Medicaid Operations Services
It is the intent of the State to solicit proposals to obtain a Contractor to perform operations service functions utilizing the Medicaid Management Information System (MMIS). The Medicaid Provider network consist of approximately 40,856 active providers. The Contractor will perform the following services:
Mailroom functions;
Document control (including sorting, batching and electronic scanning of hardcopy claims);
State of the art imaging technology scanning, data entry and key verification, ;
Transmission of both hardcopy and electronic claims data to MMIS;
Output (including printing and distribution of processing reports);
Claims resolution and adjustment preparation;
Provider enrollment activities;
Provider communication and education;
Provider Service Center operation;
Electronic Data Interchange (EDI) support center operation; and
MMIS education and training for SCDHHS staff.
