DHCS Consolidated Data Strategy Response for OCIO - State of

					OCIO Data Questionnaire                                              Application

           Application Name                     Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                            Vendor     Programs/                                Source?    (Y/N)
                                                                                        Divisions                                 (Y/N)
   (Medicare) Buy-In (BYN), Title   Medicare Buy-In, Title XVI - A        IBM         DHCS           Yes                        No        No
   XVI (16) - Core MEDS             monthly data exchange between
                                    DHCS and CMMS producing 2
                                    extract files of MEDS db D

   Able Bodied Adult Without                                              IBM         DHCS           Yes                        No        No
   Dependents (ABAWD)
                                    This screen provides statewide
                                    tracking for individuals subject
                                    to the Food Stamp Able Bodied
                                    Adult Without Dependents
                                    rules. It provides a mechanism                                              Person,
                                    to record for a 36-month                                                    Application,
                                    chronological basis, any one                                                food stamps,
                                    individual’s status for ABAWD.                                              eligibility
                                                                          IBM, JAVA   DHCS           Yes                        Yes       No
   Access for Infants and           Low cost health insurance for low
   Mothers (AIM),                   income pregnant women. D
   Accounts Receivable System       Tracks any receivables from           IBM         DHCS           Yes        Invoices,       Yes       No
   (ARS)                            outside resources to DHCS.                                                  vendor,
                                                                                                                Delinquent
                                                                                                                Letters
                                    Owned by DSS, but DHCS                Microsoft   DHCS           Yes                        No        Yes
                                    maintains it, controlling access to
   Aid to Children in Emergency     MEDS via Meds network. No data
   (ACE)                            container




Page 1                                                                                                                                          8/1/2011
OCIO Data Questionnaire                                            Application

           Application Name                    Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                           Vendor     Programs/                                Source?    (Y/N)
                                                                                       Divisions                                 (Y/N)
   Airline System (AS)                                                   Powerbuild DHCS            Yes        employee,      Yes        No
                                                                         er                                    travel agent,
                                                                                                               American
                                                                                                               Express Bill
                                                                                                               File, Travel
                                                                                                               Agent Ticket
                                                                                                               File, expense,
                                                                                                               itinerary
                                   Airline Ticket Processing
   AJAX                                                                  Microsoft   DHCS           Role                       Yes       Yes

                                   A group of interrelated web
                                   development techniques used for
                                   creating interactive web
                                   applications or rich Internet
                                   applications. With Ajax, web
                                   applications can retrieve data from
                                   the server asynchronously in the
                                   background without interfering
                                   with the display and behavior of
                                   the existing page D
   Alternate Health System (AHS)                                         IBM         DHCS           Yes                        No        No
                                   Alternative Health Syss - an
                                   obsolete name for any of many
                                   non-fee-for-service health care
                                   deliv sys. No data container. D
   Antispam                        Application that provides          Proofpoint DHCS               Role                       Yes       No
                                   protection against inbound threats
                                   such as spam, viruses, phishing
                                   and denial-of-service attacks D



Page 2                                                                                                                                         8/1/2011
OCIO Data Questionnaire                                                Application

             Application Name                      Description                Software   Departments/   Security    Type of Data     Best     Critical
                                                                               Vendor     Programs/                                 Source?    (Y/N)
                                                                                           Divisions                                  (Y/N)
   Appeals                             Appeals system for claims and         IBM         DHCS           Yes                         Yes       No
                                       TAR's. D
   Application Tracking                Tracking DHCS equipment               IBM         DHCS           Yes                         Yes       No
                                       purchased on the behalf of
                                       beneficiaries. D
   Audits and Investigations                                                 Microsoft DHCS             Yes                         Yes       No
   Production (AIP)                                                          Visual Basic
                                       The AIP network allows Audits
                                       and Investigations (A&I)
                                       personnel access to a case
                                       tracking system. A&I enters
                                       their cases into the application,
                                       the data is written to a database
                                       and updates are made to
                                       document the current status of
                                       the case. The application uses
                                       Crystal Reports to provide
                                       information to the users on the                                             Provider,
                                       status of their cases and their                                             beneficiary,
                                       case inventory.                                                             case
   Automated Eligibiity Verification                                         Microsoft DHCS             Yes                         No        Yes
   System (AEVS)                                                             Visual Basic
                                       AEVS is an Interactive Voice
                                       Response (IVR) system and Web                                               beneficiary,
                                       Interface that is used by the                                               provider,
                                       provider community. AEVS gives                                              eligibility
                                       information about recipient                                                 determination,
                                       eligibility, Share of Cost, Medi-                                            dates of
                                       service reservation, FPACT HAP                                              coverage,
                                       Cards, DUR conflict messages, POS                                           authorization
                                       reject codes, CDP-EWC eleigibility.                                         id



Page 3                                                                                                                                              8/1/2011
OCIO Data Questionnaire                                             Application

           Application Name                     Description              Software    Departments/   Security    Type of Data    Best     Critical
                                                                          Vendor      Programs/                                Source?    (Y/N)
                                                                                       Divisions                                 (Y/N)
   Automated Transaction                                                 IBM         DHCS           Yes        Claim,          No        No
   Generator                         Automated Transaction                                                     beneficiary,
                                     Generator (ATG) , is a                                                    error code
                                     collection of utility software that
                                     allows automatic processing of
                                     suspended claims without
                                     human intervention. D
   BENDEX                            One of 4 data exchanges under       IBM         DHCS           Yes                        No        Yes
                                     MMA (Medicare Modernization                                           Person,
                                     Act)                                                                  Income
   Beneficiary Identification Card                                                   DHCS           Unknow Beneficiary,        No        No
   (BIC)                             Provide sufficient controls,                                   n      BC ID
                                     checks/balances, and in-
                                     process quality controls
                                     throughout the production and
                                     mailing of BIC/HAP cards. D
   Blackberry Enterprise Server      Application that allows access to   Research    DHCS           Yes                        No        No
                                     email via Blackberry device.        in Motion                             email, sms
   BMC Remedy Asset                  Software to assist in lowering IT   BMC         DHCS           Role                       Yes       No
   Management                        costs, manage compliance, and
                                     improve return on capital with an
                                     operational approach to life cycle,                                       contracts,
                                     inventory, contract, and cost                                             cost data,
                                     controls of IT assets.                                                    process
                                                                                                               management,
                                                                                                               performance
                                                                                                               measurements




Page 4                                                                                                                                         8/1/2011
OCIO Data Questionnaire                                         Application

           Application Name               Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                      Vendor     Programs/                                Source?    (Y/N)
                                                                                  Divisions                                 (Y/N)
   BMC Remedy Change          A change management application BMC               DHCS           Role                       Yes       No
   Management                 that delivers comprehensive
                              policy, process management, and
                              planning capabilities to help
                              increase the speed and
                              consistency in which changes are                                            process
                              implemented while minimizing risk                                           management,
                              and errors.                                                                 change
                                                                                                          management
   BMC Remedy Incident        An application that provides         BMC          DHCS           Role                       Yes       No
   Management                 incident and problem automated
                              workflow solutions that can cost-                                           Incident
                              effectively reduce the number of                                            Tickets,
                              incidents handled, improve                                                  Incident
                              resolution times and prevent                                                activity
                              future incidents from occurring,                                            tracking,
                              while improving IT staff efficiency.                                        alerts,
                                                                                                          workflow
                                                                                                          routing,
                                                                                                          performance
                                                                                                          measurements
   BMC Remedy Service Level   An application that can keep IT       BMC         DHCS           Role                       Yes       No
   Management                 service delivery and support
                              closely aligned with business
                              requirements and continually                                                process
                              improve service quality.                                                    management,
                                                                                                          change
                                                                                                          management,
                                                                                                          performance
                                                                                                          measurements



Page 5                                                                                                                                   8/1/2011
OCIO Data Questionnaire                                       Application

           Application Name                 Description               Software   Departments/   Security    Type of Data      Best     Critical
                                                                       Vendor     Programs/                                  Source?    (Y/N)
                                                                                   Divisions                                   (Y/N)
   Breast Cancer & Cervical                                          IBM         DHCS           Yes                          Yes       No
   Treatment Plan (BCCTP)        The Breast and Cervical
                                 Cancer Treatment Program
                                 (BCCTP), also administered
                                 through the Department of
                                 Health Services, provides free
                                 cervical cancer treatment to low-
                                 income, uninsured women. No                                               Finance,
                                 data container. D                                                         budgets
                                                                     Clipper     DHCS           Yes                          Yes       No
                                 BUDS (Budget Utilization and
                                 Development System) is the
                                 Department's budget system used
                                 to maintain fund allocations by
                                 organization and program. It is
                                 also used to develop the
                                 budgetary reports due to the
   Budget Utilization and        Department of Finance during the                                          Finance,
   Development System (BUDS)     budget building process.                                                  budgets
   California Point Of Service                                       IBM         DHCS           Yes                          Yes       Yes
   (CALPOS)                                                                                                beneficiary,
                                 CALPOS was designed to                                                    eligibility,
                                 perform on-line, real time                                                pharmacy
                                 prospective drug use review as                                            claim, history,
                                 well as on-line, real time                                                provider,
                                 adjudication of pharmacy                                                  formulary,
                                 claims.                                                                   drug reviews




