Develop and maintain menu-driven help screens, up-to-date manuals, Data Element Dictionary and instructional 622. DWB45 materials, which assist CHFS, or its designee, designated users in their use of the DSS/DW. Obtain CHFS, or its designee, approval for any changes to the 623. DWB46 DSS/DW processes, prior to implementation. Review the database structure to streamline and minimize the 624. DWB47 length of time for updates. Ensure that the system maintains the capability to perform 625. DWB48 various manipulations or calculations of data necessary to support CHFS, or its designee, requests. Provide the capability to analyze the drug usage of Medicaid members and review the dispensing patterns of pharmacies 626. DWB49 and prescribing physicians. Also, produce reports/information identifying aberrant usage or prescribing practices. Develop queries and reports/information to fulfill CHFS’s 627. DWB50 analytical needs, per a timeframe defined by CHFS. Provide for automated cost settlement functionality, including 628. DWB51 Provider Statistical and Reimbursement (PS&R) System, for nursing facilities and hospitals. Provide user-friendly way of manipulating data (i.e., wizards, 629. DWB52 more drop-down boxes). 630. DWB53 Build cost settlement spreadsheets from claims history. Generate settlement notices to the provider and apply 631. DWB54 adjustments to claim/encounter history. Provide CHFS with access to all Drug Rebate module and 632. DWB55 Supplemental data.
622. DWB45 Develop and maintain menu-driven help screens, up-to-date manuals, Data Element Dictionary and instructional materials, which assist CHFS, or its designee, designated users in their use of the DSS/DW. 623. DWB46 Obtain CHFS, or its designee, approval for any changes to the DSS/DW processes, prior to implementation. 624. DWB47 Review the database structure to streamline and minimize the length of time for updates. 625. DWB48 Ensure that the system maintains the capability to perform various manipulations or calculations of data necessary to support CHFS, or its designee, requests. 626. DWB49 Provide the capability to analyze the drug usage of Medicaid members and review the dispensing patterns of pharmacies and prescribing physicians. Also, produce reports/information identifying aberrant usage or prescribing practices. 627. DWB50 Develop queries and reports/information to fulfill CHFS’s analytical needs, per a timeframe defined by CHFS. 628. DWB51 Provide for automated cost settlement functionality, including Provider Statistical and Reimbursement (PS&R) System, for nursing facilities and hospitals. 629. DWB52 Provide user-friendly way of manipulating data (i.e., wizards, more drop-down boxes). 630. DWB53 Build cost settlement spreadsheets from claims history. 631. DWB54 Generate settlement notices to the provider and apply adjustments to claim/encounter history. 632. DWB55 Provide CHFS with access to all Drug Rebate module and Supplemental data.
Attachment_I_-_MEMS_Fiscal_Agent_Requirements[1].docx