Specifications include, but are not limited to: l. Contractor shall provide secure electronic transmission of medical claims to insurance companies and electronic eligibility and benefit verification of patient insurance coverage for the State and Third Party Health Departments, as may be identified in agreements between the Contractor and Third Party Health Departments. A.4. Service Description. The Contractor shall deliver the services outlined herein. a. Kickoff Meeting. The Contractor shall participate in a planning and strategy meeting with the State within ten (10) business days after the Effective Date to introduce the Contractor to State staff. b. Project Management. The Contractor shall designate one, dedicated project manager to serve as the Contractor's primary point of contact for all activities. c. Payer Client List. The Contractor shall maintain, during the term of this contract, a Payer Client List that includes, at a minimum, Blue Cross Blue Shield of Tennessee, United Healthcare in Tennessee, Cigna in Tennessee, Aetna in Tennessee, Humana in Tennessee, and the managed care organizations that contract with the State of Tennessee Bureau of TennCare to administer managed care medical services for TennCare enrollees. d. Electronic Claims Submission. During the term of this Contract, Contractor shall provide access to updates to the State of payers added to its Payer Client List and payers removed from its Payer Client List. Contractor shall have the ability to transmit State claims to payers on its Payer Client List after sixty (60) days of the Effective Date of the contract with the State. e. Coding Systems. The Contractor shall use the most current versions of industry standard health care coding systems: American Medical Association (AMA®) Current Procedural Terminology International Classification of Diseases Tenth Revision (ICD-10), CDT (Current Dental Terminology), and Healthcare Common Procedure Coding System (HCPCS) . Contractor shall maintain, at no additional cost to the State, and use the most current releases of National Correct Coding Initiative (NCCI) edits from the Centers for Medicare and Medicaid Services (CMS). Contractor shall provide the State a dictionary of current coding systems used for claims.
