Medicaid Provider Screening Portal - Screening Rules for Selected Provider Types Part 7

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Challenge Overview

The United States Center for Medicaid Services ("CMS") is running a Challenge (a series of TopCoder contests) through the NASA Center of Excellence for Collaborative Innovation (CoECI) and TopCoder to develop a web-based portal to support provider enrollment and screening.  Medicaid is a healthcare program that is funded by the US federal government and by individual states.  It is operated by individual states.  The portal developed in this Challenge will allow medical service providers to register themselves in their individual state for compensation from the Medicaid program.  While this alone will provide a very welcome new procedure for providers, who must often fill out many paper forms today, the true goal of the portal will be to automatically screen potential providers for fraud risk before they are approved for Medicaid payments.  The portal will assign a potential level of risk to each registrant, and will do this by applying a suite of dynamic business rules.  Once a level of risk has been assigned, the registrant's application will be sent to the appropriate sub-system for additional screening and processing.

In this Conceptualization contest you are asked to enumerate only the screening rules for selected Provider Types.



Final Submission Guidelines

http://apps.topcoder.com/wiki/display/docs/Medicaid+Provider+Screening+Portal+-+Screening+Rules+for+Selected+Provider+Types+Part+7

ELIGIBLE EVENTS:

2013 TopCoder(R) Open

Review style

Final Review

Community Review Board

Approval

User Sign-Off

ID: 30031621