Page 6                                                                                                                                       8/1/2011
OCIO Data Questionnaire                                          Application

           Application Name                    Description              Software   Departments/   Security    Type of Data     Best     Critical
                                                                         Vendor     Programs/                                 Source?    (Y/N)
                                                                                     Divisions                                  (Y/N)
                                                                       Natoma     DHCS            Role                        No        Yes
                                                                       Technologi
                                    California State On-Line Query     es,
                                    (Cal-SOLQ) provides real-time      Microsoft
                                    access to the Federal Social       .net                                  Access
                                    Security Administration’s SSN,                                           Control, Medi-
                                    Title II and Title XVI
                                                                                                             Cal and
                                    information. California Medicare
                                                                                                             Medicare
                                    Modernization Act Query (Cal-
                                                                                                             eligibility,
                                    MMA) provides authorized
                                    users with an integrated view of                                         prescription
                                    a client’s complete Medi-Cal                                             drug plan
                                    and Medicare eligibility,                                                information,
                                    prescription drug plan                                                   diagnosis
                                    information, diagnosis                                                   information
                                    information and medication                                               and
   California State On-Line Query   history across public and                                                medication
   (Cal-SOLQ)                       private information sources.                                             history
   CALSTARS Interface                                                  IBM         DHCS           Yes                         No        No
                                    Department Personnel Reporting D




Page 7                                                                                                                                       8/1/2011
OCIO Data Questionnaire                                         Application

           Application Name                    Description           Software   Departments/   Security    Type of Data    Best     Critical
                                                                      Vendor     Programs/                                Source?    (Y/N)
                                                                                  Divisions                                 (Y/N)
   Cancer Detection Program (CDP)                                     Microsoft, DHCS          Yes                        No        Yes
                                    All enrollment data is input into WebSphere
                                    the system by Primary Care
                                    Providers (PCPs) only and is
                                    done through a Web- based
                                    form originally developed for
                                    electronic billing for Breast
                                    Cancer     Early    Detection
                                    Program. Case management
                                    fees are only reimbursable for
                                    CDP:EWC providers identified
                                    as PCPs.        The Cancer
                                    Detection Programs: Every
                                    Woman Counts (CDP EWC) is
                                    a Web application used to
                                    enroll women and enter data on
                                    the Internet for the California                                       Person,
                                    Department of Public Health                                           Health,
                                    (CDPH) Cancer Detection                                               Claims,
                                    Section's (CDS) breast and                                            eligibility,
                                    cervical cancer screening                                             provider,
                                    program                                                               application,
   Case Identification/Recovery     D                                 IBM        DHCS          Yes                        No        No
   (CIR)




Page 8                                                                                                                                    8/1/2011
OCIO Data Questionnaire                                           Application

           Application Name                  Description                 Software   Departments/   Security    Type of Data    Best     Critical
                                                                          Vendor     Programs/                                Source?    (Y/N)
                                                                                      Divisions                                 (Y/N)
   Case Management Information                                          Websphere DHCS             Role                       Yes       Yes
   System (CMIS)

                                 The Case Management
                                 Information System (CMIS) was
                                 developed for the Medical Case
                                 Management (MCM) program and
                                 the In-Home Operations (IHO)
                                 program of the Department of
                                 Health Care Services (DHCS). The
                                 CMIS application is an intranet
                                 application that assists case
                                 managers, support staff, and                                                 person,
                                 management oversee and manage                                                service
                                 cases covered under Medi-Cal. The                                            requests,
                                 CMIS application tracks                                                      medical case,
                                 beneficiaries, their providers, and                                          approved
                                 any Medi-Cal services rendered                                               services,
                                 after a beneficiary is accepted into                                         correspondenc
                                 either MCM or IHO program.                                                   e, provider




Page 9                                                                                                                                     8/1/2011
OCIO Data Questionnaire                                       Application

           Application Name                 Description            Software   Departments/   Security   Type of Data    Best     Critical
                                                                    Vendor     Programs/                               Source?    (Y/N)
                                                                                Divisions                                (Y/N)
   Case Management, Information                                    IBM        DHCS           Yes                       Yes       No
   and Payrolling System (CMIPS) The Case Management,
                                 Information and Payrolling
                                 System (CMIPS) tracks case
                                 information and processes
                                 payments for the California
                                 Department of Social Services
                                 In-Home Supportive Services
                                 Program, enabling nearly
                                 400,000 qualified aged, blind,
                                 and disabled individuals in
                                 California to remain in their own
                                 homes and avoid
                                 institutionalization. D
   Cash Control                                                    IBM        DHCS           Yes                       No        No
                                 Cash Control enters data which
                                 updates the Accounts Receivable
                                 (AR) VSAM Master File and feeds
                                 the COBRA system. D
   Casualty Insurance Collection D                                 IBM        DHCS           Yes                       Yes       No
   (CIC)




Page 10                                                                                                                               8/1/2011
OCIO Data Questionnaire                                         Application

           Application Name                 Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                        Vendor     Programs/                                Source?    (Y/N)
                                                                                    Divisions                                 (Y/N)
   Centers for Medicaid and                                           Microsoft DHCS             Role                       Yes       Yes
   Medicare Services (CMS) 64                                         Visual Basic
   System                       The CMS64 Accounting System is
                                developed to automate many of
                                the accounting and reporting
                                requirements of the DHS
                                Accounting/Medical Care Services
                                Section. It is designed to provide
                                for a single point of entry for all
                                Checkwrite and Handfiled Claim
                                Schedules, and HCFA and non-                                                Claim
                                HCFA adjustments. It creates files                                          Payments,
                                and documents necessary to                                                  reports,
                                interface with the State                                                    federal
                                Controller's Office, CALSTARS, and                                          matching
                                the State Treasurer.                                                        funds
   Change Cycle Management      Tracks all change requests through Microsoft DHCS                Yes        Organization,   Yes       No
   System (CCMS)                life cycle.                        Visual Basic                             change
                                                                                                            requests,
                                                                                                            status




Page 11                                                                                                                                    8/1/2011
OCIO Data Questionnaire                                       Application

           Application Name                 Description              Software   Departments/   Security    Type of Data    Best     Critical
                                                                      Vendor     Programs/                                Source?    (Y/N)
                                                                                  Divisions                                 (Y/N)
                                                                    IBM         DHCS           Yes                        Yes       Yes

                                 All children enrolling through
                                 the CHDP Gateway who appear
                                 eligible for no-cost Medi-Cal as
                                 a result of the screening
                                 process qualify for Accelerated
                                 Enrollment (AE) and access to
                                 Healthy Families (HF). The                                               person,
                                 child is provided with immediate                                         application,
                                 temporary Medi-Cal coverage,                                             eligibility,
   Child Health and Disability   for month of application and the                                         provider,
   Prevention (CHDP)             month following.                                                         coverage
   Childrens Medical Services                                       In-House,   DHCS           Role                       Yes       Yes
   Case Management - CMS-                                           MUMPS
   NET                           Medical Case Management system
                                 for Children Services. Manages the                                       person,
                                 approved providers, eligible                                             service
                                 beneficiaries, and services                                              requests,
                                 allowed. These are for specialized                                       medical case,
                                 services to children. Creates                                            approved
                                 Service Authorizations for claim                                         services,
                                 payment approval. Run under an                                           correspondenc
                                 outsource contract.                                                      e, provider
   Cisco Intrusion Detection     Software that provides real-time Cisco         DHCS           Role                       Yes       Yes
                                 detection of suspicious network
                                 activty and suggests remedition
                                 alternatives. D




Page 12                                                                                                                                   8/1/2011
OCIO Data Questionnaire                                              Application

