592. DWB15 Provide exception reports/information. 593. DWB16 Provide control file reports/information. 594. DWB17 Provide management reports/information. Ensure that shown on reports/information include a description, including codes for procedures, drug, and 595. diagnosis codes, CLIA certification codes, specialty, and any other codes, and provide on all reports that display codes. Ensure that reports are available online and allow authorized users to sort, group, regroup, summarize, print, export to PC 596. DWB19 software, and perform other output management functions, including drill-down to the original claims data for a more detailed view. Ensure that reports meet the guidelines for compliance with 597. DWB20 Federal SUR requirements. Match HEDIS (Healthcare Effectiveness Data and Information 598. DWB21 Set) reports to Federal requirements. Ensure that the DSS/DW data is correct, internally consistent, 599. DWB22 and consistent with comparable data used in other MEMS functions and reports. Ensure that data in the DSS is synchronized to reflect the data in the MEMS, the Eligibility Determination module, PBM, Drug Rebate, and the web portal, including additions due to 600. DWB23 updates from other sources. The DSS/DW is to be synchronized on a weekly basis to reflect the data in the MEMS, as well as additions due to updates, unless otherwise specified by CHFS.
592. DWB15 Provide exception reports/information. 593. DWB16 Provide control file reports/information. 594. DWB17 Provide management reports/information. 595. Ensure that shown on reports/information include a description, including codes for procedures, drug, and diagnosis codes, CLIA certification codes, specialty, and any other codes, and provide on all reports that display codes. 596. DWB19 Ensure that reports are available online and allow authorized users to sort, group, regroup, summarize, print, export to PC software, and perform other output management functions, including drill-down to the original claims data for a more detailed view. 597. DWB20 Ensure that reports meet the guidelines for compliance with Federal SUR requirements. 598. DWB21 Match HEDIS (Healthcare Effectiveness Data and Information Set) reports to Federal requirements. 599. DWB22 Ensure that the DSS/DW data is correct, internally consistent, and consistent with comparable data used in other MEMS functions and reports. 600. DWB23 Ensure that data in the DSS is synchronized to reflect the data in the MEMS, the Eligibility Determination module, PBM, Drug Rebate, and the web portal, including additions due to updates from other sources. The DSS/DW is to be synchronized on a weekly basis to reflect the data in the MEMS, as well as additions due to updates, unless otherwise specified by CHFS.
Attachment_I_-_MEMS_Fiscal_Agent_Requirements[1].docx