Financial Subsystem. The financial function encompasses claim payment processing, adjustment processing, accounts receivable processing, and all other financial transaction processing. This function ensures that all funds are appropriately disbursed for claim payments and all post-payment transactions are applied accurately. The financial processing function is the last step in claims processing and produces remittance advice statements/explanation of benefits and financial reports. The Contractor’s financial subsystem shall contain such items as: update of provider payment data, tracking of financial transactions, including TPL recoveries and maintenance of adjustment and recoupment processes.
Financial Subsystem. The financial subsystem must provide the necessary data for 100% of all accounting functions including cost accounting, inventory, fixed assets, payroll, general ledger, accounts receivable, accounts payable, financial statement presentation, and any additional data required by TDH. The financial subsystem must provide management with information that can demonstrate that the proposed or existing HMO is meeting, exceeding, or falling short of fiscal goals. The information must also provide management with the necessary data to spot the early signs of fiscal distress, far enough in advance to allow management to take corrective action where appropriate. Functions and Features:
Financial Subsystem. 94 10.7 UTILIZATION/QUALITY IMPROVEMENT SUBSYSTEM ............................95 10.8
Financial Subsystem. (A) The System implemented by CONTRACTOR must include a Financial Subsystem that provides the necessary data for all accounting functions including:
Financial Subsystem. 25 (5) Utilization/Quality Improvement Subsystem......................................................26 (6)
Financial Subsystem. 16.8 Utilization/Quality Improvement Subsystem
Financial Subsystem. The financial subsystem must provide the necessary data for 100% of all accounting functions including cost accounting, inventory, fixed assets, payroll, general ledger, accounts receivable, accounts payable, financial statement presentation, and any additional data required by HHSC. The financial subsystem must provide management with information that can demonstrate that the proposed or existing HMO is meeting, exceeding, or falling short of fiscal goals. The information must also provide management with the necessary data to spot the early signs of fiscal distress, far enough in advance to allow management to take corrective action where appropriate.
Financial Subsystem. 99 ------------------- 1999 Renewal Contract Tarrant Service Area 3 August 9, 1999 4
Financial Subsystem. The financial function encompasses claim payment processing, adjustment processing, accounts receivable processing, and all other financial transaction processing. This function ensures that all funds are appropriately disbursed for claim payments and all post-payment transactions are applied accurately. The financial processing function is the last step in claims processing and produces remittance advice statements/explanation of benefits and financial reports.
Financial Subsystem. 100 1999 Renewal Contract Harrxx Xxxvice Area 3 August 9, 1999