           Application Name                    Description                Software   Departments/   Security    Type of Data       Best     Critical
                                                                           Vendor     Programs/                                   Source?    (Y/N)
                                                                                       Divisions                                    (Y/N)
   Cisco Security Agent            Host based software that provides Cisco           DHCS           Role                          Yes       Yes
                                   real-time detection of suspicious
                                   host activty and suggests                                                   alerts, traffic,
                                   remedition alternatives.                                                    configuration,
                                                                                                               remediation
   Cisco Security Monitoring       Software that provides security       Cisco       DHCS           Role                          Yes       Yes
   Analysis and Response System    monitoring for network devices                                              Alerts, routing
   (MARS)                          and host applications                                                       activity,
                                                                                                               configuration,
                                                                                                               response
   CiscoWorks                      Network managemtn software           Cisco        DHCS           Role                          Yes       No
                                   tool that assista in the monitoring
                                   and maintenance of network
                                   hardware. D
   Claims Processing               Processes Provider medical Fee       IBM          DHCS           Yes                           Yes       Yes
                                   For Service and Crossover
                                   electronic/paper claims for Medi-
                                   Cal. The Claims Processing
                                   subsystem is divided into four (4)
                                   main modules: 1) Input
                                   Preparation; 2) Daily Adjudication;                                         Person,
                                   3) Weekly Adjudication; and 4)                                              Providers,
                                   Reporting Module. As claims are                                             Policy, claims,
                                   processed through CA-MMIS, they                                             attachment,
                                   pass through these modules and                                              error codes,
                                   specific claims editing, referred to                                        denials,
                                   as edits and audits, is performed.                                          suspense,
                                                                                                               reports, rates,
                                                                                                               history
   Collections Processing System   D                                     Clipper     DHCS           Yes                           Yes       No
   (CPS)


Page 13                                                                                                                                           8/1/2011
OCIO Data Questionnaire                                        Application

           Application Name                 Description             Software     Departments/   Security    Type of Data     Best     Critical
                                                                     Vendor       Programs/                                 Source?    (Y/N)
                                                                                   Divisions                                  (Y/N)
   Common Application            Providers use CATS when checking IBM            DHCS           Yes                         Yes       No
   Transaction System (CATS)     eligibility D
   Consolidated Omnibus Budget                                      Microsoft    DHCS           Yes                         Yes       No
   Reconciliation Act (COBRA)    The Consolidated Omnibus Budget Visual Basic
                                 Reconciliation Act (COBRA)
                                 reporting system is designed to
                                 assist Accounting in calculating
                                 Federal Financial Participation
                                 (FFP) for federal reporting
                                 purposes. requires state to return
                                 federal share of over-payment                                             claims, rules,
                                 within 60 days.                                                           reports
   Contract Tracking System                                         Computer     DHCS           Yes                         No        No
                                 CMSSTAT is CMU's on-line           Associates
                                 contract tracking system
                                 accessible through the Public
                                 Folder that provides the most
                                 recent data available about the
                                 status or whereabouts of a
                                 particular contract as it moves                                           Contracts,
                                 through the approval process.                                             vendors
   CoSort for Windows                                               CoSort       DHCS           Yes                         No        No
                                 Tool used for mainframe sort and Company
                                 data migration projects; data
                                 warehouse starging, integration,
                                 and ETL; database reorgs; business
                                 intelligence; field-level privacy;
                                 and, application development. D
   Cost and Billing              D                                  IBM          DHCS           Yes                         Yes       No




Page 14                                                                                                                                    8/1/2011
OCIO Data Questionnaire                                               Application

           Application Name                       Description                 Software   Departments/   Security    Type of Data    Best     Critical
                                                                               Vendor     Programs/                                Source?    (Y/N)
                                                                                           Divisions                                 (Y/N)
   Cost and Billing Assistant (CBA)   D                                      Microsoft DHCS             Role                       Yes       No
                                                                             Visual Basic

   County Mental Health System                                               Microsoft   DHCS           Yes                        No        No
   (CMHS)                             The CMHS users are the county          SQL
                                      users who have signed up to
                                      receive their data from Medi-Cal
                                      on electronic format. Currently,
                                      CMHS users can get their weekly
                                      File RF-O-046 and their monthly
                                      File RF-F-134 from the Web site.
                                      Data files are kept for 11 weeks for                                         Claims, county
                                      users to download.                                                           user, security
   CRM NICE                           This is the recording system for       NICE        DHCS           Role       Voice          Yes        No
                                      the CRM call center.                                                         Recording
   CSA                                An endpoint security solution that     Cisco       DHCS           Role                      Yes        No
                                      combines zero-update attack            Systems
                                      protection, data loss prevention,
                                      and signature-based antivirus. D




Page 15                                                                                                                                           8/1/2011
OCIO Data Questionnaire                                     Application

           Application Name              Description              Software   Departments/   Security    Type of Data       Best     Critical
                                                                   Vendor     Programs/                                   Source?    (Y/N)
                                                                               Divisions                                    (Y/N)
   Customer Relationship                                         Computer DHCS              Role                          Yes       Yes
   Management (CRM)           The Customer Relationship          Associates
                              Management (CRM) System is
                              a technology-based information
                              system that uses established
                              databases to capture, track,
                              and trend customer information
                              from start to finish. PR
                              Organization staff members
                              use different components of
                              CRM to perform their daily
                              work. The CRM solution equips
                              the Contractor PRO and
                              authorized Department staff                                              Person,
                              with the tools and access to                                             Providers,
                              comprehensive provider                                                   Policy,
                              information necessary to                                                 correspondenc
                              resolve billing issues on the first                                      e, call scripts,
                              encounter.                                                               call knowledge
   DB2 QMF for Windows        Query building tool that enables    IBM        DHCS           Role                          No        No
                              users to create reports, it has the
                              ability to display data from
                              multiple data sources in a large
                              number of intuitive formats and
                              images. D




Page 16                                                                                                                                   8/1/2011
OCIO Data Questionnaire                                      Application

           Application Name               Description               Software   Departments/   Security    Type of Data    Best     Critical
                                                                     Vendor     Programs/                                Source?    (Y/N)
                                                                                 Divisions                                 (Y/N)
   Denti-Cal                   Manages the claim processing        Mixed       DHCS           Role       Claims, policy, Yes       Yes
                               for eligible beneficiaries using                                          eligibility,
                               providers approved for dental                                             rules,
                               services through Denti-Cal.                                               provider,
                                                                                                         beneficiary,
                                                                                                         reports, rates,
                                                                                                         appeals,
                                                                                                         finance,
                                                                                                         denials



   Device Lock                                                     Smart Line DHCS            Yes                        Yes       No
                               Endpoint device control software
                               to limit secure access to
                               infromation storage media D
   DHCS Inventory Management                                       AIC         DHCS           Yes                        Yes       No

                               The WASP Scanner is used to scan
                               new, moved, or disposal
                               equipment. The information is
                               then uploaded in to the database
                               in a To Be Reviewed mode. The
                               Asset Manager reviews the                                                 Equipment,
                               uploaded data and approves it to                                          Office
                               be uploaded into the master                                               locations,
                               database. Tracks assets purchased                                         Ownership,
                               through the FI for DHCS contracts                                         Software,
                               to run Medi-Cal applications.                                             assets




Page 17                                                                                                                                  8/1/2011
OCIO Data Questionnaire                                        Application

           Application Name                  Description             Software   Departments/   Security    Type of Data    Best     Critical
                                                                      Vendor     Programs/                                Source?    (Y/N)
                                                                                  Divisions                                 (Y/N)
   Dimensions                     Management of source control for Dimensions DHCS             Role                       Yes       No
                                  all development of non mainframe                                        Source Code,
                                  systems.                                                                Documentatio
                                                                                                          n
                                                                   Microsoft DHCS              Role                       Yes       No
                                                                   Visual Basic
   Disproportionate Share Hospital D
   Ecora                           Software that provides automated Ecora       DHCS           Role                       Yes       No
                                   Configuration Auditing & Analytics
                                   that allow a proactive view of the
                                   IT infrastructure to ensure critical
                                   business services remain
                                   operationally effective, secure,
                                   and compliant with internal and
                                   external standards. D




Page 18                                                                                                                                  8/1/2011
OCIO Data Questionnaire                                         Application

           Application Name                  Description              Software   Departments/   Security   Type of Data    Best     Critical
                                                                       Vendor     Programs/                               Source?    (Y/N)
                                                                                   Divisions                                (Y/N)
   Electronic Perscrutation                                         Business     DHCS           Yes                       No        No
   Indagation Processing System                                     Objects
   (ePIPS)

                                  ePIPS is an acronym for electronic
                                  Perscrutation Indagation
                                  Processing System, which is a
                                  hosted crystal reports server.
                                  ePIPS was first installed when a
                                  new Windows server was
                                  purchased and two existing Crystal
                                  Report servers were consolidated
                                  onto this new server. The
                                  environment has since been
                                  extended to include both a
                                  production environment and a test
                                  environment. ePIPS uses the
                                  Business Objects Crystal Report
                                  Server software and connects to
                                  multiple dataset systems to
                                  generate pre-defined reports on a
                                  scheduled or on-demand basis. D
   ELM                            A search engine that gathers       GFI         DHCS           Role                      Yes       No
                                  search results from all of the
                                  major crack, serial and keygen
                                  sites. D
   Email                          E-mail siftware that provides      Microsoft   DHCS           Role                      Yes       Yes
                                  unified communications across the
                                  Enterprise D




