that differ from SPD?
No, the dropdown lists on the notes panel are not specific to a work unit. The options in these fields will be the same for each user in CTMS. The Reason, Completion, and Type codes on the questions panel are the only fields that will be have options based on the DHS unit or division.
- Can we track due dates in PA like we do in CTMS?
This question is referring to a “work list” type tracking similar to the CTMS homepage, and the answer is “no”, due dates are not tracked in PA as they are in CTMS.
- Are the county codes on the system the same as the FIPS codes?
Yes - the county code listed is the same as the FIPS code.
- Will CTMS utilize the wildcard search (accessed by using the percent key)?
No, you won’t need the wildcard symbol (%) for searches. A partial name or number will yield all possible results. For instance, if you’re searching for provider “Stu Tipton” but aren’t sure how the last name is spelled, type “Tip” and all possibilities will be shown.
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Course # 35 - Pharmacy Benefits Management (PBM)
- If I try to change the font size on the MMIS screen, some fields are no longer visible. Will this be corrected in the live environment?
The MMIS page format, including font size, is set by the system, not by the user. There are no plans at this time to allow different font sizes without changing the page format.
- Will MMIS Online Help sort reports by name? Reports are currently listed by number, but an option to sort by name would be helpful.
No. Computer Output to Laser Disk (COLD) displays hit results by date, but doesn’t sort by name.
- Where is benefit coordination information on the new MMIS?
For policy data on benefit coordination, use the Third Party Liability (TPL) Search or TPL Information panels. Use the Claims panel for data on a Coordination of Benefits (COB) submitted on a claim (Other Payer and Cost Accounting Standards (CAS) Inquiry).
The recipient’s Other Insurance (OI) can be found by searching Third Party Liability. The OI Plan panel shows the types of third party health coverage a recipient has.
Here’s the navigation path: [Reference] - [Benefit Administration] - [Other Insurance] - [Other Insurance Plan].
- Where can I find the Other Coverage Code (OCC) on MMIS?
The OCC is available on the OI Plan panel. See question #3 (above) for more information.
- Where can I find the name of everyone who’s paid on a particular claim?
That information is on the claim submitted by the pharmacists.
- Will the Health Services Commission (HSC) warning always appear when saving a Super Prior Authorization (PA)?
Yes.
- Will DHS and contractor EDS share the First Data Bank (FDB) drug file in the test environment?
Yes. The FDB file will be visible to both DHS and EDS users. There is no separate test environment for pharmacy and non-pharmacy processing.
- What happens when two users are on the same record and one makes a modification? Will users get an alert that a change has occurred?
Two people may try to perform the same function on the same case at the same time. There is no alert for this situation. But only the data entered by the first user to successfully “SAVE” will go on the database. Once the modification is saved, the second user will receive a message showing duplicate functions, but may be able to append the previous action, depending on the subsystem.
- Will compound and denied Point of Sale (POS) pharmacy claims show National Council of Prescription Drug Programs (NCPDP) codes?
NCPDP reject codes are only for Encounter claims. Explanation of Benefits (EOB) and Error Status (ESC) codes are stored in the database. NCPDP error codes are not. Error codes prompt the system to send the claim back to the pharmacist.
- When searching for an Fee for Service (FFS), do I select the FFS Claim Only option on the Claim Advanced Search panel to exclude Managed Care pharmacy claims?
Yes, select FFS Claim Only if no other option is given. You may also use region Internal Control Number (ICN) codes to search for FFS pharmacy claims.
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Course # 36 - Maintaining Providers
- How will MMIS store changes submitted by a provider contact responsible for mailing correspondence? Will the contact information be changed to reflect the mailing address?
Any mailed correspondence is sent to the address on file. The contact’s name does not appear in the address block or on the envelope. If the “In Care of” field on the Provider Location Name and Address panel is checked, only the first line of the address is available. The “In Care of” name is stored in the first line of the address with C/O in front.
- Will letters be formatted the same way they were in the training environment, and can the temporary user settings be changed on them?
Letter formatting is set by the system, not the user. A user must initiate a change request to alter formatting.
- If a letter is viewed several times before it’s saved or printed, is it sent multiple times, or does the save or print button send the letter? And every time you make changes, does it generate a new draft or accept and generate the last letter updated?
Users should only save once. Saving again will create another letter. That’s why it’s important to carefully read and edit the letter before saving.
The save and print button sends the letter before it’s printed. The PDF version cannot be printed. The new MMIS has an icon that prints the letter one time only. When the letter is saved, a copy is stored in Electronic Data Management System (EDMS).
- All contracts are capitalized except “anesthesia.” Does this need to be updated?
