MMIS-Provider Services Module

Download MMIS-Provider Services Module  Portfolio Map

A Medicaid Management Information System (also known as “MMIS”) is a mechanized claims processing and information retrieval system that all states are required to have according to section 1903(a)(3) of the Social Security Act defined in Federal Code 42 CFR 433.111. 

The Provider Services module will support provider enrollment, re-validation, and maintenance. The Provider Services vendor will provide a configurable, web based, self-service solution that allows healthcare providers to enroll electronically with Healthcare Programs and provide an option for provider self-service updates.  

Below are some highlights of the benefits from the prospective contract awards:

1.  Modern Provider Enrollment system that is highly configurable, web based, and automates many of the manual functions occurring in the legacy MMIS (e.g., automated workflows, automatically triggered communication based on key elements within the provider’s enrollment record).

2.  User centric Provider Management module that includes a number self-service features not currently available today to improve customer interaction with the State’s Medicaid Agency.

3.  Provider Services solution that is configured “out of the box” to be compliant with current Federal Regulations

Client Network Services, LLC (CNSI) Client Network Services, LLC (CNSI) View Details

DXC Technology Services LLC DXC Technology Services LLC View Details

Digital Harbor, Inc. Digital Harbor, Inc. View Details

HHS Technology Group, LLC HHS Technology Group, LLC View Details

MAXIMUS MAXIMUS View Details

OptumInsight, Inc. OptumInsight, Inc. View Details

Participating Addenda (4)

Lead State

  • Montana
    John Thomas
    [email protected]
    (406) 444-0110
  • Awarded:
    06/01/2018
  • Expiration:
    05/28/2025
  • Renewals Limit:
    05/28/2028

Documents/Details