Page 19                                                                                                                                   8/1/2011
OCIO Data Questionnaire                                      Application

            Application Name              Description               Software   Departments/   Security   Type of Data    Best     Critical
                                                                     Vendor     Programs/                               Source?    (Y/N)
                                                                                 Divisions                                (Y/N)
   Email Encryption            An enterprise wide solution for  Voltage.       DHCS           Yes                       No        Yes
                               encrypting e-mail communication.
                               D
   EnCase                      Computer forensic investigation  Guidance       DHCS           Yes                       No        No
                               technology tool capable of       Software
                               conducting large-scale and
                               complex investigations. D

   Encounter Data Processing                                       IBM         DHCS           Yes                       No        No
                               Encounter data is transmitted
                               by MCPs through the Medi-Cal
                               Web site and processed
                               through daily, weekly, and bi-
                               monthly edits and generates
                               reports regarding the encounter
                               data. D
   Encounter Data Unit (EDU)                                       Microsoft DHCS             Yes                       No        No
                                                                   Visual Basic
                               The non-mainframe part of the
                               Encounter Data Unit (EDU) is the
                               Medi-Cal Extranet for State
                               Healthcare (MESH). Managed Care
                               Plans (MCPs) are able to receive
                               their eligibility information
                               through MESH. The following
                               information is transmitted to the
                               Contractor from Department of
                               Technology Services (DTS) using
                               File Transfer Protocol (FTP): D




Page 20                                                                                                                                 8/1/2011
OCIO Data Questionnaire                                          Application

           Application Name                  Description                Software   Departments/   Security    Type of Data     Best     Critical
                                                                         Vendor     Programs/                                 Source?    (Y/N)
                                                                                     Divisions                                  (Y/N)
                                                                       Microsoft   DHCS           Role                        No        No
                                                                       .Net                                  Eligibles, FFS
                                                                                                             paid claims,
                                                                                                             encounters,
   Enhanced Medi-Cal Budget       Used to forecast Medi-Cal budgets                                          Regressions,
   Estimate Redesign (EMBER)      for future years.                                                          Policy
   Enterprise Image Management                                         IBM JAVA    DHCS           Role                        Yes       Yes
   System (EIMS)                  EIMS replaced the Image
                                  Management System and
                                  MaxRetriever software by                                                   Paper Claims,
                                  integrating both applications into                                         correspondenc
                                  one image repository by                                                    e, claim
                                  consolidating into IBM OnDemand.                                           attachments
   eReports                                                            JDK         DHCS           Yes                         No        No
                                  eReports was developed as a Java-
                                  based reporting application to
                                  schedule, execute, and manage
                                  fixed or canned reports for the
                                  SURGE, CMIS, and kTAR
                                  applications. eReports uses an
                                  internal report generator and
                                  scheduler to produce the pre-
                                  defined reports D
   Estate Recovery System (ERS)   System tracks the collection of   IBM            DHCS           Yes        Person,          Yes       No
                                  Medi-Cal expenditures from                                                 Claims,
                                  beneficiary estates.                                                       Provider,
                                                                                                             Cases.
                                                                                                             Finance,
                                                                                                             estate
                                                                                                             information



Page 21                                                                                                                                       8/1/2011
OCIO Data Questionnaire                                   Application

           Application Name              Description           Software   Departments/   Security    Type of Data    Best     Critical
                                                                Vendor     Programs/                                Source?    (Y/N)
                                                                            Divisions                                 (Y/N)
   EventSentry                Real-time monitoring solution for EventSentr DHCS          Role                       Yes       No
                              servers, workstations and network y
                              devices to ensure maximum
                              availability D
                                                                IBM        DHCS          Yes        Person,         Yes       No
                                                                                                    eligibility,
                              Medi-Cal Eligibility History                                          application,
   Extended History           Reporting                                                             aid codes
   Faxing                     Software applicatiomn tha       Captairs    DHCS           Yes                        No        No
                              proveds a data network based
                              faxing solution. D
   FEMR                       Online transactions, part of    Websphere DHCS             Yes                        No        No
                              FAME and testing tools for
                              ITSD (FEMRTST and other
                              related online modular
                              programs). D
   FEVR                       Online transactions, part of    Websphere DHCS             Yes                        No        No
                              FAME and testing tools for
                              ITSD (FEVSNEW & FEVSTST
                              and other related online
                              modular programs). D
   FileMatch                                                  IBM         DHCS           Yes                        Yes       No
                              Adds/blocks clients to/from MEDS
                              based on checks across sent insu
                              co lists & Medi-Cal lists. D
   FINALIST                   FINALIST is an address           IBM        DHCS           Yes                        Yes       No
                              standardization software package
                              that is used by MEDS and some
                              other systems.                                                        Addresses




Page 22                                                                                                                            8/1/2011
OCIO Data Questionnaire                                              Application

           Application Name                     Description                Software   Departments/   Security    Type of Data     Best     Critical
                                                                            Vendor     Programs/                                 Source?    (Y/N)
                                                                                        Divisions                                  (Y/N)
                                   Backup for MEDS as in query            IBM         DHCS           Yes                         No        Yes
                                   server. Also processes initial card
                                   swipes/access. Eligibility interface                                         Person,
                                   application to support Fiscal                                                eligibility,
   Fiscal Intermediary Access to   Intermediary MMIS systems.                                                   share of cost,
   Medi-Cal Eligibility (FAME)                                                                                  aid code
   Formulary and Online Pharmacy                                          OPUS        DHCS           Yes                         No        No
   Update System (OPUS)
                                   The Contractor's Change Support
                                   Analysts and pharmacists use
                                   Online Pharmaceutical Update
                                   System (OPUS) to maintain the
                                   Medi-Cal Formulary File. OPUS
                                   processes the National Drug Data
                                   File (NDDF) received monthly from
                                   First Data Bank, and creates a
                                   Formulary Update Transaction file
                                   that is uploaded to the mainframe
                                   to update the VSAM Formulary                                                 Policy,
                                   File.                                                                        Formulary
   FPACT Waiver (FPR)              Application for FPACT users to      IBM        DHCS               Yes        claims,          Yes       No
                                   track waiver information for                                                 person,
                                   reporting and enrollment.                                                    eligibility
   FTK (Forensics Tool Kit)        Tool used to extract computer       AccessData DHCS               Yes        access,          Yes       No
                                   information for forensic evaluation                                          employee
                                                                                                                information,
                                                                                                                computer id,
                                                                                                                useage
                                                                                                                information




Page 23                                                                                                                                          8/1/2011
OCIO Data Questionnaire                                              Application

           Application Name                    Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                           Vendor     Programs/                                Source?    (Y/N)
                                                                                       Divisions                                 (Y/N)
   Gentran                         Gentran is a COTS product             Sterling    DHCS           Yes                        No        Yes
                                   marketed by Sterling Commerce.        Software
                                   It is used at Medi-Cal to translate
                                   between ANSI X12 formatted
                                   transactions and Medi-Cal
                                   proprietary data layout for both
                                   inbound and outbound
                                   transactions. D
   Global Document Assignment                                            Microsoft DHCS             Yes                        Yes       No
   Information System (GDAIS)                                            Visual Basic

   GlobalScape                     Secure File Transfer Protocol D       GlobalScap DHCS            Yes                        No        No
                                                                         e
   Guardian Edge Encryption Plus   Full hard disk encryption D           Guardian DHCS              Yes                        No        No
   Hard Disk                                                             Edge
   Health Inventory System (HIS)   Tracks medical equipment.             IBM        DHCS            Yes        Person,         Yes       No
                                                                                                               insurance
                                                                                                               coverage
   Health Recovery System (RCV)                                          IBM         DHCS           Yes                        Yes       No

   Healthy Families                Healthy Families - Contracted     IBM             DHCS           Yes        person,         Yes       Yes
                                   program providing specific low                                              eligibility
                                   cost health care for Californians
                                   who may not otherwise qualify for
                                   welfare




Page 24                                                                                                                                        8/1/2011
OCIO Data Questionnaire                                         Application

