MITS is Ohio's new Medicaid Information Technology System which will replace the 20-year-old legacy Medicaid Management Information System (MMIS). The go-live date for MITS is August 2, 2011.
What are some of the benefits that MITS will offer Ohio Medicaid?
When fully operational, MITS will provide many benefits to ODJFS staff, Medicaid providers, consumers, sister state agencies, and other Medicaid stakeholders. Here are just a few of the benefits.
• Integrate currently standalone software and business processes into a single strategic Medicaid system;
• Provide more timely access to Medicaid data to support policy making, identify areas of progress or areas needing intervention and better informed decision making.
• Offer Web-based access to providers for claims submission as well as claims verification and status reports; submission of prior authorization requests; verification of consumer eligibility status, and submission of provider enrollment applications and re-applications.
• Include clinical claims editing with the ability to track the appropriate utilization of certain health care services.
• Automate several manual and paper driven processes through implementation of an electronic document management system.
What will not change with MITS?
The following will not change with MITS:
• ODJFS will maintain its responsibility to administer the Ohio Medicaid program and related health care programs. As such ODJFS will maintain its commitment to assuring compliance with state and Federal laws and rules, cost efficiency, program integrity, and consumer access to quality care.
• Medicaid covered services will not be changed by MITS.
• Health care providers will still need to have an approved Medicaid provider agreement in order to participate in the program.
• Providers will still submit claims for services provided to Medicaid consumers and receive payment for them. ODJFS will remain the primary point of contact regarding issue resolution for claims.
• Providers will continue to be able to verify consumer eligibility through the new MITS Web Portal.
• Specified Medicaid services will still need to be prior authorized before they can be approved for Medicaid payment.
• Information on the Medicaid program, such as billing rules and coverage, will continue to be available on the ODJFS Website and in the public section of the new MITS Web portal.
• Existing direct deposit information for providers will not change with the implementation of MITS. Providers will be able to have their Electronic Funds Transfer (EFT) go to a personal or business checking or savings account.
• Some functions related to the Ohio Administrative Knowledge System (OAKS) such as EFT, will not change as a result of MITS.
What features will be available in the new MITS Web Portal?
The new MITS Web Portal will retain all of the features currently available in the current legacy Medicaid Portal and will introduce many new features. The new MITS Web Portal will contain two sections, one open to the public and one that is secure for access only by providers or their designees.
The public section will be accessible to anyone with Internet access via Internet Explorer version 6.5 – 8.0 or Firefox 1.5 – 3.5. High speed connectivity is strongly recommended. The public section will contain general information about the Ohio Medicaid program including fact sheets, forms, policy manuals, and other program information. New features available via the public section of the new MITS Portal include:
• Ability for the public to locate Medicaid providers via a Provider Directory.
• Ability to view fee schedules.
• Ability to submit and track Provider Enrollment applications and related documentation.
• Ability to enroll as a trading partner.
• Ability to submit Prior Authorization requests for medical services.
The secure section of the new MITS Web Portal will continue to be private and security protected as it contains confidential and personal information. It may be accessed only by providers, and other authorized entities, who have a formal business relationship with Ohio Medicaid. These providers can perform all current functions provided by the current legacy Medicaid Portal (direct data entry of claims, Medicaid eligibility verification and obtaining remittance advice) plus other functions such as:
• Maintain certain provider demographic information.
• Submit and track requests for prior authorization for certain services or equipment, including electronic submission of medical documentation and other related attachments.
• Receive "real time" status report of requests for prior authorization, duplicate submissions.
• Enroll as a Medicaid provider.
• Submit claims in "real time," including related attachments.
• Receive immediate feedback regarding claims that have been submitted for payment and have the opportunity to revise and resubmit claims online.
• Upload the 6653 timely filing form for consideration.
Other Important facts include:
• TPL and/or Medicare claims must be submitted via EDI or web portal.
• 6780 forms are no longer being accepted (as of 6/27/11). If a form is mailed to ODJFS, it will be returned to you. PRC Medical will submit secondary electronic claims for all of our clients who use the PM+ system.
• 6653 are also being returned as of 6/27/11. They will still accept paper 6653 forms, but they cannot be mailed until after the MITS go live date. These are going to be handled by another department so responses are handled in a more timely manner.
• 6768 (claim reversal form) will also be discontinued as of 6/27/11.
• The ODJFS customer service staff will be going back through a crash course on the MITS system the week prior to go live.
• MMIS web portal is available until 7/22/2011 for claim submissions. There will then be a dark week until the 8/2/11 go live date.