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Medicaid Management Information System

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Submitted By hasanthi
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Information system (Medicaid Management Information system)
I would like to pick up MMIS (Medicaid Management Information system) as my topic today.
MMIS is coupled with multiple entities like claims, provider, client, PA(Prior Authorization), TPL(Third Party Liability), DRB ( Drug Rebate) subsystems.
First of all client enrolls into the state medicaid system. When the client goes to the provider, they will verify the insurance and claims to it. All this data was collected from frond end screens, paper, fax, imaging and stored in Oltp system. The data is then moved to ware house by using ETL tools like datastage, informatica etc. The same data will be used to reporting purposes by using tools like cognos, business objects etc.
The components of the information system are:
1. Hardware: It is equipment that processes the data for information and it includes input, output, storage and communication devices. Typically in MMIS environment we need to figure the # of server’s needed, capacity, storage before kicking off the project.
2. Software: software is a set of instructions written in a specialised code that convert data into information. Need to decide what COTS products need to be used for the project.
3. System Policies: It governs the operation of a computer system. Set some system policies for securing the data, testing policies etc.
4. Data: Data was used by the programs to produce useful information. Data are stored in machine readable form until the computer needs them.
5. People: The combination of all of hardware, software makes it possible for people in organizations to analyze data much more effectively.IT is the component that mostly influence the success or failure of information

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