MHBE Provider Directory A service of Maryland Health Benefit - - PowerPoint PPT Presentation

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Sep 27, 2022 296 likes •364 views

MHBE Provider Directory A service of Maryland Health Benefit Exchange Background The MHBE Provider Directory helps consumers identify the providers that participate in QHPs and Medicaid MCOs Developed in 2013 and maintained by CRISP,

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A service of Maryland Health Benefit Exchange

MHBE Provider Directory

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Background

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The MHBE Provider Directory helps consumers identify the providers that participate in QHPs and Medicaid MCOs

– Developed in 2013 and maintained by CRISP, Maryland’s Health Information Exchange – Averaged over 650 users per day during OE3

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Background

3 Provider Error Corrections QHP and MCO provider Files Optum PDM and P360 (data standardizing, matching, and de-duplicating) CRISP (biweekly unified

utput files)

CRISP Provider Search

Data Submission Provider Data Processing Consumer Sites

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Background

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Provider Directory funded in FY2016 through MOU with Maryland Health Care Commission (MHCC)

– Leverages MHCC’s expertise to provide oversight and ensure CRISP performance

More robust provider directory platform will be developed for Integrated Care Network

– Will be designed to meet needs of multiple stakeholders – Cost to develop and maintain would be shared by multiple stakeholders

HB1318 prohibits the MHBE Board from setting standards on carrier provider directories until 2019.

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FY 2017 Proposal

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FY 2017 budgeted amount is $265,000 total funds ($151,050 state funds) Proposed NTE is $251,526 total funds (143,370 state funds) Continue to fund through MOU with MHCC Proposed MOU includes the following services:

CRISP Service Annual Cost PDM (Optum) - Core Processing $138,000 P360 (Optum) - Data Cleansing $39,900 Hosting at Amazon $8,760 Project Management / Operations $42,000 Overheads $22,866 Total $251,526