Nebraska Medicaid Program

Current Initiatives

MMIS Replacement Project Bidders' Library

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Updated: 06/15/2007 10:29 AM

Medicaid Program Information

• Nebraska General Information Report 2006
• Title 471 -- Nebraska Medical Assistance Program Services
• Title 482 -- Nebraska Medicaid Managed Care
• Title 471 -- Nebraska Medical Assistance Program - Appendix Forms

Organizational Charts

• DHHS Organizational Chart
• IS&T Organizational Chart
• Office of the CIO Organizational Chart

Current System Documentation

• MMIS System Overview
• Managed Care Auto Assignment Algorithm
• Managed Care Enrollment / Disenrollment
• MMIS Interfaces - Summary

File Layouts and Information

• MMIS Data Dictionary
• MMIS M92CLAIM File
• MMIS - NIS Data Formats
  • Control Summary
  • Journal Entry Distribution
  • Journal Entry Interface
  • Variable Transaction
  • Voucher Payment Transaction

DB2 Database Layouts
TAG	MMIS SUBSYSTEM	DATA CONTENT
MCPII	Medical Claims Processing (MCP)	Control / Supporting Data
MCP2	Medical Claims Processing (MCP)	History
MCP3	Medical Claims Processing (MCP)	Suspense
HIPAA EDI Transactions
	270/271	Eligibility & Inquiry and Response
	276/277	Claim Status Inquiry & Response
	277RP	Electronic Claim Activity
	278	Prior Authorization
	820	Premium Payments
	834	Benefit Enrollment
	835	Remittance Advice
	837D	Dental Claim
	837I	Institutional Claim
	837P	Professional Claim
	MCP246	Reversal Processing, displaying previous and current claim information on the 835
MPSII	Medical Provider Subsystem (MPS)	Provider and Trading Partner
MTRI2	Sybase Translator database	EDI transactions maintained in a UDB - Windows Server only
NMCII	Nebraska Managed Care (NMC)	Enrollment Data
NMCI2	Nebraska Managed Care (NMC)	Encounter
NMCI3	Nebraska Managed Care (NMC)	Assessment, Outreach
RFSII	Third Party Liability (TPL)	Health and Casualty
RFSI3	Recipient File Subsystem (RFS)	Recipient and Prior Authorization
RSSI2	Reference File Subsystem (RSS)	Code Sets
SECII	Screening Eligible Children (SEC)	EPSDT
SURII	Surveillance and Utilization Review Subsystem (SURS)	SURS

MMIS Translator

• MMIS Translator Configuation Management System
• MMIS Translator Subsystem Domain
• MMIS Translator / Mainframe Flowchart
• MMIS Translator Inbound / Outbound Processing Overview
• MMIS Translator Inbound X12 Process
• MMIS Translator Outbound X12 Process

Translator Transactions

• Transaction 270 Inbound
• Transaction 271 Outbound
• Transaction 276 Inbound
• Transaction 277 Outbound
• Transaction 278 Inbound
• Transaction 278 Outbound
• Transaction 820 Outbound
• Transaction 834 Outbound
• Transaction 835 Outbound
• Transaction 837D Inbound
• Transaction 837I Inbound
• Transaction 837P Inbound

Reports

• MMIS Report Index

DHHS IS&T Production Network Diagram

• DHHS IS&T Network Diagram

DHHS Information Technology (IT) Policies and Standards

• Software Acceptable Use Policy
• Software Acceptable Use - Employee Home Use Standard
• Software Acceptable General Use Standard
• Information Technology (IT) Security Policy
• Information Technology (IT) Risk Assessment Standard
• Information Technology (IT) Security Audit Standard
• Information Technology (IT) Security Access Control Standard
• Information Technology (IT) Incident Reporting Standard
• Information Technology (IT) Resources Acceptable Use Policy
• Information Technology (IT) Resources Acceptable Use Standard

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