No KPI Eligibility & Provider EE07 Disenroll Provider 1 2 Currently a mix of manual steps and limited automation Enrollment Enrollment Partner Portal not fully implemented Management No automated decision making (EE) No business rules engine Limited workflow tools Standards needed for data exchange and interface Limited use of web verification services No KPI Eligibility & Provider EE08 Inquire Provider 1 2 Limited use of web based technology and communications Enrollment Enrollment Information Partner Portal not fully implemented Management No automated decision making (EE) No business rules engine Limited workflow tools Standards needed for data exchange and interface No KPI Financial Accounts FM01 Manage Provider 1 2 No automated decision making Management Receivable Recoupment No business rules engine (FM) Management Limited workflow tools Standards needed for data exchange and interface No KPI Financial Accounts FM02 Manage TPL 1 2 No automated decision making Management Receivable Recovery No business rules engine (FM) Management Limited interchange Limited workflow tools Standards needed for data exchange and interface No KPI Limited exchange of Third Party Liability (TPL) data with
No KPI Eligibility & Enrollment Management (EE) Provider Enrollment EE07 Disenroll Provider 1 2 Currently a mix of manual steps and limited automation 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 Eligibility & Enrollment Management (EE) Provider Enrollment EE08 Inquire Provider Information 1 2 Limited use of web based technology and communications Partner Portal not fully implemented No automated decision making No business rules engine Limited workflow tools Standards needed for data exchange and interface No KPI Financial Management (FM) Accounts Receivable Management FM01 Manage Provider Recoupment 1 2 No automated decision making No business rules engine Limited workflow tools Standards needed for data exchange and interface No KPI Financial Management (FM) Accounts Receivable Management FM02 Manage TPL Recovery 1 2 No automated decision making No business rules engine Limited interchange Limited workflow tools Standards needed for data exchange and interface No KPI Limited exchange of Third Party Liability (TPL) data with