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Medicaid Management Information System (MMIS) FAQs

For more detailed information regarding payments or the MMIS implementation click on one of the links below:

General FAQs
  • What is Medicaid Management Information System (MMIS) and why is it changing?
    • The new MMIS replaces the existing MMIS and significantly enhances the claims processing and related activities for DCH-managed programs, such as PeachCare for Kids® and Medicaid. The go-live date for MMIS is November 1, 2010.
    • The new MMIS was constructed with the following priorities:
      • Assumption of operations without disruption in services or payments;
      • Maintaining and achieving federal MMIS certification;
      • Ability to process all requirements of Georgia Medicaid Reform;
      • Compliance with all HIPAA requirements;
      • Timely design and development of new components affecting providers (Web portal, Web-based claims submission);
      • Design and development of components that improve efficiency and convenience for State staff; and
      • Design and development of components that improve Contractor efficiency.
  • What are the benefits of the new MMIS?
    • Real-time processing of claims, weekly financial cycle. Providers can submit their claims and follow up immediately if they're being paid. If there is no problem, the claim will be paid that week.
    • Provider can follow up on claims status anytime (paid, suspended, and denied) regardless of if they are paper or electronic. They always know what's going on with getting paid for their services.
    • Eligibility verification requests submission via the Internet. Providers can go directly to the internet to determine eligibility before they provide the service. This will reduce fraud and Medicaid cost.
    • Numerous Web-based options, including provider enrollment and service authorization.
    • Web-based eligibility verification with additional eligibility information. Provider can go to the web to find if a member is eligible for a service. This ensures payment to the provider and saves time.
    • Computer-based training available on the Web. Providers can learn how to use the system on the internet instead of attending a class. For providers in rural areas this keeps them serving patients instead of being away from the office in training.
    • Remittance Voucher access via the Internet. The RA can be accessed via the internet instead getting a bulky paper document. Saves time and saves money. DCH does not have the mail the RA and the provider can store it electronically for later review.
  • What is new to providers?
    • Web-based eligibility verification with additional eligibility information;
    • Computer-based training available on the Web;
    • Interactive claim submission of claims with rapid response times;
    • Claim status capabilities via the Internet; and
    • Remittance Voucher access via the Internet.