Procurement Library

DSHS Organization
State Medicaid Manual
Medicaid Management Information System (MMIS)
Medicaid Statistics

MMIS Systems Documentation
Sample MMIS Reports
Edits/Audit Business Rules
 

Social Service Payment System (SSPS) Information
Project Deliverables for vendor RFP
HIPAA Privacy
RFP Documentation
Business Process Documentation
Data Warehouse Documentation
Enterprise Architecture Program Documentation
Interface Documentation
Contact Information

DSHS Organization

DSHS Organization
HRSA (MAA) Organization

 

Medicaid Management Information System (MMIS) Documentation

Washington State Medicaid Statistics

Eligibility Data
Call Center Stats
Call Center ACD Report
2004 Healthy Options (HMO) Paper Enrollments

MMIS Systems Documentation

Data Element Dictionary*

*Data Element Dictionary will be  provided on request.

Record Element Directory

 

Sample ProviderOne/Claims Processing Reports

Current Operational Report Output
WSR Log
WSR Index
WSR CSR List
POS CSR Index
POS CSR List
POS CSR Log
CSR Stats
CSR Log
CSR Index
Daily Exception Summary
POS Adjudication Summary
Operational Performance Summary
Active Batch Summary
Claims Processing Daily Summary
Claims Processing Thru put Analysis
Monthly Claims Count
POS Adjudication Summary
Monthly Exception Summary
Suspend File Analysis by Claim Type
Claims Statistics by Submitter
 

Edits/Audit Business Rules

Exception Code Notes
Exception Code Cross Reference
Audits
Current Washington Medicaid Provider Manuals

Social Service Payment System (SSPS)

Social Service Payment System (SSPS) Information

Overview

Authorization Form
Authorization Turnaround
Electronic Funds Transfer
FICA Tax Report
Invoice
Report List
Reporting Unit Table
SCAR Word Form
Service Code Table
Social Service Payments
Social Service Notice
Warrants
Social Service Payment System Web Site (SSPS)

SSPS IVR Documentation

IVR System
IVR Main flow & block diagrams
IVR Caller Transfer flow & block diagrams
IVR Unlock Invoice flow & block diagrams
SSPS IVR Script

SSPS Reference Manual

Section	Section Title
01	Basic Instructions
05	DSHS 14-154(X) Social Services Authorization
10	Processing Authorization Documents
15	DSHS 14-159, Change of Service Authorization
20	Payments
25	Provider File
30	Edit Error Codes

Sample Social Services Program Detail

Project Deliverables for vendor RFP

ACES Interface Assessment Report
MMIS Needs and Issues Report
Stakeholder Management Plan
Business Process Review Report
Existing Technical and Organizational Environment Report

HIPAA Privacy

HIPAA Privacy

Denied Claims
Paid Claims
Client
NDC
Provider
Statistical Sampling Methodology

Enterprise Architecture Program Documentation

Enterprise Architecture Overview

Interface Documentation:

Batch Interface Documentation
Interface Inventory-Overview

Business Process Documentation:

Health Insurance Premium Payments
Garnishment Process/Requirements

For questions, please contact:

Travis Sugarman
RFP Coordinator
360 664-6075
SugarTS@DSHS.wa.gov