Claims Processing and Management Services Module

Description

The State of Georgia has published a Notice of Intent to Utilize Cooperative Purchasing Agreement (Notice), identifying its intent to utilize the NASPO ValuePoint Medicaid Management Information System (MMIS) Claims contract. The Department of Community Health (DCH or State Entity) desires to enter into a Participating Addendum with a NASPO ValuePoint awarded supplier for Claims Processing and Management Services Module as per the MMIS Claims Processing and Management Services Module, RFP No. DPHHS-RFP-2020-0254T, executed by the State of Montana on January 4, 2021. The Master Agreement provides the Core Service which is a SaaS solution that will adjudicate, edit, price, and determine reimbursement amounts for Medicaid healthcare claims. In addition to the Core Service, the Master Agreement also offers the following additional options: ¿ Option A ¿ Financial Management and Financial Reporting ¿ Option B ¿ Call Center (Member and Provider Call Center) ¿ Option C ¿ Federal Reporting DCH is interested in procuring all three (3) options (Financial Management, Call Center, and Federal Reporting) in addition to the Core Service for a Claims Processing and Financial Management solution from a single supplier.