           Application Name                   Description            Software   Departments/   Security    Type of Data    Best     Critical
                                                                      Vendor     Programs/                                Source?    (Y/N)
                                                                                  Divisions                                 (Y/N)
   HIPAA EDI Activation Testing                                       Microsoft DHCS           Role                       No        No
   System (HEATS)                  The HEATS System was built to      Visual Basic
                                   help Medi-Cal staff work with
                                   Medi-Cal submitters to work
                                   through the process of testing the
                                   submitter's ability to submit the
                                   837 V4010A1 transaction and
                                   become activated for different
                                   claim and media types. D
   HIPP (TPL)                      HIPP Cost Avoidance - Health      IBM        DHCS           Yes                        Yes       No
                                   Insurance Premium Payment
                                   Program pays private health
                                   insurance premiums for certain
                                   high cost Medi-Cal beneficiaries.
                                   Part of TPL D
   HIS/OHC (Health Insurance       HIS (Health Insurance System)     IBM        DHCS           Yes                        Yes       Yes
   Insurance / Other Health        (OHC) (Other Health Coverage) the
   Coverage) - Core MEDS           identification of all health
                                   insurance belonging to Medi-Cal
                                   beneficiaries; maintaining the                                         Person,
                                   automated HIS.                                                         insurance
                                                                                                          coverage
   Home and Community Based        D                                IBM         DHCS           Yes                        Yes       Yes
   Waiver System (HCW)
                                                                    IBM         DHCS           Yes                        Yes       Yes
   Homeless Assistance Payments
   / Family Planning Access to Care
   & Treatment (HAP/FPACT)          D
                                                                    IBM         DHCS           Yes                        Yes       Yes
   Homeless Assistance Payments    Homeless Assistance Payments -
   / HOMEless (HAP/HOME)           Core Meds D


Page 25                                                                                                                                   8/1/2011
OCIO Data Questionnaire                                             Application

           Application Name                     Description                Software   Departments/   Security   Type of Data    Best     Critical
                                                                            Vendor     Programs/                               Source?    (Y/N)
                                                                                        Divisions                                (Y/N)
   Hospital Monitoring System       D                                     IBM         DHCS           Yes                       Yes       No
   (HMS)
   HPOpenview                                                             HP          DHCS           Role                      Yes       Yes
                                    Suite of software applications
                                    which allow large-scale system and
                                    network management of IT
                                    infrastructure D
   IBM’s DB2 for z/OS               DB2 support for WIC-MEDS D            IBM        DHCS            Role                      No        Yes
   Idera Suite                      SQL monitoring tool D                 Idera      DHCS            Role                      Yes       No
   Imanage                          Document management solution          Interwoven DHCS            Role                      Yes       No
                                    that provides on-line
                                    collabaoration D
                                    Verifies a beneficiary’s income and   IBM         DHCS           Yes                       No        Yes
                                    asset information. Submits inquiry
                                    transactions to other state and
                                    federal computer systems
                                    attempting to locate income and
   Income and Eligibility           asset data. Core MEDS D
   Verification System (IEVS)
   Indian Health Program (IHP)      D                                     IBM         DHCS           Yes                       Yes       Yes
   In-Home Health Services System                                         IBM         DHCS           Yes                       Yes       Yes
   (IHSS)                           In-Home Support Services D
   Internet Information Services    Web front end presense D              Microsoft   DHCS           Role                      Yes       Yes
   (IIS)
   ISA Server                       Proxy- load balancing front end D     Microsoft   DHCS           Role                      Yes       No




Page 26                                                                                                                                        8/1/2011
OCIO Data Questionnaire                                             Application

              Application Name                   Description              Software   Departments/   Security    Type of Data    Best     Critical
                                                                           Vendor     Programs/                                Source?    (Y/N)
                                                                                       Divisions                                 (Y/N)
                                                                                     DHCS           Yes                        No        No

                                     Extensive use is made of
                                     Optical Character Recognition
                                     (OCR) and Image Management
                                     System (IMS) for data entry and
   Key Data Entry - OCR              digitally stored claim images D
   Listserv                          Application that allows mass    L-Soft     DHCS                Yes                        No        No
                                     emailing to large groups or
                                     individuals.                                                              Documents
   Litigation Case Tracking System   Tracks litigation cases for the Computer DHCS                  Yes                        Yes       No
   (LCTS)                            department.                     Associates
                                                                                                               Litigation
                                                                                                               Cases
   Livelink                                                              OpenText, DHCS             Role                       Yes       No
                                                                         Microsoft                             Documentatio
                                     Livelink is a Web-based system      Visual Basic                          n, Contracts,
                                     that the Contractor and DHCS use                                          Change
                                     for CA-MMIS collaborative                                                 Control,
                                     knowledge sharing and document                                            projects,
                                     management. Livelink provides the                                         correspondenc
                                     following                                                                 e
   Local Education Agency (LEA)      Local Educ Agy granting health      IBM         DHCS           Yes                        Yes       No
                                     svcs for Medi-Cal students D
   Mass Emailing                                                         ListServe   DHCS           Role                       No        No
                                     Special usage of e-mail that allows
                                     for widespread distribution of
                                     information to many users D




Page 27                                                                                                                                       8/1/2011
OCIO Data Questionnaire                                        Application

           Application Name               Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                      Vendor     Programs/                                Source?    (Y/N)
                                                                                  Divisions                                 (Y/N)
   Maximus                    Manages the enrollment process        Mixed       DHCS           Role                       Yes       Yes
                              for beneficiaries enrolling in the
                              managed care plans for Medi-Cal.
                              Service contract for Managed
                              Care. No software or hardware
                              owned by DHCS. Managed Care
                              contracts are awarded to various
                              Payors by DHCS to provide
                              healthcare to qualifying
                              beneficiaries that Maximus
                              provides eligibility determination.
                              Managed Care plans frm Payors
                              supply encounters to DHCS for                                               Person,
                              analysis for capitation and benefit                                         Managed Care
                              oversight.                                                                  Enrollment,
                                                                                                          Managed Care
                                                                                                          Contracts




Page 28                                                                                                                                   8/1/2011
OCIO Data Questionnaire                                        Application

           Application Name                  Description            Software   Departments/   Security    Type of Data     Best     Critical
                                                                     Vendor     Programs/                                 Source?    (Y/N)
                                                                                 Divisions                                  (Y/N)
                                                                   Microsoft, DHCS            Yes                         No        Yes
                                                                   Macromedi
                                  Through CHDP, children can       a, JAVA
                                  obtain preventive health
                                  assessments to prevent current
                                  and potential health problems.
                                  The primary function of the
                                  CHDP subsystem is to provide
                                  the necessary information and
                                  management controls to ensure
                                  appropriate health care for
                                  program beneficiaries. Provides
                                  children, regardless of
                                  immigration status, full scope
                                  Medi-Cal services for up to two
   Medi-Cal CHDP Gateway          months.
   Medi-Cal Drug Reporting System D                                 IBM        DHCS           Yes                         Yes       No
   (MDR)
   Medi-Cal Elgibility Data       MEDS processes eligibility        IBM        DHCS           Yes                         Yes       Yes
   System                         applications and tracks all                                            Person,
                                  eligibility for beneficiaries AID                                      eligibility,
                                  codes and eligible periods for                                         application,
                                  Fee For Service and Managed                                            aid codes,
                                  Care.                                                                  share of cost,
                                                                                                         care plan
   Medi-Cal Eligibility Quality                                    IBM         DHCS           Yes                         No        Yes
   Control (MQC)                  D




Page 29                                                                                                                                   8/1/2011
OCIO Data Questionnaire                                           Application

           Application Name                    Description              Software   Departments/   Security    Type of Data    Best     Critical
                                                                         Vendor     Programs/                                Source?    (Y/N)
                                                                                     Divisions                                 (Y/N)
   Medi-Cal Enterprise Information                                    Microsoft, DHCS             Yes                        No        No
   System (MENTIS)                 MENTIS is a Windows Server and     Computer
                                   Unix-based integrated Local/Wide   Associates,
                                   Area Network (LAN/WAN) system      Visio
                                   that provides office automation
                                   for the Medi-Cal Contractor.
   Medi-Cal Federal Reporting                                         IBM          DHCS           Yes                        Yes       No
   System (MFR)
   Medi-Cal FFS Check-Write        Processes Provider Fee For Service IBM          DHCS           Yes                        Yes       Yes
                                   claims to be paid and sends to
                                   SCO. Produce Warrants for all paid
                                   claims to be forwarded to the CMS
                                   64 and post paid warrants from
                                   SCO. D

   Medi-Cal Management             Decision Support system for all      NCR        DHCS           Yes        Person,         No        No
   Information System - Decision   medical claims and managed care                                           eligibility,
   Support System (MIS-DSS)        encounters including eligibility and                                      formulary,
                                   formulary supporting data.                                                claims,
                                                                                                             encounters,
                                                                                                             Providers,
                                                                                                             Policy
   Medi-Cal Paid Claims Upfront    D                                  IBM          DHCS           Yes                        No        No
   Processing (MTR)




Page 30                                                                                                                                      8/1/2011
OCIO Data Questionnaire                                         Application

