ME06 Manage Member This is an all-manual Business Results Condition Documents should be scanned Grievance and Appeal process. Grievances and the case file automated and and appeals are filed shared among case workers. via fax and USPS. Confidential documents are transferred by certified mail. ME06 Manage Member No standards beyond Industry Standard Condition Establish local documentation Grievance and Appeal general requirements standards and work towards for establishing a MITA standards case. ME07 Manage Member A data store Reporting Condition Enable the data store to be used member’s Information record will include all to provide information and eligibility and statistics for a variety of enrollment spans, and activities support flexible administration of benefits from multiple programs so that a member may receive a customized set of services ME07 Manage Member This process is Modularity Standard Develop open interfaces and Information associated with many expose standard services other processes which utilize Member Information ME08 Perform Population and Process is Business Results Condition Use automation to improve Member Outreach high costs results in targeting populations reduce frequency of needing outreach and education. outreach.
ME06 Manage Member Grievance and Appeal This is an all-manual process. Grievances and appeals are filed via fax and USPS. Confidential documents are transferred by certified mail. Business Results Condition Documents should be scanned and the case file automated and shared among case workers. ME06 Manage Member Grievance and Appeal No standards beyond general requirements for establishing a case. Industry Standard Condition Establish local documentation standards and work towards MITA standards ME07 Manage Member Information A member’s data store record will include all eligibility and enrollment spans, and support flexible administration of benefits from multiple programs so that a member may receive a customized set of services Reporting Condition Enable the data store to be used to provide information and statistics for a variety of activities ME07 Manage Member Information This process is associated with many other processes which utilize Member Information Modularity Standard Develop open interfaces and expose standard services ME08 Perform Population and Member Outreach Process is high costs reduce frequency of outreach. Business Results Condition Use automation to improve results in targeting populations needing outreach and education.