No. We don’t plan to update the word “anesthesia” before the implementation, but it might be considered in future modifications.
- Can users manually change the 1st and 2nd notice dates for expired licenses and contracts?
No. Those dates are set when the first and second notices are sent. If the notices aren’t sent, the dates don’t change.
- Please clarify the difference between the Issue Date and the Status Date.
The Issue Date is the date the payment was made. The date entered into the Status field is the date the check was cashed or reissued.
- Who produces the Owner ID when completing the Owner panel information?
DHS will assign the number. The process will be set prior to implementation of the new system. This is subject to normal DHS business policies. Ask your manager for clarification.
- “Provider > Rpts and Letters > AdHoc Reports > Provider ID From” and “Provider ID” both require nine characters for a provider ID, but other panels require only six. A user can successfully save by adding three characters, but then the IDs don’t match. Is this correct?
The six digit provider ID required on the Ad Hoc Report is a new system defect that will be corrected before implementation.
- Provider>search for Provider>Provider Maintenance>Provider Contacts>Phone field has a four-digit extension field, but some providers have five-digit extensions. Is this going to be changed before “go live”?
The four digit extension is part of the original technical design. Currently there are no plans to change it, although it could be included in future modifications.
- Provider>Related Data>Other>License>Name - name has one long entry field. What if a user enters a name incorrectly, but with the same license number?
A license number can only be entered once for each license type. For example, if a physician’s license was entered as MD1234 for Dr. John Doe, then again for Dr. Jane Doe, an error message would show that the effective and end dates overlap an existing record.
The user would then need to back out of the record and do a search to determine which physician the number belongs to. If MD1234 is a typographical error and a different license type is selected, the record would be saved. The record can be deleted if the user realizes they’ve entered an incorrect record.
It’s important to note that users will enter fewer license records because the new system interfaces with the licensing board.
- Will the password in the new MMIS require a certain format, such as starting with a letter or number or a specific combination of characters?
The password won’t require a specific combination of characters and can begin with either a letter or number.
- Does the MMIS Letter Generator have a spell checker?
No - the new system doesn’t feature a spell checker.
- What do the longitude and latitude panels on the Location Name Address panel do? Do they change when the address is manually updated?
The latitude and longitude panels automatically update when the address is entered or changed. These fields support the Geographic Information System (GIS) which will enable Oregon to map, chart, and plot Medicaid data across national, regional and state geographical areas.
- Will MMIS automatically update contact information to the letterhead on a system-generated letter?
No, the contact person will not be added to correspondence, this must be done manually.
- Why do the phone number formats differ between the Tax ID panel and the Provider Information panel?
Each number is used by a separate function that requires a particular format, as designed into the new system. The Tax ID panel uses a hyphen to divide the three sets of numbers and the Provider Information panel uses parentheses around the area code and a hyphen in the phone number.
- Why can’t we copy and paste text from the Provider Information panel and the Tax ID phone number field?
Once the provider is enrolled, data on the Provider Information panel cannot be changed, including the copy and paste features. This is a security feature. For more clarification please check with your manager.
- Why doesn’t the field level search for the financial institution in the Provider > EFT account panel allow capital letters?
This feature was not coded into the new MMIS, but may be changed in the future.
- How do we determine where provider payments are sent if two or more active banks are listed in the Provider > EFT Account panel?
The provider can only have one EFT segment open at one time. Consequently, only the active or open financial institution receives payment.
- Is MMIS compatible with Windows Vista? Which version of Internet Explorer will it use?
The Web portal will be compatible with Vista and Internet Explorer 6.0 and 7.0.
- Can nursing home employees be listed in the SPD Owner panels? If so, are they required to be Medicaid providers?
No, employees are not listed in this field, since nursing facility owners do not “own” employees. Only other owner facilities are listed in this field.
- The first type sort from “Provider > Rpts and Letters > AdHoc Reports > Type from Field” lists code 72 with a description of “SPD Transportation” before “Acupuncturist.” Why aren’t the results alphabetical?
This is the result of the type from sort command on the Provider Ad Hoc report. If you click on “search for the type from,” then “sort on the type description,” “SPD Transportation” appears before “Acupuncturist.” This is because in the database, ‘SPD Transportation’ has a space before the “s” and the sort starts with blank spaces before moving to the first letter of the alphabet.
- Provider > Rpts and Letters > AdHoc Reports > Provider ID From and Provider ID requires nine (9) character IDs, but the other panels require six (6). A save can be made with three (3) additional characters, but then the provider IDs don’t match. Why does this happen?
This is a defect in the system and is being corrected before we “go live.”
