J4 MSPRC NonIT Deliverables 12012010 DRAFT.pdf

MSPRC Non IT Deliverables

Attachment J-4 1

Related

SOW

Section

Number

Major Section

Name Deliverable Name Deliverable Description Deliver to

Deliverable

Due Date Frequency

C.3 Program Management

Requirements

Standard Operating

Procedures (SOP)

Provide copies of all SOPs related to each requirement in the contract.

Project

Officer

When updates are made.

C.3.1.1

Functional

Requirements

Non-Scheduled Downtime Supply a report for each incidence of non-scheduled system downtime for each instance greater than 30 minutes.

Project

Officer

As needed

C.3.1.2.1

The Medicare Data

Communications

Network (MDCN)

MDCN Connectivity Request Supply a connectivity request to OIS and complete the technical exchange necessary.

Project

Officer

C.3.1.4

Federal Telecommunications

System 2001 Network

Downtime

Supply a report when telecommunications equipment services are interrupted for more than 30 minutes.

Project

Officer

As needed

C.3.2.8 Record Retrieval Requests Supply a report showing the number of record retrievals requests containing the date of request, nature of request, and the date of retrieval.

Project

Officer

Within 5 days of retrieval request.

Attachment J-4 2

Related

SOW

Section

Number

Major Section

Name Deliverable Name Deliverable Description Deliver to

Deliverable

Due Date Frequency

C.3.3.2 Program Management

Requirements

Training Materials The training materials will be made available upon request.

Project

Officer

One Time and when updates are made.

C.3.3.2 Program Management

Requirements

Report of Training Trend

Analysis

Supply a report showing how quality issues and trends identified equate to training initiatives.

Project

Officer

When updates are made.

C.3.3.4.12 Letter Language Supply copies of all recommend letters to be used in the recovery process which are not contained in Attachment J1.5. CMS will respond to the requested letters within 5 business days from receipt of the letter..

Project

Officer

As needed.

C.3.3.4.20 Bankrupt/Liquidated Entity

Listing

Supply a report documenting identified

MSP debtors having filed for bankruptcy/liquidation and their current filing specifics.

Project

Officer

Quarterly

C.3.3.4.23 MSP Savings Report Supply a monthly report of savings due to recovery.

Project

Officer

Within 5 days after prior month end.

Monthly

C.3.5.1 Joint Operating Agreements Execute JOAs with all interfacing entities to ensure all parties understand and agree to their respective roles and responsibilities.

Project

Officer/BCC

/QICs/Medi care Claims

Processing

February 15 th

Annually

Attachment J-4 3

Related

SOW

Section

Number

Major Section

Name Deliverable Name Deliverable Description Deliver to

Deliverable

Due Date Frequency contractors/

C.3.5.3 QIC Referrals Supply a report listing the volume of QIC nd level appeal referrals, date referred, QIC decision with date, nature of effectuation and date of effectuation.

Project

Officer

Monthly

C.3.5.4 Referrals to FFS/MAC Upon request supply a listing of all provider, physician or other supplier referrals as a result of receipt of a provider, physician or other supplier voluntary/unsolicited refund or VDD from the employer/insurer.

Project

Officer

Ad-Hoc

C.3.6 Banking Relations Request for Refund Voucher Submit a report with back up documentation/justification to request issuance of excess funds, duplicate recovered funds, erroneously deposited funds, etc.,.

Project

Officer

No less than

B-Weekly

C.3.7.3 AR Validation and

Certification

MSPRC CFO shall supply certification of all financial data which supports any AR adjustments on Medicare contractor converted MSP debts.

Project

Officer

End of the

Base year.

Annually

C.3.7.4 Financial Deficiencies Report Provide a report of initial Corrective

Action Plans (CAPs) that address all of the reported findings.

Project

Officer

45 days calendar days of receiving the final audit report.

Attachment J-4 4

Related

SOW

Section

Number

Major Section

Name Deliverable Name Deliverable Description Deliver to

Deliverable

Due Date Frequency

C.3.7.5 Financial Management of Trust Fund Dollars

Write-Off Closed

Recommendations

Supply are report containing recommendations to write off closed debts which meet the criteria in J1.2

Project

Officer

Quarterly

C.3.7.6 AR Trend Analysis Report Supply results of the required AR trend analysis, inclusive of aberrances, corrective actions and results.

Project

Officer

Quarterly

C.3.9.3

Corrective Action Report Provide a report detailing any internal control or quality findings, correction action plans, and proof of the resolution of the findings.

Project

Officer

Quarterly

C.3.10.3

Functional

Requirements

CAP Status Report Supply a report documenting the CAP and it status or progression to resolution.

Project

Officer

Quarterly

C.3.10.6 System Security

Certification

System Security Certification Submit a certification that system security complies with current Federal and DHHS computer security policies, standards and guidelines.

Project

Officer

20 Days after date of implement-ation

Yearly

C.3.11.1 Program Management

Requirements

Outreach Plan Supply proposed outreach plan detailing the contractors approach to the debtor and legal community.

Project

Officer

Within 30 days after award.

One Time