Transitioning from the Medicaid Management Information System to the Medicaid Information Technology System |
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Rule 5101:3-1-19.4 of the Ohio Administrative Code (OAC) is being adopted to
support a transition from the Medicaid Management Information System (MMIS) to
the Medicaid Information Technology System (MITS) being implemented by the Ohio
Department of Job and Family Services (ODJFS). With MITS, Ohio Medicaid will
retire its nearly 30-year old MMIS and create a more multi-functional, secure,
and provider-accessible system. Beginning July 1, 2011, ODJFS will return to
providers and trading partners certain types of paper-based transactions
because: 1. Several claim formats are being discontinued or replaced. These outdated paper claim forms cannot be processed in MITS. 2. Time must be allowed for current paper transactions to be processed in MMIS and included in the data base before MITS is implemented. The first reason is critical to the successful implementation of MITS because ODJFS will no longer have the technical ability to process outdated institutional, dental, and professional claim forms. ODJFS will need to return paper claims that have not been processed by MMIS to providers for submission through the MITS web portal or through electronic data interchange (EDI). The second reason is equally important because ODJFS needs to implement MITS with the most accurate and up-to-date information possible. This requires ODJFS start with a data base that includes processed paper transactions submitted to MMIS by providers and trading partners. Provider enrollment/reenrollment, demographic changes and certain types of paper claims that are not processed by MMIS prior to the MITS "Go Live" date will need to be returned to providers for submission through MITS. Correct and timely MITS editing, payment, and reporting require that ODJFS have in place a complete and current data base prior to Go Live. For complete information on this issue go to: |
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