- In “Provider > Rpts and Letters > Provider Application Status,” the entry fields are listed as “From Date,” “Sort Order,” “Report Format,” then “To Date.” Why doesn’t “To Date” follow “From Date”?
The Provider Application Status system requires that particular order.
- What is the Contact Panel used for?
The Contact Panel tracks phone calls and email that cannot be filed with written correspondence. This way, the system uses the address listed with written correspondence. The Address Standardization feature uses the “In Care Of” (C/O) information as default for the first address line.
- Will DHS users have access to the log of requests for all letters generated in the LG?
The letter retrieval procedure in the EDMS Users Manual says “All system generated letters will have their data stored in the database so that it can be retrieved using EDMS.” Please refer to the manual or talk with your manager for more information.
- How quickly will providers receive electronic EFT payments?
Providers should receive electronic payments in 14 days or less. The timeframe depends on how quickly the bank responds. However, if a response does not occur within seven days, DHS assumes the account is valid and processes the EFT for the next financial cycle.
- Will the EFT acceptance letter go out automatically?
No, EFT letters will not be sent to providers.
- How can we determine the most recent EFT?
There can only be one EFT on file at a time. The effective dates appear in the “Provider” or “Financial” fields. For a specific payment, enter “check, EFT” in the “Financial” field. There can be two active EFT accounts, but only one type (debit /draft) and one credit (payments).
- The error messages “A valid relationship is required” and “A valid ownership entity ID is required” appear in the Owner Cross Reference panel in the Provider>Related data>Ownership entity pat. Why does the information disappear and have to be re-typed after being entered?
This is a defect in the system and is being corrected before we “go live” so all the information remains in place.
- Are the application tracking numbers (ATN) the same in the new MMIS and the ODM, or will there be two ATN numbers?
The same ATN will be used for both MMIS and ODM. The ATN is assigned when the provider submits an enrollment application either through the Web or MMIS. This happens in both ODM and Provider Enrollment. After the ATN is assigned, it stays with that particular enrollment application permanently.
- How will we know what requests to approve from the Web portal?
For enrollment applications, you will search for open applications by status, application, provider type or ATN if the number is known.
For demographic Web portal changes, you will access the Provider Demographic Approval panel in Provider>Related data, search for “new” status and review each request to determine if it can be approved. The determination criteria are set by DHS business rules. Consequently, you should talk with your manager about the particular application this has to your job functions.
Any demographic changes that don’t require DHS approval will automatically be processed by the new MMIS.
- Provider>Related Data>Other>License>Name is one long entry field. What happens when a name is entered incorrectly with the same license number?
A license number can only be entered once for each license type. For example, if a physician’s license was entered as MD1234 for Dr. John Doe, then again for Dr. Jane Doe, an error message would show that the effective and end dates overlap an existing record. The user would then need to determine which physician the number belongs to. However, if MD1234 is a typographical error and a different license type is selected, the record would be saved.
The record can be deleted if the user realizes they’ve entered an incorrect record. Also, users will enter fewer license records because of the new licensing board interfaces.
- Are payments from Financial>Payment Information>Payment related or linked to HIPPA 835 or 820 payments?
EOB processes are not linked to the way a provider is paid. A provider can get both an electronic EOB and a paper check. If the provider returns money to the state via the 837, it will be recorded on the cash receipt panel.
- Does a current EFT stay in active status until the one pending is pre-noted?
A provider cannot have two EFTs on file with overlapping effective dates. It is possible for a provider to receive a paper check until the new one is approved.
- Does the financial summary report include capitation?
The financial summary panel shows all financial activity, including debits and credits for the provider’s account.
- Why can’t provider letters be saved more than once before they’re generated and sent? Can a letter be recalled after it’s saved and generated?
Once the “Save/Send” option is chosen, you cannot recall a letter to make corrections. Anything submitted to the batch queue will be generated and sent to the central printer.
However, you can preview a letter, and then answer “no” to the “Save\Send” command if you need to make corrections before printing. If you’ve already saved and printed the letter locally, you can simply generate a new letter.
- Can a provider retract a request sent on the Web portal to change demographic or EFT information?
Submissions made by the provider on the Web portal are updated in real time. If approval is required, the provider can call and ask DHS to deny the request then submit another. But if the change directly updated the database, the provider must submit another request to override the previous one.
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Course # 37 - Provider Call Center
- Will the provider subsystem utilize the wildcard search (accessed by using the percent key)?
No, you won’t use the wildcard symbol (%) for searches. A partial name or number will yield all possible results. For instance, if you’re searching for provider “Stu Tipton” but aren’t sure how the last name is spelled, type “Tip” and all possibilities will be shown.
