A. Before a provider or MCO is allowed to create an online account with the Contractor or before the Contractor is allowed to initiate the case review, the Contractor must have a case review agreement signed by the provider and MCO. B. The case review agreement must contain the language provided in Appendix 3. C. The Contractor shall store and retain the case review agreement for ten (10) years. D. The Contractor shall maintain an electronic web portal and data storage system allowing for: 1. The creation of user-specific and password-protected accounts with multifactor authentication managed by the Contractor that allows access to user-specific files pertinent to the case(s). System should alert users of pending password expirations and allow the user to update their password their account. 2. The ability by the Contractor to suspend account access to providers or MCOs as directed by MDH; 3. The ability to accept electronic submissions of requests for case reviews from providers/submitters; 4. The ability to generate and send a receipt to the submitter immediately that is printerfriendly and time stamped, includes a system-generated unique case number, and is stored electronically for access by the Contractor, MDH, MCO staff, and the provider requesting the case review; 5. The electronic forwarding of the medical case review request in a printer-friendly format to the appropriate MCO within three (3) business days from the date that the provider submits a request for a review; 6. The electronic uploading of the case record by an MCO within five (5) business days of receipt of the medical case review request; 7. The electronic notification via email to parties of any status update to the case; 8. The electronic uploading and simultaneous sending of the case review decision in a printer-friendly format to the MCO and the provider; 9. The immediate availability of a fully functional back-up system if the primary system fails for a period greater than 24 hours; 10. The ability to present a summary file in Excel sortable by case number, submitter, submitter’s group or hospital affiliation, MCO, case review status, paid status, and medical service type denied...
