Specifications include, but are not limited to: The Contractor will: • provide a Contractor hosted solution (web application) to support NYS’ management of Early Intervention Program’s functions including provider enrollment and management, case management, and fiscal management. The Contractor’s solution must stay current with Health Insurance Portability and Accountability Act (HIPAA) version 5010 and the International Classification of Diseases (ICD-10) Coding System, as well as CPT and Healthcare Common Procedure Coding System (HCPCS) coding and the National Provider Identification (NPI) Database and any successor versions; • utilize commercial off the shelf (COTS) software or an existing platform that must be configurable to meet NYS requirements. The Contractor hosted system must have the ability to be modified to respond to Federal or State/Legislative changes including but not limited to changes in EIP provider reimbursement rates and methodology; • the Contractor hosted solution (web application) must be accessible via the Department of Health’s secure web portal, Health Commerce System (HCS), which requires a user ID and password via a web page and the web application must be compatible with any available internet browsers; have cross-browser compatibility with frequently used browsers; users will not need to download any proprietary software to utilize system(s); unless such software is necessary for access via mobile device; • ensure adherence to Federal Part C and state requirements1 related to provider enrollment and management, case management, and fiscal management for all EIP functions; • receive DOH-entered provider enrollment information necessary for adherence to federal and state requirements1 as well as for EIP provider and case management activities; • meet all federal and state requirements1, allow for data collection/capture, user editing/data correction/modification and reporting for all EIP provider enrollment/management, case management and fiscal management needs; • accept reference data generated by New York Early Intervention System (NYEIS), the DOH’s current EIP information management systems, until these functions transition to the Contractor (see Attachment Q); • have functionality in the vendor-hosted web application to allow EIP providers to manually enter claims and to receive HIPAA compliant electronic data files for services rendered under the EIP into the web application for processing and adjudication; • process payment of providers through a State-designated bank on behalf of municipalities, and process reimbursement of the State share owed to municipalities; • submit EIP provider claims electronically to third-party payers, including commercial insurers, Child Health Plus (CHP), and Medicaid, for payment; • maximize third-party payments, including Medicaid and commercial insurance; • ensure that claims are paid accurately and in conformance with DOH requirements1 and with Generally Accepted Accounting Principles (GAAP); • allow for data entry by EIP of vendors who can provide ATD, respite and transportation and process claims for reimbursement; • ensure Medicaid Code 35 assignments (see Attachment R) are made and claims are processed appropriately.