Verify the quality and readability of all imaged claims and 282. CRB28 documentation. Develop and implement procedures to ensure the integrity of 283. CRB29 claims submitted by providers via Direct Data Entry (DDE) on the internet or other electronic submission of claims. Maintain a dedicated EDI unit adequately staffed within Frankfort, KY to assist customers with EDI issues, the receipt 284. CRB30 of electronic remittance advices, and future technological advances in electronic data transmission. Produce claims entry statistics reports, in a format conducive 285. CRB31 to assessing performance compliance, and deliver to the CHFS. Accept original forms (red ink) or copies/faxes of a claim 286. CRB32 and be able to process it into the MEMS. Provide a data entry system that includes, but is not limited to, hardcopy claims and claim adjustment/voids, which provides 287. CRB33 for field validity edits and pre-editing for fields, such as: provider number, member ID number, procedure codes, diagnosis codes, or others, as defined by the CHFS. 288. CRB34 Perform data entry of all hardcopy claims. Maintain a 98% accuracy rate of all keyed claims and any 289. CRB35 data manually entered by the MEMS Vendor or contract data entry staff. Maintain and staff a data entry unit adequate to key hard copy 290. CRB36 claims within a maximum of five workdays from the TCN date. Provide monthly reports/information that show the overall data 291. CRB37 entry error rate, the error rate per keyer, a corrective action
282. CRB28 Verify the quality and readability of all imaged claims and documentation. 283. CRB29 Develop and implement procedures to ensure the integrity of claims submitted by providers via Direct Data Entry (DDE) on the internet or other electronic submission of claims. 284. CRB30 Maintain a dedicated EDI unit adequately staffed within Frankfort, KY to assist customers with EDI issues, the receipt of electronic remittance advices, and future technological advances in electronic data transmission. 285. CRB31 Produce claims entry statistics reports, in a format conducive to assessing performance compliance, and deliver to the CHFS. 286. CRB32 Accept original forms (red ink) or copies/faxes of a claim and be able to process it into the MEMS. 287. CRB33 Provide a data entry system that includes, but is not limited to, hardcopy claims and claim adjustment/voids, which provides for field validity edits and pre-editing for fields, such as: provider number, member ID number, procedure codes, diagnosis codes, or others, as defined by the CHFS. 288. CRB34 Perform data entry of all hardcopy claims. 289. CRB35 Maintain a 98% accuracy rate of all keyed claims and any data manually entered by the MEMS Vendor or contract data entry staff. 290. CRB36 Maintain and staff a data entry unit adequate to key hard copy claims within a maximum of five workdays from the TCN date. 291. CRB37 Provide monthly reports/information that show the overall data entry error rate, the error rate per keyer, a corrective action
Attachment_I_-_MEMS_Fiscal_Agent_Requirements[1].docx