Authorization Number : 50750283
Agency Series No. : 2020-00-04
Status : Active
Agency Web Link :
Agency : ODM
Confidential Description : Records may contain individual private Protected Health Information (PHI), Confidential Personal Information (CPI), Personally Identifiable Information (PII), or State Sensitive Information (SSI).
Division : ODMFISC
Vital Description : Transactional data processed and produced by the system includes data associated with claims, prior authorizations, encounters, and financial management; and is needed by the agency to perform its operations on a daily basis. The same holds true in the event of a disaster.
Section : ODMFISC
Record Title : Fiscal Intermediary Records and Data Retention Schedule
Revision : 0
Record Description : The Fiscal Intermediary (FI) module will store and process data associated with adjudication and payment of Fee-for-Service (FFS) claims, routing of Managed Care claims submitted by Managed Care participating Providers to Managed Care Organizations (MCOs), processing and management of FFS Prior Authorization requests and responses, routing of Managed Care Prior Authorization requests and responses between Managed Care participating Providers and MCOs, receiving Managed Care Encounters from MCOs, and reconciliation activities. The FI vendor will also be responsible for storing and processing data resulting from ODM’s financial management operations.