Bidder's Library

Current System Documentation

• Drug Rebate Users Manual (5.7Mb pdf)
• Information Available Online via the DHS Website (18kb pdf)
• MMIS Internal Control Number (ICN) Batch Ranges (85kb pdf)
• MMIS Pricing, Eligibility, Recipient Liability, Financials, Adjustment Logic (279kb pdf)
• MMIS Tables Manual (1.49Mb pdf)
• ND MMIS Current State (565kb pdf)

Data Elements

• Claim Data Elements (409kb pdf)
• Eligibility Data Elements (153kb pdf)
• Pricing Data Elements (128kb pdf)
• Provider Data Elements (115kb pdf)

File Layouts

• MMIS File Layouts
  • Data Entry CMS-1500 Record layout (216kb pdf)
  • Data Entry Dental Record Layout (97kb pdf)
  • Data Entry Drug Claim Record Layout (100kb pdf)
  • Data Entry UB-92 Claim Record Layout (172kb pdf)
  • Drug Rebate History File (14kb pdf)
  • Eligibility File Layout & X-ref Record (38kb pdf)
  • History File Layout (84kb pdf)
  • Online adabas Layout for Drug Rebate (14kb pdf)
  • Provider File Layout (21kb pdf)
  • SB172110 Data Record Layout Sheet (17kb pdf)
  • Simulated Eligibility File Layout (13kb pdf)
• Vision File Layouts
  • Vision System File Layout (510kb pdf)

Flowcharts

• Aging Services Provider Inquiry System (344kb pdf)
• MMIS Business Process Diagram (26kb pdf)

• Translator
  • Translator 270-271 4010A1 (12kb pdf)
  • Translator 276_277 4010A1 (11kb pdf)
  • Translator 278 4010A1 (13kb pdf)
  • Translator 834 4010A1 (10kb pdf)
  • Translator 835-837PPR 4010A1 (10kb pdf)
  • Translator 837-835-820 4010A1 (21kb pdf)
  • Translator Flowcharts Components (47kb pdf)

Reports

• Claims Processing Thruput Analysis (12kb pdf)
• Error Distribution Analysis (83kb pdf)
• MMIS Electronic Distribution Reports (23kb pdf)
• MMIS Paper Distribution Reports (35kb pdf)
• Monthly Statistical Report on Medical Care Part I Section A (13kb pdf)
• Monthly Statistical Report on Medical Care Part I (14kb pdf)
• Monthly Statistical Report on Medical Care Part II Section C (13kb pdf)
• Monthly Statistical Report on Medical Care Part III (12kb pdf)
• Monthly Statistical Report on Medical Care Part IV Section A (14kb pdf)
• Monthly Statistical Report on Medical Care Part IV Section B (14kb pdf)
• Provider Filing analysis (20kb pdf)
• Provider Participation Analysis (80kb pdf)
• Recipient Explanation of Benefits (33kb pdf)
• Yearly HMO PCP Enrollment (18kb pdf)

 

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