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Course # 38 - Provider Correspondence
- “Send email” on the Provider Location Name Address panel generates a message to the Web portal. Can the provider see the updated email address, or should the user provide the information in their response?
Choosing “Send email” will generate an email telling the provider a message is available on their Web-portal account, or will provide a link that opens to a secure location.
- Does MMIS store messages from the provider’s Web portal or returned email messages?
E-mail correspondence, like letters, is saved in the Electronic Data Management System. Emails are not saved on the new MMIS, but can be retrieved from the Contact Management Training System (CTMS).
- Is there a maximum number of pages that can be attached to one Correspondence Tracking Number (CTN)?
You probably won’t have to worry about the number of pages attached! The system allows up to 9,999 pages on each portion of the CTN. That means that each note segment may have up to 9,999 documents attached. Similarly, each question may have up to 9,999 note segments and each CTN may have up to 9,999 questions.
- How long will the system archive CTMS records?
This is subject to normal DHS business policies. Ask your manager for clarification.
- Can MMIS reports that were pulled by a user be audited?
Report PRV-0530-W provides a weekly summary by clerk ID; however, it doesn’t include detail on which providers were added, changed, or deleted. The audit panel shows which individual changed information for a provider.
- How will MMIS update the standardized address software?
The system will update the software every month.
- When sending messages on the Web portal, will the provider be able to see the updated email address from the “Send Email” button located on the Provider Location Name Address Panel? Will the provider be able to see the updated email address at all, or should users include it in their response?
The system gives users a choice to send an e-mail that tells the provider they have mail on their Web portal account, or provide a link to a secure location that they can click to view the message.
- Will contracts be auto populated to the MMIS from CSTAT?
CSTAT is used for legal document contracts, not provider contracts. A contract is a legal document that outlines the effective dates and services in both provider business and contract management business processes. A provider contract is a classification of benefits a class or specific universe of providers are allowed to bill.
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Course # 39 - Provider Enrollment-Disenrollment
- How does the new MMIS determine which provider to bill when duplicate providers are entered?
DHS and the National Provider Identifier (NPI) are currently working on this issue to ensure proper billing. Currently, the system will use the state Provider ID or NPI, Taxonomy and zip code plus four to determine the correct Provider Service Location. If there are more than one Provider Service Locations with this combination, the default NPI service location will be used (if one has been selected). Otherwise the claim will post an edit.
- What safeguards does MMIS have to prevent duplicate entries?
The system displays alerts if a Tax ID or license is already being used on other provider service locations. It also checks against Provider Name and Application Types already entered. For added security, the new MMIS will generate a Potential Duplicate Report that checks:
- Name and provider type
- Zip code plus four
- NPI
- Tax ID
- License number
- How will MMIS bill providers that have the same Tax ID but have several different providers, such as in a clinic?
The claim links to a specific Provider Service Location for billing. The Tax ID matches the billing Provider Service Location.
- The Service Location panel has a drop down menu to choose a Tribal Facility. What’s the difference between choosing “N/A” and leaving the field blank?
There is no difference. The drop down menu helps narrow or enhance a search.
- Do the enrollment applications give the provider options on their type and specialty? How do we determine the correct type and specialty to enter?
An enrollment application has been created that includes a list of provider types and specialties. More information on the application will be distributed before implementation. Providers who submit enrollment applications through the Web portal will be required to select provider type and specialty.
- Why doesn’t the Tax ID panel “auto fill” (auto populate) and record tax information that was entered into the Base Information panel? Why doesn’t the new MMIS interface with the Secretary of State to get the correct Tax ID information?
The Provider Base panel contains the provider’s personal Social Security Number (SSN) as required by DHS. The Tax ID panel contains provider tax information required by the Internal Revenue Service (IRS). They cannot auto populate each other because they each contain different field and combinations. The text/fields must be the same to auto populate. Also, the IRS would not allow MMIS to link to the federal system. When a user clicks “add” on the Application Base Information panel, the Tax ID information is recorded automatically from the Application Base information.
- Why doesn’t the Taxonomy panel automatically populate text from the Type and Specialty panel?
There are two different taxonomies in the system - one is the taxonomy displayed on the Provider Type and Specialty panel, and the second is the Provider Billing Taxonomy the provider uses for their billing. The Provider Type and Specialty list doesn’t have as many combinations as the Taxonomy list. They cannot auto populate each other because they each contain different field and combinations. The text/fields must be the same to auto populate.
- How does the new MMIS trigger the leveraged provider application process?
