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MPATH Claims Processing and Management Services Module


Location
Montana
Publication Date
10/31/2019 08:33 AM EDT
Closing Date
02/18/2020 04:00 PM EST
Issuing Organization
State of Montana - Department of Public Health & Human Services
Solicitation Number
Description

Specifications include, but are not limited to: The intent for this RFP is for DPHHS to obtain a discrete module that aligns with the Final Rule for Mechanized Claims Processing and Information Retrieval Systems as described in 42 CFR 433.111. This module will support specific business objectives within the Montana Healthcare Programs enterprise that are detailed in Sections 3.9 High Level Scope of Work and 3.10 Detailed Scope of Work in this RFP and will be required to have interoperability with other MPATH modules. Consistent with definitions in the Final Rule for Mechanized Claims Processing and Information Retrieval Systems, DPHHS defines a module as a group of business processes that can be implemented through software, data and interoperable interfaces that are enabled through design principles in which functions of a complex system are partitioned into discrete, scalable, reusable components.

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