Post status on AVRS/REVS of provider payment information for the most recent weekly Business Process processing cycle Steps Calculate payment status Display payment status on an aggregate on REVS with its assigned check-digit provider ID Post Provider claim detail information on a daily and weekly basis with claim adjudication – status on e-CSI (electronic Claims Status Inquiry) – Provider security data Shared Data Predecessor Completion of weekly claims processing and payment cycle Successor Provider communications Federal and Rules and Regulations Constraints Systems constraints Failures Provider check information is required to be posted on REVS and made available each Monday Performance morning. Measures Claims status information is required to be posted every evening on e-CSI after each daily CP cycle and weekly after each weekly CP cycle. Inquire Payment Status Workflow Manage Payment Information Manage Payment Information Business Process Item Details Description The Maintain Payment Information business process supports the maintenance of provider payment information. Weekly Check write process Trigger Event Database is updated and reconciled with correct payments Result have access to payment information Receive data from Operations Management Area business processes Business Process Steps Load data into the STAT file and other MMIS payment files, building new records and updating, or status changes Archive data in accordance with state and federal record retention requirements None Shared Data Predecessor Financial payment process/run Successor Inquire on payment status information Generate reports
Business Process Steps Post status on AVRS/REVS of provider payment information for the most recent weekly processing cycle Calculate payment status Display payment status on an aggregate on REVS with its assigned check-digit provider ID Post Provider claim detail information on a daily and weekly basis – with claim adjudication status – on e-CSI (electronic Claims Status Inquiry) Shared Data Provider security data Predecessor Completion of weekly claims processing and payment cycle Successor Provider communications Constraints Federal and Rules and Regulations Failures Systems constraints Performance Measures Provider check information is required to be posted on REVS and made available each Monday morning. Claims status information is required to be posted every evening on e-CSI after each daily CP cycle and weekly after each weekly CP cycle. Inquire Payment Status Workflow Manage Payment Information Manage Payment Information Business Process Item Details Description The Maintain Payment Information business process supports the maintenance of provider payment information. Trigger Event Weekly Check write process Result Database is updated and reconciled with correct payments have access to payment information Business Process Steps Receive data from Operations Management Area business processes Load data into the STAT file and other MMIS payment files, building new records and updating, or status changes Archive data in accordance with state and federal record retention requirements Shared Data None Predecessor Financial payment process/run Successor Inquire on payment status information Generate reports
AS-ISBusinessProcessValidation-FinalUpdatedv6February19,2009.docx