PM05 Manage Provider Completed decisions, Reporting Condition Coordinate with other agencies Grievance and Appeal after research and due performing reporting of results of process is completed, this process to adhere to MITA are communicated standards and stored PM05 Manage Provider The transaction Modularity Standard Expand tracking capabilities (and Grievance and Appeal received by Receive automated reminders from the Inbound Transaction tracking function) thru the use of process is logged and a rules engine tracked PM06 Manage Provider Process is responsible Business Results Condition Use more online application information for managing all processing (with aspects of the provider verification/validation performed registry for both against a user-controlled rules current and engine) prospective providers; uses several manual paper-based processes PM06 Manage Provider The Registry includes Reporting Condition Use of MITA standards and information contractual terms, interfaces will increase efficiency such as the services and consistency the provider is contracted to provide, related performance measures, and the reimbursement rates for those services; information is communicated and received from various sources including MCOs
PM05 Manage Provider Grievance and Appeal Completed decisions, after research and due process is completed, are communicated and stored Reporting Condition Coordinate with other agencies performing reporting of results of this process to adhere to MITA standards PM05 Manage Provider Grievance and Appeal The transaction received by Receive Inbound Transaction process is logged and tracked Modularity Standard Expand tracking capabilities (and automated reminders from the tracking function) thru the use of a rules engine PM06 Manage Provider information Process is responsible for managing all aspects of the provider registry for both current and prospective providers; uses several manual paper-based processes Business Results Condition Use more online application processing (with verification/validation performed against a user-controlled rules engine) PM06 Manage Provider information The Registry includes contractual terms, such as the services the provider is contracted to provide, related performance measures, and the reimbursement rates for those services; information is communicated and received from various sources including MCOs Reporting Condition Use of MITA standards and interfaces will increase efficiency and consistency