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

Steve Sisolak Suzanne Bierman, JD, MPH Governor Administrator Division of Health Care Financing and Policy Medicare Care Advisory Committee Medicaid Management Information System (MMIS)Modernization Briefing April 9, 2019

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 2 Division of Health Care Financing and Policy

Nevada Medicaid Management Information Systems • Issue Tracking Closed Aging Report 200 180 1 2 2 160 3 140 71 4 120 100 80 60 35 60 19 40 39 11 30 45 20 17 6 8 17 11 11 6 0 7 or less 8-14 15-21 22-28 more than 28 3 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 4 Division of Health Care Financing and Policy