Common use of Input Processing Clause in Contracts

Input Processing. The Contractor shall support both hardcopy and electronic submission of claims and encounters for all claim types (hospital, medical, behavioral, dental, pharmacy, MLTSS, etc.). The Contractor should also support hardcopy and electronic submission of referral and authorization documents, claim inquiry forms, and adjustment claims and encounters. Providers shall be afforded a choice between an electronic or a hardcopy submission. Electronic submissions include diskette, tape, clearinghouse, electronic transmission, and direct entry. The Contractor must process all standard electronic formats recognized by the State. The Contractor may use any clearinghouse(s) and/or alternatively provide for electronic submission directly from providers to the Contractor. The Contractor will have the ability to accept all electronic crossover claim submissions from the State’s fiscal agent. The system shall maintain the receipt date for each document (claim, encounter, referral, authorization, and adjustment) and track the processing time from date of receipt to final disposition.