Provider Provider PM01 Manage Provider Current process is manual 1 2 Management Information Information Partner Portal not fully implemented (PM) Management No automated decision making No business rules engine Limited workflow tools Standards needed for data exchange and interface Limited use of web verification services Communications are available only in a limited number of languages No KPI Provider Provider PM08 Terminate 1 2 Partner Portal not fully implemented Management Information Provider No automated decision making (PM) Management No business rules engine Limited workflow tools Standards needed for data exchange and interface Limited use of web verification services No KPI Provider Provider PM02 Manage Provider 1 2 Limited use of web based technologies and alerts Management Support Communication No formal communications management plan (PM) Limited use of automated workflow Communications are available only in a limited number of languages No KPI Provider Provider PM07 Manage Provider 1 2 Process is mostly manual Management Support Grievance and Appeal No business rules engine (PM) Limited workflow tools Standards needed for data exchange and interface Access to data warehouse is limited
Provider Management (PM) Provider Information Management PM01 Manage Provider Information 1 2 Current process is manual Partner Portal not fully implemented No automated decision making No business rules engine Limited workflow tools Standards needed for data exchange and interface Limited use of web verification services Communications are available only in a limited number of languages No KPI Provider Management (PM) Provider Information Management PM08 Terminate Provider 1 2 Partner Portal not fully implemented No automated decision making No business rules engine Limited workflow tools Standards needed for data exchange and interface Limited use of web verification services No KPI Provider Management (PM) Provider Support PM02 Manage Provider Communication 1 2 Limited use of web based technologies and alerts No formal communications management plan Limited use of automated workflow Communications are available only in a limited number of languages No KPI Provider Management (PM) Provider Support PM07 Manage Provider Grievance and Appeal 1 2 Process is mostly manual No business rules engine Limited workflow tools Standards needed for data exchange and interface Access to data warehouse is limited