APPENDIX I
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| 1. | Advance Planning Document (APD) | |
| 2. | WVMMIS HIPAA Impact Assessment | |
| 3. | WVMMIS HIPAA Blueprint Document June 28, 2001 | |
| 4. | Information Packet includes: | |
| * | Performance-enhancing operational plans and products | |
| * | Components that reside on the ACS's, the State's, or the Department's mainframes, client servers or PC workstations | |
| * | Current production and maintenance schedules | |
| * | Staffing organizational charts for local office staff, programming staff, EDI staff, and pharmacy Point-of-Sale staff | |
| * | Listing of proprietary components | |
| 5. | MMIS information on 3490 magnetic tape cartridge includes: | |
| * | West Virginia MMIS & supporting programs, in most current version | |
| * | Job Control Language (JCL) or other system instructions for operating the West Virginia MMIS, in most current version | |
| * | Record layouts for data files, in most current version | |
| * | Source code, object code, and copybooks | |
| 6. | West Virginia MMIS User Documentation June 2002 | |
| User and operational manuals and other documentation |
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| 7. | West Virginia MMIS System Documentation June 2002 | |
| System and program documentation | ||
| 8. | West Virginia MMIS Production Flow Charts | |
| documents the run sequence of West Virginia MMIS production jobs |
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| 9. | Data Entry (exam entry) and Resolution Manual | |
| 10. | West Virginia Medicaid Billing Instructions | |
| 11. | Provider Enrollment Application Information | |
| Additional Criteria for Specialty, and Various Letters | ||
| 12. | Provider Training Coordinated Payor Workshop Notice & Handout June 2002 (sample) | |
| 13. | Provider Payment Narrative | |
| 14. | Various Reports: | |
| * | Lists of BMS Reports - Daily, Weekly, Monthly, and MARS | |
| * | EDI Monthly Status Reports | |
| * | Monthly Reports for Sterilizations and Hysterectomies | |
| * | Provider Relations Statistics | |
| * | Crosswalks - Local Codes, EOB Codes, Taxonomy to HIPAA Standard Codes | |
| * | Program Instruction Distribution Schedule | |
| * | Provider Enrollment Monthly Reports - See Addendum #2 , Sec. Reference for Question #70 | |
| * | Grants Management Payment Report - WVMC8050-R001 | |
| Proprietary Claim Forms (samples) - available only at the Purchasing Division Offices | ||
| West Virginia State Medicaid Plan - available at the CMS Website http://cms.hhs.gov | ||
Office of Administration And Claims Processing / 350 Capitol Street Room 251 /
Charleston, WV 25301-3709
Updated: 02/02/06