Modernizing Medicaid Management Systems For Escalating Claims Volume
Future-proofing State-wise Medicaid Systems
My3Tech’s MMIS Modernization helps states shift from legacy MMIS to a modern, modular Medicaid system. Powered by GenAI,
cloud-native tech, and API-first design, it aligns with MITA 3.0 and CMS guidelines—cutting costs, speeding compliance, and
improving experiences for providers, beneficiaries, and administrators.
Modernization
Modernized and modular Medicaid systems helping states adopt new features into Medicaid programs
AI-automation
Opportunity to integrate AI and automation tools to improve MMIS operational capabilities
Interoperability
Better interoperability with state Medicaid programs and healthcare systems for data exchange
Featured Use Case
Modernized a Claims CSR Portal on
MITA Compliant Architecture for
(US State name)
Built a unified platform for child health
and the state Medicaid program of
(US State name)
Modernized a Claims CSR Portal on
MITA Compliant Architecture for
(US State name)
MMIS – Our Solution Focus Areas
MMIS Modernization
Phased transformation to upgrade individual MMIS components, including provider management, claims processing, and enrollment.
Medicaid Enterprise Systems Transition
Navigating a shift from traditional MMIS ecosystems to advanced Medicaid Enterprise Systems (MES) for program efficiency.
Access-defined User Portals
Intuitive, accessible, and secure interfaces developed and customized for state workers, providers, and beneficiaries.
CMS & MITA Compliance Readiness
Compliance alignment with federal mandates to ensure future-proofing of systems, regulatory readiness, etc.
Modular Transformation
A low-risk modular approach to Medicaid modernization transforming individual components such as case management, remittances, etc.
Faster Data Interoperability (FHIR)
FHIR services for care providers and state Medicaid agencies to achieve seamless, secure, and standardized data exchange.
Different Modules To Modernize MMIS
Our Medicaid Modules provide a centralized, user-friendly platform that strengthens collaboration between state Medicaid agencies and healthcare providers. By minimizing reliance on traditional methods such as paper forms, faxes, and phone calls, the solution enhances communication, streamlines operations, and enables faster, more efficient, and cost-effective interactions.
Explore The Core Modules
- Non-Emergency Medical Transportation System
- Data Warehouse, Analytics, Decision Support
- Provider Enrollment (PE) Portal
The NEMT module assists eligible Medicaid recipients with travel reimbursements for non-emergency medical
needs, covering medical appointments, prescription pickups, and essential medical supplies.
Recipients can access and review claims and update manage banking information.
Recipients can receive reimbursements of medical appointments, overnight travel, and lodging.
Travel providers can register, manage banking, submit & track TA claims, and access messages.
State staff can review, process or deny claims and Travel Advances (TAs), and review payroll reports.
The NEMT module assists eligible Medicaid recipients with travel reimbursements for non-emergency medical
needs, covering medical appointments, prescription pickups, and essential medical supplies.
Recipients can access and review claims and update manage banking information.
Recipients can receive reimbursements of medical appointments, overnight travel, and lodging.
Travel providers can register, manage banking, submit & track TA claims, and access messages.
State staff can review, process or deny claims and Travel Advances (TAs), and review payroll reports.
The NEMT module assists eligible Medicaid recipients with travel reimbursements for non-emergency medical
needs, covering medical appointments, prescription pickups, and essential medical supplies.
Recipients can access and review claims and update manage banking information.
Recipients can receive reimbursements of medical appointments, overnight travel, and lodging.
Travel providers can register, manage banking, submit & track TA claims, and access messages.
State staff can review, process or deny claims and Travel Advances (TAs), and review payroll reports.
Other Featured Modules
User Administration
/Maintenance
Establishes foundational access controls within the Medicaid portal, managing user roles and permissions, with the ability to track and monitor real time.
Incident Reporting & Case Management
Enables electronic submission of incident reports with attachments to federal/state agencies supporting compliance and efficient incident management.
Claims Management
Module offers comprehensive claims management tools, facilitating submission, status tracking, and queue management for simplified claims submission.
Care Management
Facilitates the program management for primary care providers and health homes, improving care access, care quality, care costs, and outcomes.
Medicaid Remittance Advices (RA)
Allows providers to access and download remittance advices (RAs) in PDF format, including details on claim status, denial reasons, billed and paid amount.
TSU Call Log
Offers state wise Telephone Service Units (TSUs) with a system to log and manage Medicaid service calls for service improvements.
Appeals & Communications Case Management
Providers can submit appeals and coverage requests, enabling state staff to review and process them efficiently, with real-time, two-way communication.
Recipient Eligibility & Service Limit Inquiry
Equips providers with tools to inquire about Medicaid coverage eligibility and service limits for recipients, ensuring informed care and compliance.
In-Patient Stay Reporting & Case Management
Module tracks and manages cases for patients with extended hospital stays to improve care, covering all Medicaid recipients, including
Specialized Solutions Set Us Apart
States Prevent More Frauds
Better fraud prevention with advanced system besides identity verification and real-time analytics. This enables states to detect and stop claims fraud before they occur.
Admins Experience Better Performance
Modular tools enable incremental upgrades without disrupting essential services, improving system performance and end-user experiences.
Stakeholders Have Real-time Visibility
As data-driven analytics unlocks valuable Medicaid insights, providers and states gain real-time visibility into ops, spending, and program outcomes.
Faster Processing With Claims Accuracy
Agents can validate claims during pre and post payment checks to maintain compliance and reduce errors. With improved claims accuracy, approvals are more quicker.
Members Have Expanded Access To Care
Diverse Medicaid modules streamline eligibility and enrollment, removing barriers and simplifying member experiences - from eligibility to claims approval to funding.