Information from the Provider Services Unit instructs the user to complete the State Share panel. This will require a communication process which will be developed by the Provider Services Unit before implementation.
- Does MMIS report sanctions to the Office of the Inspector General (OIG)?
Yes, the CMS Sanction Report lists all Providers sanctioned by DHS.
- Does the Taxonomy panel have to be completed to enroll a provider?
Yes. The taxonomy information is important for health care providers using a billing with a National Provider Identifier (NPI) on multiple service locations. The billing taxonomy helps determine which service location should be matched to a claim.
- Why doesn’t the address information automatically populate in some panels?
Address information cannot “auto populate” in the new MMIS due to multiple billing possibilities in the form. Only static fields can be auto populated.
- Can a provider have more than one NPI per service location?
Providers can only be enrolled in one service location at a time. When a provider has more than one, enter the first location without completing the Provider ID field on the Application Base Information panel. When the application is approved, click on the Enroll Provider hyper link at the bottom of the page.
Once the initial provider service location has been enrolled for each subsequent service location, the Provider ID field can be populated by clicking the “Search” link and selecting the original provider. When their application is approved and saved, select the “Add New Service Location” link. Follow the same sequence for each service location.
- Why would a user override a Tax ID?
In some rare cases the Tax ID and name don’t match; for instance, when a provider’s marital status changes. If the provider updates their name information before updating the information with the IRS, the user may show that the Tax ID and name do not match and were not correct at the time of enrollment and disenrollment.
- How does a user add multiple National Provider Identifiers (NPI)?
Users cannot add multiple NPIs. The new MMIS will only allow one NPI at a time for a Provider Service Location.
- Why do I need to do a field search for a taxonomy number before I enter the number into the open field?
This function ensures that only valid data is saved to the database.
- Is there a separate provider welcome letter for encounter providers?
No, there is only one provider welcome letter.
- How can I see the provider welcome letter that’s been generated? Can it be generated again? Can the letter be faxed to a provider?
The welcome letter will be printed locally by the enrollment clerk. It is not available online but can be printed and faxed to a provider. The user may create a question and pull up the letter in CTMS and then print it.
- Do claims compare provider names against the sanctions panel in the new MMIS?
The Sanctions panel is used by MMIS to either report or produce a warning to providers on the sanction table. DHS business policies determine penalties for sanctioned providers. For instance, if DHS terminates a provider, Claims takes steps to ensure that the provider is no longer eligible.
- What is the definition and/or interpretation of the Sanctions panel?
This panel displays provider sanctions that are transmitted to DHS monthly through the Office of the Inspector General (OIG) sanction interface. Providers who have been sanctioned by other entities are entered into the database. A monthly report lists providers or applications in process that match the sanctioned provider list. The system warns the user when a provider from the list attempts to enroll another service location.
- Will we be able to restrict all claim types (Claim Type 0) in the Provider Restrictions Services panel?
No, this function is not currently available and there are no plans to provide it at implementation.
- Where do I add the Diagnostic Related Group (DRG) rates when enrolling a provider?
Once the provider is enrolled, enter the information in the Provider DRG Rate panel on the Provider Maintenance Service Location page.
- Does the Clinical Laboratory Interstate Act (CLIA) site interface with MMIS? How do we enter this data? Is there a cross-reference? Will it bring up all providers associated within that CLIA?
The CLIA master table is updated through an interface with the Centers for Medicare and Medicaid Services (CMS)/Online Survey Certification and Reporting (OSCAR).To enter the information, go to the Provider Maintenance Service Location page, select the CLIA panel and enter the provider service location CLIA number. This links the provider with the CLIA number.
- Can a provider have more than one type in the MMIS?
Yes they can, but another service location must be added for that provider.
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Course # 40 - Case Management
- How often is the McKesson Disease Report processed by the new system (MMIS)?
This file is updated daily and applied each night during processing.
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Course # 45 - MMIS for the Local Office - CAF Child Welfare Data Inquiry
- Will MMIS replace systems such as IIS, Trax and FACIS?
No, MMIS will not replace these systems. FACIS and IIS are child welfare systems that are used, in part, to determine client eligibility and assist in case management. IIS also notifies MMIS of Medicaid eligibility. Trax is used for case narration. And even though the new MMIS also has contact tracking narrative, it will not replace Trax.
- Will FACIS interface with MMIS? How will MMIS interact with FACIS?
FACIS and the new MMIS will not interface directly. FACIS interfaces with Child Welfare’s IIS, and IIS interfaces with the new MMIS.
- Does the PCM/MCO list programs the recipient is eligible for?
