Agency : ODM
Confidential Description : Records may contain client private (PHI) Protected Health Information and/or (CPI) Confidential Personal Information. As such, the records are deemed protected under federal HIPPA and HI-TECH privacy laws.
Revision : 1
Record Description : Claims are received from physicians, dentists, medical suppliers and various providers for payment of services rendered to Medicaid recipients. Records contain detailed information regarding recipient’s background, medical history, provider, type of service, and complete cost breakouts of services rendered to ensure compliance with CMS requirements and Medicaid program policy to minimize potential billing discrepancies. Claims are submitted into the MITS system via electronic imaging, portal or EDI applications. Prior to July, 2011 claims were keyed into the system manually either by internal staff or by a contracted vendor.