CMS Certification with ReadyCert

ReadyCert was built to drive Certification projects at lightning speed. ReadyCert treats your project RTM like a Certification checklist, and treats your Certification checklist like a project RTM. Using the familiar process of requirements fulfillment, ReadyCert empowers your Enterprise to recycle the work of Certification by transforming checklist items and solution requirements into relate-able data elements. When loaded in ReadyCert your system review criteria, fulfillment responses, evaluations and artifacts are quantified and tracked across projects and enterprises to provide deep intelligence and insight into your Compliance narrative.

PL.PR2.1

Provider Management Checklist (MMIS Module)

CSF PR2: State ensures quality of provider network and accuracy of payment arrangement.

PL.PR2.1

Checklist Item Guidance

For R1, evidence could include acquisition documents, user stories or epics, requirements specifications, a ConOps that explains how this functionality will be implemented, or other planning documents that demonstrate plans to incorporate this capability. For R2 and R3, evidence could include a list of provider-specific reimbursement rates, including periods for which they were / are valid. This list should be an extract from the system. For R3, evidence should show that this capability was functional at go-live. For R2 (if not a desk review) and R3, the state should be prepared to give a demonstration of this capability.

Checklist Item Source

SMM

Checklist Item Criteria

The system maintains multiple provider specific reimbursement rates with begin and end dates, consistent with state policy. Examples include: per diems, level-of-care per diems, case mix, percentage-of-charge rates, rates based on level of care, preferred provider agreements, managed care agreements, volume purchase contracts, or other cost-containment initiatives with begin and end effective dates.

Certification with ReadyCert

ReadyCert saves time and effort when producing the required evidence and reports for compliance with PL.PR2.1. Does your company's solution or medicaid enterprise system comply with ... "The system maintains multiple provider specific reimbursement rates with begin and end dates, consistent with state policy. Examples include: per diems, level-of-care per diems, case mix, percentage-of-charge rates, rates based on level of care, preferred provider agreements, managed care agreements, volume purchase contracts, or other cost-containment initiatives with begin and end effective dates." ... Prove it meaningfully with ReadyCert. Provide clear and concise linkage from the RFP, to the Test Case, to the utilization reports and a secure and convenient application specially engineered to make compliance work quick and easy.

ReadyCert is the Software as a Service (SaaS) answer to Compliance! Take the tour with one of our subject matter experts with you or your entire team. You'll learn how ReadyCert will save your team time and effort when performing compliance work by automating mundane tasks and streamlines reporting across projects, enterprises and frameworks. Our team will show you how ReadyCert improves consistency and eliminates duplicate work scenarios, how it tracks vendor information and how controls are mapped to your enterprise's business areas.

Fill out this form and/or give us a call! +1.850.201.7146

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.