The list shows available recipient plans. However this doesn’t mean the recipient is eligible for each plan listed - eligibility is determined by DHS business rules.
- Who initiates an ID card when a child enters foster care? Does the case worker key in the request, or is it done automatically when the child is first entered into the system?
This is subject to normal DHS business policies. Ask your manager for clarification.
- Can we print Medical Plan Cards in MMIS? It looks like we can only print ID cards.
No. Semi-permanent ID cards are issued in a nightly batch cycle.
- What does “NA” represent under the format field in the ELG-0900-D COLD Report?
This is a training code.
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Course # 47 - MMIS for the Local Office - CAF Self Sufficiency Data Inquiry (Local Office)
- Is provider’s service location data connected to Provider>search> green I process for accessing service locations? A mini search window appears instead.
Usually, the mini search window appears so the user can look up another provider file. Mini windows may also appear on the group pane. The window is used so the provider information window remains active while opening another window.
- What systems will be replaced by the new MMIS? Will the new MMIS interface with the other CAF self-sufficiency systems? What screens will be replaced by the new MMIS?
The current MMIS system will be replaced by the new MMIS. A new CM screen that looks and functions like ENRC will provide interface with managed care enrollment information. This function will operate in, “real time” and be very similar to eligibility and enrollment updates made by case workers now.
For specific screen changes, see the question at the top of this page, “What will happen to the MMIS screen I use now when the system goes live?”
- How long are permanent ID cards valid once they are issued?
The card is valid indefinitely if the recipient’s Prime ID number does not change. If the Prime ID number changes, a new ID card is generated and sent to the recipient.
The ID is not a guarantee of medical eligibility; DHS policy requires that a provider validate eligibility. Tools in the new MMIS including an active voice response phone system and a provider Web portal will help providers confirm recipient eligibility.
- Will users create cases in the new MMIS?
No, eligibility determination systems such as CM, IIS, FACIS, OACCESS, and JJIS will continue to provide this function.
- Will the new MMIS feed information to the eligibility systems the same way the eligibility systems feed information to MMIS?
Yes, an interface in the new system allows a user to send MMIS information when requested by an eligibility system.
- Will the system be available between the end of the training sessions and the “go live” date?
No, the system may only be used for training until go live.
- Does the MMIS system automatically issue cards at a specified time?
ID cards are issued in a nightly batch cycle.
- Will there be sort-by-year capability on the Premium Collection Search Results panel?
Each column in the Search Results panel can be sorted by clicking the header. The month\year column will sort by month first then year, but not by year then month.
- Why is entering ID numbers inconsistent from subsystem to subsystem? For example, when searching in Managed Care, the current ID must be capitalized. But in other areas, the system automatically converts lower case to uppercase, and in others it doesn’t matter.
Many of these inconsistencies will be resolved. However, this is considered a minor defect. Major defects have higher priority, so this won’t be resolved until the major defects are dealt with.
- Why do we have to re-enter the ID number to navigate other subsystems?
This is a function of the original system design and, for now, this function will remain the same in the new system, although this could change in future modifications to the new system.
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Course # 49 - MMIS for the Local Office - SPD Contact Management Tracking System (CTMS)
- What happens if you click on the “Save” button more than once after routing a question to a clerk?
Each time you click the “Save” button, it changes the current question to “transferred” and creates a new question with the transferred user’s ID. This also locks all the fields on the questions panel so you can’t modify the transferred question.
After choosing the “To Clerk” option, the “To Department” field displays all the areas in that department. If the user belongs to a single department, it’s automatically selected. However, if several departments are listed you must select one of them. If there’s a value selected for “To Clerk” but not for “To Department” an error message will appear after clicking the “Save” button.
Only the user who created the question can transfer it. However, users who didn’t create the question can to transfer it to themselves; this creates a new question that can then be transferred to anyone.
- How does MMIS training fit into the user’s daily work life? What systems will the new MMIS replace?
The new MMIS is replacing the existing MMIS and the Buy-In system. Training prepares DHS employees to use the new functions in MMIS.
- How will SPD use CTMS once MMIS goes live? How often will SPD employees be expected to use it?
This is subject to normal DHS business policies and SPD employees should consult with their manager regarding usage of CTMS in the new system.
- Will MMIS replace the current OACCESS database?
No, the new MMIS will not replace the current OACCESS database.
- What systems are being replaced by MMIS?
The system replaces the old MMIS system only. No SPD systems are being replaced by the new MMIS.
- Will providers have access to CTMS to look up calls tracked by DHS users?
No, providers will not have access to CTMS.
- A provider or recipient ID is mandatory on the Base Information panel to create a new record in CTMS. What happens when a person who is neither a provider or recipient contacts DHS? Can the record be created on the Base Information panel without a recipient or provider ID?