           Application Name                 Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                        Vendor     Programs/                                Source?    (Y/N)
                                                                                    Divisions                                 (Y/N)
   Medi-Cal Portal                                                    SUN,       DHCS            Role       Web pages,      No        Yes
                                The My Medi-Cal Portal allows for     Microsoft,                            documents,
                                a common entry point to the           PERL,                                 links, policy
                                applications that are the most        JAVA,                                 information,
                                useful. The portal is a dynamic and   Macromedi                             Medi-Cal
                                user configurable entry point         a                                     portal
                                based on user's needs. The portal                                           entrance
                                interface uses an intuitive
                                windows interface that allows
                                users to personalize their own
                                portal placing the tools they need
                                on their portal. The My Medi-Cal
                                Portal is extendable, applications
                                that the portal "points" to are
                                added or removed based on need.
                                D
   Medi-Cal Short Doyle (MSD)                                         Microsoft   DHCS           Role       Claims, policy, Yes       Yes
                                                                      .Net                                  eligibility,
                                                                                                            rules,
                                                                                                            provider,
                                                                                                            beneficiary,
                                                                                                            reports, rates,
                                                                                                            appeals,
                                                                                                            finance,
                                                                                                            denials
                                Comprehensive system of
                                community mental health services




Page 31                                                                                                                                     8/1/2011
OCIO Data Questionnaire                                             Application

           Application Name                     Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                            Vendor     Programs/                                Source?    (Y/N)
                                                                                        Divisions                                 (Y/N)
   Medi-Cal Subscription Services                                      Microsoft, DHCS               Yes                        No        No
   Systems (MCSS)                   The Medi-Cal Subscription Services WebSphere
                                    (MCSS) System is the Contractor
                                    Web client that provides easy
                                    access to the databases that
                                    manage the mailing and reporting
                                    of Medi-Cal Provider Manual
                                    monthly updates to the provider                                             publications,
                                    and subscriber populations.                                                 providers
                                                                          Cisco       DHCS           Role                       Yes       No


                                    The Cisco phone system provides
                                    non-contact center employees a
                                    telephone system that is based on
                                    Voice over Internet Protocol (VoIP)
                                    and is configured to allow any
                                    employee to log on to any phone
                                    at any location across the campus.
                                    This Extension Mobility feature
                                    allows employees to work from
                                    different locations across the
                                    enterprise at will and have their
   Medi-Cal Telephony               phone number follow them with
   Communications Systems - Call    minimal telephony support
   Manager                          personnel interaction. D
   Medi-Cal Web - Internet Bulletin                                       Microsoft DHCS             Yes                        No        No
   Board System (IBBS)              The IBSS provides a transaction       Visual Basic
                                    gateway to submit various
                                    transactions in batches for AEVS,
                                    CMC, BCCTP, and others. D


Page 32                                                                                                                                        8/1/2011
OCIO Data Questionnaire                                           Application

           Application Name                    Description              Software   Departments/   Security    Type of Data    Best     Critical
                                                                         Vendor     Programs/                                Source?    (Y/N)
                                                                                     Divisions                                 (Y/N)
   Medicare Buy-In (BYN), Title XVI                                    IBM         DHCS           Yes        benficiary,     No        Yes
   (16)                             Medicare Buy-In, Title XVI - A                                           SSA income
                                    monthly data exchange between
                                    DHCS and CMMS producing 2
                                    extract files of MEDS db
   MEDS Central Database (CDB)      County Welfare Offices within      IBM         DHCS           Yes                        Yes       Yes
                                    the State of California have
                                    online MEDS Network access
                                    that allows them to update
                                    information on the Food
                                    Stamp/CDB portion of the
                                    database. D
   MEDS41                           A security-featured logon to       Microsoft DHCS             Yes                        No        Yes
                                    MEDS, intended for circa 500       Visual Basic
                                    county users only. Part of MANA                                          logon user
                                    project.                                                                 admin
   Microsoft Active Directory       Technology that provides a         Microsoft   DHCS           Role                       Yes       Yes
                                    variety of network services
                                    including LDAP like Directory
                                    services, KERBEROS based
                                    authentication and
                                    DNS based naming and other
                                    network information D
   Microsoft BizTalk               Communication protocol              Microsoft   DHCS           Role                       Yes       Yes
                                   thatconnects systems inside and
                                   across organizations, to exchange
                                   data and orchestrate processes
                                   requiring multiple systems D




Page 33                                                                                                                                      8/1/2011
OCIO Data Questionnaire                                           Application

           Application Name                   Description               Software   Departments/   Security    Type of Data      Best     Critical
                                                                         Vendor     Programs/                                  Source?    (Y/N)
                                                                                     Divisions                                   (Y/N)
   Microsoft Content Management Web front end presense for EPO D Microsoft         DHCS           Role                         Yes       Yes
   Server (CMS) 2002

   Microsoft Office SharePoint    Content Management for a single      Microsoft   DHCS           Role                         Yes       No
   Server (MOSS)                  solution that combines the ability
                                  to easily create corporate Web
                                  portals with document
                                  management, content searching,
                                  and team collaboration D

   MMEF Print                     D                                    IBM         DHCS           Yes                          No        No
   Mobile Messaging               Wireless data communication such Research        DHCS           Yes                          Yes       No
                                  as Blackberry D                      in Motion
   Meds Online Point of service   MEDS Online PointOfService           IBM         DHCS           Yes                          No        Yes
   Inquiry (MOPI)                 Inquiry (and AVES) inquiries
                                  provide enrollment/ eligibility info
                                  on Medicare Part D. MOPI is just                                           statewide
                                  one of the MEDS CICS transactions.                                         eligibles,
                                                                                                             provider
   MS SQL 2000                    Database Version D                   Microsoft   DHCS           Role                         Yes       Yes
   MS SQL 2005                    Database Version D                   Microsoft   DHCS           Role                         Yes       Yes
   Ngenius                        Netscout tool for managing           NetScout    DHCS           Role                         Yes       No
                                  application and network                                                    Bandwidth
                                  performance                                                                and utilization
                                                                                                             reporting
   Office of AIDS Waiver Reporting D                                   IBM         DHCS           Yes                          Yes       No
   System (OOA)




Page 34                                                                                                                                        8/1/2011
OCIO Data Questionnaire                                           Application

           Application Name                     Description            Software   Departments/   Security    Type of Data    Best     Critical
                                                                        Vendor     Programs/                                Source?    (Y/N)
                                                                                    Divisions                                 (Y/N)
   Online Claims Correction (OLCC)                                      SUN,      DHCS           Yes                        Yes       No
                                     The OLCC system allows DHCS and iPlanet,
                                     PRO-authorized staff to select any JAVA
                                     claim adjudicated in the last six
                                     months or currently on the
                                     Suspense Master File (CP-F-006),
                                     correct any field on the original
                                     claim, and resubmit the claim into                                     Claims
                                     the Claims Daily System.                                               Suspense
   Personnel Inventory                                                  IBM       DHCS           Yes                        Yes       No
   Management System (PIMS)
   Planview                                                             Planview, DHCS           Role       project plans   Yes       No
                                     PlanView is an enterprise-level    Microsoft
                                     portfolio and project management Visual Basic
                                     system allowing project
                                     stakeholders, resources, and
                                     managers to monitor and control
                                     projects and resources.
                                     Components within PlanView
                                     allow for resource time reporting,
                                     resource planning, resource
                                     reporting, project planning,
                                     project reporting, and project
                                     financial invoicing. D




Page 35                                                                                                                                    8/1/2011
OCIO Data Questionnaire                                              Application

           Application Name                     Description                 Software   Departments/   Security    Type of Data    Best     Critical
                                                                             Vendor     Programs/                                Source?    (Y/N)
                                                                                         Divisions                                 (Y/N)
   Point Of Service (POS)                                                  Omni        DHCS           Yes        Network         No        Yes
                                                                           3300,                                 routing
                                                                           Microsoft
                                    The Medi-Cal POS dial-up and           C++
                                    leased-line network is designed to
                                    accept electronically submitted
                                    transactions related to the
                                    delivery of services to California
                                    Title XIX (Medicaid) recipients by
                                    providers of those services.
                                    Electronic transaction submittal is
                                    currently limited to providers that
                                    are enrolled as active providers in
                                    the Medi-Cal Program or Other
                                    Intermediaries. D
   Position Vacancy Reports (PVR)   D                                   Microsoft DHCS                Unknow                     Unknow No
                                                                        Visual Basic                  n                          n

   Project Inventory Report (PIR)   D                                      Microsoft DHCS             Yes                        Yes       No
                                                                           Visual Basic

                                                                           IBM         DHCS           Yes                        Yes       No
                                    This is the collection point for all
                                    Paid claims, Encounters, and
                                    Eligibility information from various
                                    claims/encounter systems
   Provider Claims Encounter        produced within the Medi-Cal                                                 Claims,
   System (PCES)                    applications.                                                                encounters




Page 36                                                                                                                                          8/1/2011
OCIO Data Questionnaire                                           Application

