System and Data Integration Requirements Sample Clauses
The System and Data Integration Requirements clause defines the obligations and standards for ensuring that different software systems and data sources can effectively communicate and operate together. It typically outlines the technical protocols, data formats, and security measures that must be followed when integrating new or existing systems, such as requiring the use of specific APIs or data exchange standards. This clause is essential for preventing compatibility issues, streamlining workflows, and ensuring that information flows seamlessly between platforms, thereby reducing operational inefficiencies and integration risks.
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System and Data Integration Requirements. 4.17.5.1 All of the Contractor’s applications, operating software, middleware, and networking hardware and software shall be able to interface with the State’s systems and will conform to standards and specifications set by the Georgia Technology Authority and the agency that owns the system. These standards and specifications are detailed in Attachment L.
4.17.5.2 The Contractor’s System(s) shall be able to transmit and receive transaction data to and from the MMIS as required for the appropriate processing of Claims and any other transaction that may be performed by either System.
4.17.5.2.1 The Contractor shall generate encounter data files no less than weekly (or at a frequency defined by DCH) from its claims management system(s) and/or other sources. The files will contain settled Claims and Claim adjustments and encounters from Providers with whom the Contractor has a capitation arrangement for the most recent month for which all such transactions were completed. The Contractor will provide these files electronically to DCH and/or its designated agent in adherence to the procedure and format indicated in Attachment L.
4.17.5.2.2 The Contractor’s System(s) shall be capable of generating all required files in the prescribed formats (as referenced in Attachment L) for upload into state Systems used specifically for program integrity and compliance purposes.
4.17.5.3 The Contractor’s System(s) shall possess mailing address standardization functionality in accordance with US Postal Service conventions.
System and Data Integration Requirements. 1. Adherence to Standards for Data Exchange
a. Health Plan Systems shall be able to transmit, receive and process data in HIPAA-compliant formats that are in use as of the Contract Execution Date; these formats are detailed in Section XI.J.
b. Health Plan Systems shall be able to transmit, receive and process data in the Agency-specific formats and/or methods that are in use on the Contract Execution Date, as specified in Section XI.J.
c. Health Plan Systems shall conform to future federal and/or Agency specific standards for data exchange within one hundred twenty (120) Calendar Days of the standard’s effective date or, if earlier, the date stipulated by CMS or the Agency. The Health Plan shall partner with the Agency in the management of current and future data exchange formats and methods and in the development and implementation planning of future data exchange methods not specific to HIPAA or other Federal effort. Furthermore, the Health Plan shall conform to these standards as stipulated in the plan to implement such standards.
System and Data Integration Requirements. 17.3.1 The Contractor’s applications shall be able to interface with ASES’s systems for purposes of data exchange and will conform to standards and specifications set by ASES. These standards and specifications are detailed in Attachment 9.
17.3.2 The Contractor’s System(s) shall be able to transmit and receive transaction data to and from ASES’s systems as required for the appropriate processing of Claims.
17.3.3 Each month the Contractor shall generate Encounter Data files from its claims management system(s) and/or other sources. The files will contain settled Claims and Claim adjustments and Encounter Data from Providers for the most recent month for which all such transactions were completed. The Contractor shall provide these files electronically to ASES and/or its Agent in adherence to the procedure, content standards and format indicated in Attachment 9. The Contractor shall make changes or corrections to any systems, processes or data transmission formats as needed to comply with Encounter Data quality standards as originally defined or subsequently amended.
17.3.4 The Contractor’s System(s) shall be capable of generating files in the prescribed formats for upload into ASES Systems used specifically for program integrity and compliance purposes.
17.3.5 The Contractor’s System(s) shall possess mailing address standardization functionality in accordance with US Postal Service conventions.
System and Data Integration Requirements. The Contractor’s systems shall be able to transmit, receive and process Data in HIPAA-compliant formats that are in use as of the Contract Implementation Date.
System and Data Integration Requirements