A record can be saved without a recipient, provider or contract ID. However, this must be documented. To do this, select the appropriate contact source, then populate the contact’s first and last name and organization fields. You can enter free text in the organization field.
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Course # 50 - MMIS for the Local Office - SPD Data Inquiry and update
- Where will copies of letters be stored on MMIS?
All letters generated in Contact Management Tracking System (CTMS) are stored in the Electronic Data Management System (EDMS). Letters must be coded to be stored and retained.
- Will MMIS user log-on names be the same as the current RACF ID?
No, they will not be the same. The MMIS user log-on names will use the Employee Identification (EIP) number.
- What is the MMIS standard resolution?
Resolution is set individually for each PC by the user.
- Is information on the Patient Liability panel the same as the current patient “pay in?”
No, these are two different sets of information. The “pay in” helps determine payments for persons who make too much money to qualify for Medicaid. The “Patient Liability” panel is used to track monthly Supplemental Security Income (SSI) payments.
- Will the Patient Liability panel in the Recipient subsystem display different care settings for the recipients?
Yes. The 'type' codes on the Patient Liability panel differ according to financial responsibility and living arrangements (care setting).
- Will users have to enter both the FIPS/ZIP for a zip code search?
No, the ZIP is sufficient.
- How frequently can a temporary ID card be issued?
This is subject to normal DHS business policies. Ask your manager for clarification.
- What font is being used for the COLD reports? Does it comply with ADA recommendations?
The reports feature zoom control, so the font can be made as large as necessary.
- What is the “History Status” information for in the Managed Care Enrollment Panel? Is it there to correct a data entry error?
The history segment is the same as a void. Information here officially never happened, but is stored in the database.
- Will a feed from CMS wipe out any changes that were made in MMIS? Or, if a recipient’s phone number was changed in MMIS but not in CMS, will the next CMS feed overwrite the phone number change made in MMIS?
The information on CMS is data input provided to EDS. The information on the input file will populate to MMIS, so changes made in CMS are the same in MMIS.
- Will there be a limit to the number of drop-down items in the Recipient Information panel? For example, can Benefit Plan, Case/Certification, and Managed Care all appear on the drop down list?
There is no limit to the number of items that can appear on the drop-down lists within this panel.
- How is eligibility determined and who determines it? What do all the numbers in the case number represent?
This is subject to normal DHS business policies. Ask your manager for clarification.
- What is the Material Suppress field?
The field instructs DHS to stop - or suppress - all correspondence to the recipient.
- Is the date in the Case/Certification Field on the Recipient Maintenance panel the case eligibility date or the end date?
This is the earliest effective date for the recipient on the selected case.
- In the MC program, how can we tell if the provider has exceeded the amount of recipients that can be enrolled before hitting “enter” and getting an error message?
This is counted and displayed at the Region Level for each PMP.
- Can a temporary ID card be generated for a recipient whose eligibility has expired? Will the system show that the recipient’s eligibility has expired before printing?
Note: Temporary ID cards can be issued through the system at any time; but it is a DHS policy question and business decision as to whether this functionality will be allowed. DHS employees should consult with their manager regarding these two questions.
- What is the Case/Certification field on the Recipient Information panel for?
The Case/Certification field is the earliest effective date for the recipient on the selected case.
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Course # 53 - MMIS for the Local Office - SPD Plan of Care
- Can a record be modified after a Plan of Care (POC) service authorization is paid out?
Modifications may be made to anything but the Current ID (recipient) header once a claim is paid against a POC.
Once a claim is paid against a line item, conditional updates may be made to these data elements:
Dollars cannot be set lower than what has been used
Units cannot be set lower than what has been used
Effective/End Dates cannot be set to exclude a paid claim date of service
Once a claim is paid against a line item, changes cannot be made to these data elements:
Service code (procedure code or revenue code)
Service Type Code
Rendering Provider
Unit Qualifier
Payment Method
Frequency
Modifiers
Payment Method
- Will the MMIS be able to identify duplicate POC claims that have already paid out?
Yes. The claims system will deny or suspend duplicate claims submitted against a POC.
- How will I know when a POC note is sent to a provider through the Web portal? Is there a report that tracks these notes?
There isn’t a report that tracks external notes. POC external notes are displayed on the service authorization notice, not the Web portal. Notices are delivered daily and can be viewed on the Web portal once they’re generated and the notice date is sent out.
- What happens if the user clicks the BACK button from the Internet Explorer while in “add” mode?
