Medicaid Management Information System
GPTKB entity
Statements (51)
| Predicate | Object |
|---|---|
| gptkbp:instanceOf |
healthcare information system
|
| gptkbp:abbreviation |
gptkb:MMIS
|
| gptkbp:component |
claims processing
decision support member management provider management management reporting third party liability surveillance and utilization review drug rebate processing encounter processing |
| gptkbp:country |
gptkb:United_States
|
| gptkbp:fundedBy |
gptkb:government
gptkb:state_order |
| gptkbp:integratesWith |
gptkb:Managed_Care_Organizations
Decision Support System Data Warehouse Pharmacy Benefit Management System Third Party Liability System CMS federal systems Drug Rebate System Medicaid Eligibility and Enrollment System Provider Enrollment System Surveillance and Utilization Review Subsystem |
| gptkbp:introducedIn |
1970s
|
| gptkbp:purpose |
manage Medicaid claims
process Medicaid payments support Medicaid program administration |
| gptkbp:regulates |
42 CFR Part 433 Subpart C
|
| gptkbp:relatedTo |
gptkb:Medicaid
gptkb:Medicaid_Enterprise_Systems Medicaid Eligibility and Enrollment System |
| gptkbp:requires |
Social Security Act Section 1903(r)
|
| gptkbp:supports |
Medicaid program integrity
Medicaid cost containment Medicaid fraud detection |
| gptkbp:technology |
cloud computing
mainframe web-based interfaces |
| gptkbp:type |
gptkb:financial_services_company
claims data provider data drug rebate data encounter data member data third party liability data utilization data |
| gptkbp:usedBy |
gptkb:Centers_for_Medicare_&_Medicaid_Services
gptkb:state_Medicaid_agencies |
| gptkbp:bfsParent |
gptkb:California_Medicaid_Management_Information_System
|
| gptkbp:bfsLayer |
7
|