           Application Name                  Description                 Software   Departments/   Security    Type of Data    Best     Critical
                                                                          Vendor     Programs/                                Source?    (Y/N)
                                                                                      Divisions                                 (Y/N)
   Provider Equipment Tracking                                          Microsoft DHCS             Role                       Yes       No
   System (PETS)                                                        Visual Basic

                                 The POS Help Desk and
                                 Distribution Team use PETS. The
                                 POS Help Desk uses this system to
                                 track VeriFone Omni 3300 device
                                 problems and activities using a
                                 database containing information
                                 of providers who use POS devices
                                 as well as POS equipment
                                 inventory information. The
                                 Contractor can generate mailing
                                 labels to ship devices by using the
                                 data within this system. The
                                 application runs within the                                                  Verifone
                                 MENTIS environment from local                                                trouble
                                 installation on the users' desktops;                                         tickets,
                                 the Structured Query Language                                                provider,
                                 (SQL) database resides on a shared                                           incident
                                 database server.                                                             information




Page 37                                                                                                                                      8/1/2011
OCIO Data Questionnaire                                      Application

           Application Name                Description            Software   Departments/   Security    Type of Data    Best     Critical
                                                                   Vendor     Programs/                                Source?    (Y/N)
                                                                               Divisions                                 (Y/N)
   Provider Enrollment Tracking Application that tracks provider Microsoft   DHCS           Yes        A&I referrals, Yes        No
   System (PETS)                enrollment applications through                                        provider,
                                the approval process.                                                  analyst,
                                                                                                       appeal,
                                                                                                       application,
                                                                                                       assignment,
                                                                                                       cases,
                                                                                                       classification,
                                                                                                        driver
                                                                                                       coding,
                                                                                                       corresponden
                                                                                                       ce




Page 38                                                                                                                               8/1/2011
OCIO Data Questionnaire                                       Application

           Application Name                Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                       Vendor     Programs/                                Source?    (Y/N)
                                                                                   Divisions                                 (Y/N)
   Provider Master File (PMF)                                        IBM         DHCS           Yes                        Yes       Yes


                                The Provider Subsystem
                                identifies the providers for Medi-
                                Cal and all other health
                                programs using CA-MMIS, as
                                well as the services they are
                                certified/authorized to provide.
                                The Provider Subsystem duties
                                include the maintenance of
                                Provider Master File (PMF)
                                information and any type of
                                direct contact the Contractor
                                has with the providers. The
                                Department and the Contractor
                                share responsibility for a variety
                                of activities as delineated and
                                further described throughout
                                this section. The Department is
                                primarily responsible for                                                  rates, aid
                                enrolling, entering, and                                                   codes,
                                updating provider-related data                                             provider
                                on the PMF. Application that                                               information,
                                keeps the provider rates,                                                  sanctions,
                                sanctions and specilal                                                     procedure
                                provisions for claims processing.                                          codes




Page 39                                                                                                                                    8/1/2011
OCIO Data Questionnaire                                           Application

           Application Name                  Description                 Software   Departments/   Security    Type of Data     Best     Critical
                                                                          Vendor     Programs/                                 Source?    (Y/N)
                                                                                      Divisions                                  (Y/N)
   Provider Telecommunications                                          Pronexus, DHCS             Yes        ivr scripts,     No        Yes
   Network (PTN)                 Through a POTS line, providers can     Microsoft                             login
                                 access check-write info, claim         Visual Basic                          information,
                                 status, TAR status, drug continuing                                          provider,
                                 care, procedure codes, formulary,                                            logging
                                 and operators.
   Publications (PUBS)           Publication of Medi-Cal manuals        Microsoft, DHCS            Yes                         Yes       No
                                 and storage for delivery services. D   Adobe

   RACF                          Security system that provides          IBM         DHCS           Role                        Yes       Yes
                                 access control and auditing
                                 functionality for the z/OS and                                               Employee
                                 z/VM operating systems                                                       login security
   Ramos/Craig                   Lawsuit on reinstatement after         IBM         DHCS           Yes        ramos lawsuit Yes          No
                                 termination due to increased                                                 tracking
                                 assets D
   Rational WatchFire WebXM      Web reporting tool D                   IBM         DHCS           Role                        Yes       No
   Rebate Accounting and                                                Unisys      DHCS           Role                        Yes       No
   Information System (RAIS)
                                 The RAIS network provides the
                                 server and storage resources
                                 necessary to support the
                                 Accounting Information Subsystem
                                 (AIS) and all related tables and
                                 data. It also provides server and                                            Medication
                                 storage resources for the                                                    Claims,
                                 Historical Claims Data Mart,                                                 formulary,
                                 operational and ad hoc reporting,                                            reports,
                                 paper and electronic document                                                rebates,
                                 imaging, and end-user and labeler                                            provider, drug
                                 manufacturer connectivity.                                                   companies


Page 40                                                                                                                                        8/1/2011
OCIO Data Questionnaire                                        Application

           Application Name                Description                Software   Departments/   Security    Type of Data     Best     Critical
                                                                       Vendor     Programs/                                 Source?    (Y/N)
                                                                                   Divisions                                  (Y/N)
                                                                     IBM         DHCS           Yes        policy, rules,   Yes       Yes
                                                                                                           error codes,
                                                                                                           rates

                                The Reference File Subsystem
                                collects and maintains the files
                                that are used to price and pay
                                claims (i.e., the procedure,
                                formulary, and diagnosis files),
                                as well as the edits and audits
                                criteria tables file that are used
                                to apply program policies.
                                These files contain information
                                needed primarily by the Claims
                                Processing Subsystem to
                                ensure that claims are
                                consistent with program policies
                                and procedures and are priced
                                correctly. The information in
                                the Reference File Subsystem
                                is also utilized by the
                                Management Administrative
                                Reporting Subsystem (MARS)
                                and the Surveillance and
                                Utilization Review Subsystem
                                (SURS). This is the subsystem
                                that manages policy, rates,
   Reference File Subsystem -   formulary, routing, and general
   Policy                       rules for CA-MMIS.




Page 41                                                                                                                                     8/1/2011
OCIO Data Questionnaire                                      Application

           Application Name               Description              Software    Departments/   Security    Type of Data    Best     Critical
                                                                    Vendor      Programs/                                Source?    (Y/N)
                                                                                 Divisions                                 (Y/N)
   Reports to Web (R2W)                                            IBM, JAVA   DHCS           Role       reports         No        No
                              R2W replaced the microfiche
                              technology and Mainframe paper
                              reports by providing on-line
                              reports via a Web portal. The
                              Mainframe prints the reports to
                              IBM OnDemand using Advance
                              Function Print (AFP) format. The
                              AFP reports are then loaded to the
                              R2W IBM OnDemand Servers.
   Robo FTP Client            Custom client FTP application for Serengeti      DHCS           Role       sftp files      No        No
                              script-driven file transfers capable Systems
                              of custom workflows D
   SAS IntrNET                Web application file deployment D SAS            DHCS           Role                       No        No




Page 42                                                                                                                                 8/1/2011
OCIO Data Questionnaire                                       Application

           Application Name                 Description            Software   Departments/   Security    Type of Data    Best     Critical
                                                                    Vendor     Programs/                                Source?    (Y/N)
                                                                                Divisions                                 (Y/N)
   Service Utilization Review,                                    SUN Forte   DHCS           Role                       Yes       Yes
   Guidance, and Evaluation
   (SURGE)                       E-TARs or paper TARs contain
                                 data that is made available to
                                 the State staff responsible for
                                 TAR adjudication in the Medi-
                                 Cal field offices for review
                                 through the Service Utilization,
                                 Review, Guidance and
                                 Evaluation (SURGE) database,
                                 a subsystem of CA-MMIS.
                                 State staff adjudicates the
                                 requests and enters their
                                 decisions into the SURGE
                                 system. An electronic response
                                 is generated to the provider via
                                 the website and an Adjudication
                                 Response (AR) is automatically
                                 generated and mailed or FAXed
                                 from the Contractor’s site to the
                                 provider. The SURGE system
                                 was designed to redevelop the
                                 TAR subsystem using new                                                Person,
                                 client/server technology, while                                        Providers,
                                 providing increased                                                    Policy,
                                 functionality such as reporting                                        treatment
                                 and the ability to submit TARs                                         authorizations,
                                 and access information through                                          workflow,
                                 the Internet.                                                          denials
   SFTP                          Secure File Transfer Protocol D   IPSwitch   DHCS           Role       sftp files      No        No
   SMS - Microsoft Systems       Client management and reporting Microsoft    DHCS           Role                       Yes       No
   Management Server 2003        D



Page 43                                                                                                                                 8/1/2011
OCIO Data Questionnaire                                              Application