A warning message will ask the user if they want to navigate away from the page. If the user selects “yes” they will be logged out of the MMIS.
- Will the existing Oregon ACCESS program integrate with the new MMIS?
Yes.
- When authorizing certain services such as Meals on Wheels, will there be options such as hot meals, cold meals, etc. available?
Any options available in the new MMIS will be determined by DHS business practices prior to the implementation. Talk to your manager for more information.
- How do clerks know when a service authorization transfer is routed to them?
Clerks must search authorizations for any requests that have been transferred to them.
- Will data entered into OACCESS transfer over to MMIS?
OACCESS will not populate the authorization or notes in POC.
- What happens when a user is in “add” mode and clicks BACK from the IE explorer?
A warning message will ask the user to confirm that they want to navigate away from the page. However, if the user selects YES, they will be logged out of MMIS.
- Can a POC record be modified after a service authorization has been paid out?
Once a claim has been paid against a POC, any data element can be updated except the Current ID (recipient) header.
Once a claim has been paid against a line item, the following data elements may be updated (depending on certain conditions):
- Dollars cannot be set below what has been used
- Units cannot be set below what has been used
- Effective/End Dates cannot be set to exclude a paid claim date of service
Once a claim has been paid against a line item, the following data elements cannot be updated:
- Service code (procedure code or revenue code)
- Service Type Code
- Rendering Provider
- Unit Qualifier
- Payment Method
- Frequency
- Modifiers
- Payment Method
All other information can be updated.
- Will users be notified when a POC external note is sent to the Web portal for a provider? Is there a report to track these notes?
POC external notes are not displayed on the Web portal; they’re displayed on the service authorization notice which is sent out daily. Once the notices are generated, the date can be viewed in the Web portal. There is no report to track external notes.
- Will providers use the current process or the Web portal to submit for services and payment for foster care providers and home care workers?
The systems and processes that support SPD home care workers and foster care providers are not part of the current MMIS. The EDS-MMIS system replaces the old MMIS system only. No SPD systems are being replaced by the new MMIS.
- Is MMIS replacing the 512?
The systems and processes that support SPD home care workers and the foster care providers are not part of the current MMIS. The EDS-MMIS system replaces the old MMIS system only. No SPD systems are being replaced by the new MMIS.
- How will providers submit for services and payment for foster care providers and home care workers? Will they use their current process or the Web portal?
This is subject to normal DHS business policies. Ask your manager for clarification.
- Is MMIS replacing the 512?
This is subject to normal DHS business policies. Ask your manager for clarification.
- Will user notes on OACCESS and other systems transfer automatically to MMIS or will they have to be entered twice?
OACCESS notes and narration will remain in OACCESS, and will not transfer to MMIS. Re-entry will not be necessary.
- If the client has a representative and a guardian, who gets the POC notice - the client, the representative, or the guardian?
A notice may be sent to the client, provider, and a contact associated with the client’s record, depending on the option selected on the Notice Selection panel. The contact notice will only go out when a recipient with a multi-address record has a contact type of “RP” (which stands for “other responsible person”). If “RP” is not selected, the contact indicator cannot be set or changed.
- The systems should have a “delete” button on the Line Item panel. Selecting “add” more than once when adding a service to a POC cancels the transaction.
This is a function of the original system design, and how the new system functions. However, adding a “delete” button could be part of a future modification of the new MMIS system.
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Course # 55 - MMIS for the Local Office - Account Payables
- In training, the post test has a question on the Advanced hyperlink which is inactive on the Expenditure Maintenance Panel. Is the Advanced button supposed to be active in the new MMIS?
DHS will not be using the Advance panel in the new MMIS. The question will be removed from the post test for future trainings.
- What is the procedure when a check with incorrect information has been issued? How do users void the check and reissue a correct one?
Only DHS field office employees issue checks. All DHS employees will follow the desk- level procedures that will be provided before implementation of the new system.
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Course # 57 - Buy-In BENDEX
- Can the lab exercises focus more on changing as much Medicare data as possible and not just base data?
Lab exercises will remain the same prior to implementation. However, modifications will be considered for training after implementation.
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Course # 58 - MMIS Technical Support
- What are the password standards for the new MMIS?
Passwords must have a minimum of three of the following four characteristics:
- Upper-case letters (A, B, C...)
- Lower-case letters (a, b, c...)
- Numbers (1, 2, 3...)
- Special characters (*, %, !...)
Password settings will be:
- Minimum password length: 8 characters
- Maximum password age: 60 days
- Enforce password history: Yes
- Account lockout enabled: Yes
- Number of attempts before account lockout: 3
- Administrator required to un-lock an account: Yes
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