April 9, 2019 Nevada Medicaid Management Information Systems Go - - PowerPoint PPT Presentation

April 9, 2019

Medicare Care Advisory Committee Medicaid Management Information System (MMIS)Modernization Briefing

Steve Sisolak Governor

Suzanne Bierman, JD, MPH Administrator Division of Health Care Financing and Policy

Division of Health Care Financing and Policy

Nevada Medicaid Management Information Systems

• Go Live occurred on February 1, 2019
• Modernization Accomplishments to Date
• Number of Fee For Services (FFS) claims processed (not including Point of Sale

(POS)): 1,130,904 at $185,576,070

• Number of claims submitted using Direct Data Entry through the Provider Web Portal

(PWP): 160,664

• Number of POS claims processed: 650,185 at $33,949,321
• Number of Prior Authorization requests received: 29,596
• Number of PWP log ins: 8,235,832
• Number of provider enrollment applications and change requests: 4,693

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Division of Health Care Financing and Policy

Nevada Medicaid Management Information Systems

• Issue Tracking

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45 17 11 11 6 60 39 30 17 8 71 35 19 11 6 2 20 40 60 80 100 120 140 160 180 200 7 or less 8-14 15-21 22-28 more than 28

Closed Aging Report

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Division of Health Care Financing and Policy

Nevada Medicaid Management Information Systems

• Paper items no longer accepted and returned to providers:

➢ Claim Appeals: 583 ➢ Enrollment applications: 577 ➢ EDI enrollments: 87 ➢ Authorizations: 43

• Modernization Website:

https://www.medicaid.nv.gov/providers/Modernization.aspx

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