Medical Assistance - Program Operation - Director's Subject Files
Scope and Contents
This series consists of: (1) originals and copies of Division policies, procedures and directives (2) proposals (3) computer change requests, and (4) related correspondence between departments, inter-office and other offices Also included are Claims Processing Status Reports, for Medicaid and Medicare claims, submitted on a weekly basis. Each report gives that week's: (1) total number of claims received (2) total number of claims being processed both by the Department of Medical Assistance and Department of Administrative Services (3) grand totals of claims between both DMA and DOAS, and (4) total number of claims adjudicated These reports are generally accompanied by computer printÂout sheets and related papers. These files document the operation of the Program Operation Division which is responsible for preparing and adjudicating Medicaid claims for payment. This is accomplished by: (1) coordinating the claims, processing, provider, recipient and reference sub-system of the Medicaid Management Information System (MMIS) in ensuring that the processing and payment of claims are made within Federal and State regulations (2) maintaining a close relationship with DOAS in relation to the data processing services they provide (3) expediting the payment and/or rejection of claims in "suspense" due to program edits, and (4) identifying system and programming problems which cause backlogs or erroneous payments and recommending solutions to these problems.
Dates
- Created: 1976-1979
Creator
- Medical Assistance (Organization)
Conditions Governing Access
Unrestricted
Extent
2.50 Cubic Feet
Language of Materials
English
Arrangement Note
The files are arranged alphabetically by subject. The Claims Processing Status Reports are arranged chronologically by year.
- Title
- Medical Assistance - Program Operation - Director's Subject Files
- Author
- Georgia Archives
- Description rules
- Local
- Language of description
- English
- Script of description
- Latin
Repository Details
Part of the Georgia Archives Repository
5800 Jonesboro Rd
Morrow GA 30260 United States