Improving Lives through a services-based MMIS

Until very recently, when the health care system was not even digitized, it has almost been impossible for individuals, care providers or even the payers to understand or get a real view on how it all works together.
Initially, after digital transformation in the healthcare industry, Medicaid Management Information Systems (MMIS) came into the picture in the 1970s to support Medicaid managed care. Being jointly funded by states and the federal government, Medicaid is the keystone to helping people with limited income and resources in getting high-quality care at minimal medical costs in the US. With millions of beneficiaries – from low-income adults and children to pregnant women, elderly adults and people with disabilities – the Medicaid programs have evolved to become highly complex and multibillion-dollar enterprises as used by policymakers to address various policy objectives.

Though, MMIS was initially designed as a financial and accounting system just to ensure accuracy and zero-delay healthcare transactions and claims. From managed care, clinical support, data analysis and fraud management to non-emergency transportation coordination, and prior authorization – all automated Medicaid functions were combined with MMIS. However, direct communication or information exchange was a bigger challenge. It took a lot to transform MMIS into its modernized version, a hybrid software-as-a-service model and an integrated system to support the entire Medicaid Enterprise in a standard way. Today, it alters the way in which states build, design and alter their Medicaid systems and perform IT investment planning.

Adopt MMIS in today’s changing technology landscape!

While MMIS implementations previously only had states and a single vendor, the landscape looks much different now. Transformation is never easy. The MMIS, as defined to be the single and integrated system of claims processing and information retrieval – the modularized MMIS is an important step toward delivering benefits quickly and more efficiently. Bringing together the best-of-breed tools, a good MMIS provides states with the flexibility of quick adaption to changing policies while still maintaining daily operations.

In the changing landscape of technological advances, identity theft and data breaches have also been increased. An integrated MMIS System can resolve all the complexities of Medicaid programs and work towards growing the programs with its key benefits.

A Disruptive Trend

A Disruptive Trend – Meet Consumer Requirements

Its multi-factor authentication systems with advanced authentication methods help fulfil consumer expectations while focusing on customer services.

Identification System – Get Easy Confirmation

Identification System – Get Easy Confirmation

The advanced MMIS technology helps reduce the risk of improper access, fraud or breaching – without burdening users. In a word, it has a ‘hassle-free’ confirmation system.

Risk Management – Accelerate & Balance Security

Risk Management – Accelerate & Balance Security

While using renewal apps and other flexible technology help provide unparalleled and secured access to services, risk-free access management enables user-transparency

Two key reasons to implement cloud-based MMIS platforms!

implement cloud-based MMIS platforms
Adaptable & Advanced

MMIS is adaptable to evolve with technology year after year.

implement cloud-based MMIS platforms
Scalable & Cost-effective

Its unique technology and scalable system helps create a low-cost, virtual test environment

Codetru’s Service-Oriented MMIS Approach – Simplify Medicaid Challenges!

To understand these complexities better, it’s important to understand MMIS. It is a CMS certified service-based architecture for paying provider claims. It addresses the solution for interfacing with legacy systems from the MMIS, report management, configuring specific policies, rules, etc for EOHHS, (Executive Office of Health and Human Services – the largest secretariat in Massachusetts who is responsible for the Medicaid program, child welfare, public health, disabilities, veterans’ affairs, and elder affairs.) depicting the architecture of the physical environment on which the system runs.
MMIS developed and hosted by Codetru is an automated claim-processing and data-retrieval system for states and the federal Medicaid programs. This is tailor-made to support the key business functions of the providers and maintain information in such areas as provider enrollment such as user eligibility, third party liability; benefit package maintenance; managed care enrollment; claims processing; and prior authorization.
With a scalable system towards the growth of Medicaid programs, it virtualizes external services and creates life-like” test environment through its cost effective ways and service-based approaches.

Codetru’s Service-Oriented MMIS Approach – Simplify Medicaid Challenges!
The Data-gatekeeper – Manage Diverse Data Streams
The Data-gatekeeper – Manage Diverse Data Streams

With increased scalability and security, it helps correlate multiple data sources. Its Management tools help generate synthetic test data, controlled through a self-service portal.

A safe API Gateway – Enhance User Experience

It helps share data quickly and securely with other agencies that help provide back-end service-based architecture connectivity among all the databases.

A safe API Gateway


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