           Application Name                    Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                           Vendor     Programs/                                Source?    (Y/N)
                                                                                       Divisions                                 (Y/N)
   SOC (Share Of Cost) - Core MEDS Amount paid by client in month        IBM         DHCS           Yes                        Yes       Yes
                                   before Medi-Cal coverage starts.
                                   Determined by county welfare                                                Person, share
                                   depts.                                                                      of cost
   Social Security Number monitor                                        IBM         DHCS           Yes        social security No        Yes
   (SSN)                                                                                                       number,
                                                                                                               beneficiary
                                   D
   State Data Exchange (SDX)                                             IBM         DHCS           Yes                        Yes       Yes
                                   The Social Security
                                   Administration (SSA) updates
                                   their computer file called the
                                   State Supplemental Register
                                   (SSR) and send extracted
                                   information to create the State
                                   Data Exchange (SDX) file. The
                                   SDX file is sent to the State
                                   daily and is used to update the                                             Federal SSN
                                   MEDS network.                                                               index
                                                                         IBM         DHCS           Yes        beneficiary,    Yes       Yes
                                   Tracks a unique ID across many                                              benefits
   Statewide Client Index (SCI)    statewide welfare data bases. D                                             tracking




Page 44                                                                                                                                        8/1/2011
OCIO Data Questionnaire                                            Application

           Application Name                    Description                Software   Departments/   Security    Type of Data    Best     Critical
                                                                           Vendor     Programs/                                Source?    (Y/N)
                                                                                       Divisions                                 (Y/N)
   SURS Prospector                                                       SPSS,       DHCS           Role                       No        No
                                                                         Business
                                                                         Objects
                                   SURS Prospector is a Web-based,
                                   customized decision support and
                                   statistical analysis application
                                   designed specifically to support
                                   the identification of Providers and
                                   Recipients who may be engaged in
                                   abuse or fraudulent activities
                                   while using the Medi-Cal program.
                                   SURS Prospector makes six-years
                                   of adjudicated claims history data                                          Person,
                                   available to users and provides                                             Providers,
                                   point-and-click access to an online                                         Policy, paid
                                   catalog of highly detailed reports                                          claims,
                                   and related applications from the                                           eligibility,
                                   computer desktop                                                            denials
                                                                         IBM         DHCS           Yes                        No        No
                                   Batch system to extract reports
   Surveillance and Utilization    during claims processing for
   Review Section (SURS)           investigation. D
   Symantec Antivirus              Server Antivirus D                    Symantec    DHCS           Role                       Yes       No
   Symantec Antivirus              Client Antivirus D                    Symantec    DHCS           Role                       Yes       No
   Symantec Backup Exec            A data protection solution that       Symantec    DHCS           Role                       No        No
                                   provides continuous disk-to-disk-
                                   to-tape backup and recovery D

   Symantec Ghost Solution Suite   Desktop Imaging D                     Symantec    DHCS           Role                       Yes       No




Page 45                                                                                                                                       8/1/2011
OCIO Data Questionnaire                                                 Application

           Application Name                     Description                  Software   Departments/   Security    Type of Data    Best     Critical
                                                                              Vendor     Programs/                                Source?    (Y/N)
                                                                                          Divisions                                 (Y/N)
   Symantec Security Information   Real-time security information           Symantec    DHCS           Role                       Yes       No
   Manager (SSIM)                  management to proactively
                                   identify, prioritize, and resolve
                                   critical security incidents D

                                                                            Microsoft DHCS             Yes                        Yes       Yes
                                   TCM focuses on high-risk,                JAVA Open
   Targeted Case Management        medically complicated cases to           Source
   (TCM)                           provide case management. D
   Team Foundation Server          Code release version control D           Microsoft   DHCS           Role                       Yes       No
   Test                            MEDS acceptance testing - in-            IBM         DHCS           Yes        MEDS test       No        No
                                   house D                                                                        database
   Test Data Management System     D                                        Microsoft DHCS             Yes                        No        No
   (TDMS)                                                                   Visual Basic

   Tier 1 (software and settings   Base application installation roll       Various    DHCS            Role                       Yes       No
   common to all workstations)     out D                                    (Guardian
                                                                            Edge,
                                                                            Microsoft,
                                                                            Symantec,
                                                                            Corel,
                                                                            Adobe)




Page 46                                                                                                                                           8/1/2011
OCIO Data Questionnaire                                            Application

           Application Name                     Description              Software   Departments/   Security    Type of Data    Best     Critical
                                                                          Vendor     Programs/                                Source?    (Y/N)
                                                                                      Divisions                                 (Y/N)
   Tier 2 (software and settings   Additional applications on top of    Various     DHCS           Role                       Yes       No
   common to all workstations in a Tier 1 D                             (Microsoft,
   program)                                                             Symantec,
                                                                        Corel,
                                                                        Adobe,
                                                                        IBM,
                                                                        Smartline)


   Tivoli Storage Manager (TSM)                                         IBM         DHCS           Role                       No        No
                                    Backup system for applications D
   Total Access for Development     D                                   Microsoft DHCS             Yes                        No        No
   and Analysis (TADA)                                                  Visual Basic

   TRAC                             Tracking Recipients Across          IBM         DHCS           Yes                        No        No
                                    California. The front end to WDTIP.                                       statewide
                                                                                                              eligibles
   User Manager Pro                 User account managmement and        Lieberman DHCS             Role                       Yes       No
                                    licesing D                          Software

   Verisign Managed PKI             SSL certifications D                Verisign    DHCS           Yes                        Yes       No
   Visual Studio                    Application Development Tool D      Microsoft   DHCS           Role                       No        No

   WDTIP                            Welfare Data Tracking               IBM         DHCS           Yes                        No        No
                                    Implementation Project - a time-
                                    on-aid tracking system accessible
                                    to consortia via MEDS.                                                    statewide
                                                                                                              eligibles
   Web Application Manager          Server Monitoring tool              Advantnet DHCS             Role                       Yes       No
   (WAM)



Page 47                                                                                                                                      8/1/2011
OCIO Data Questionnaire                                       Application

           Application Name              Description               Software   Departments/   Security    Type of Data    Best     Critical
                                                                    Vendor     Programs/                                Source?    (Y/N)
                                                                                Divisions                                 (Y/N)
   Web Conferencing           Used to conduct live meetings or    Avaya       DHCS           Role       conference      No        No
                              presentations over the Internet                                           calling
                              using his or her own computer                                             information

   WEB Trends                 Auditing tool for web pages D       WebTrends DHCS             Role       website         Yes       No
                                                                  Inc                                   statistics
   Websense                   Internet access management          Websense DHCS              Role                       Yes       No
                              system to monitor, report and
                              manage internal Internet useage D




Page 48                                                                                                                                8/1/2011
  Dept           Application Name             Upgrade Plan (FSR Name)        New Application Name
DHCS     Medi-Cal Short Doyle (MDS)     Health Insurance Portability and   Medi-Cal Short Doyle II (MDS)
                                        Accountability Act (HIPAA)
DHCS     TBD                            HIPAA Compliance Project           TBD
DHCS     Provider Enrollment Tracking   Medi-Cal Provider Enrollment       TBD - RFP delayed from 07-
         System (PETS)                  Automation Project (PEAP)          2008 start
 New Software   FSR Target FSR Target
     Vendor        Start    Complete
Microsoft            6-2001     6-2010

Unknown                         7-2008
Unknown              9-Feb      4-2010
       Dept          Repository          Description             Type of Data        Security



DHCS          Able Bodied Adult
              Without               Stores individual's
              Dependents            status for food     Person, Application,
              (ABAWD)               stamps for 36       food stamps,
                                    month period.       eligibility          Repository
DHCS          Accounts
              Receivable System     Stores oystanding       Invoices, vendor,
              (ARS)                 receivables.            Delinquent Letters      Repository
DHCS          Airline System (AS)   Stores ticketing        employee, travel
                                    information for         agent, American
                                    department staff        Express Bill File,
                                    travel.                 Travel Agent Ticket
                                                            File, expense,
                                                            itinerary
                                                                                    Repository
DHCS          Audits and
              Investgation          Stores cases for
              Program (AIP)         audits and
                                    investigation staff
                                    and retains history
                                    for reporting           Provider,
                                    purposes.               beneficiary, case       Repository
DHCS          AEVS

                                    Stores application,
                                    eligibility and share   beneficiary,
                                    of cost information     provider, eligibility
                                    for matching claims     determination,
                                    data for                dates of coverage,
                                    adjudication.           authorization id        Repository
DHCS          BENDATA               Stores the SSA
                                    requested data for
                                    eligibility
                                    determination.
                                    Invididual data for
                                    each person.            Person, Income          Repository
DHCS          BENDEX                Stores the SSA
                                    requested data for
                                    eligibility
                                    determination.
                                    Index to match
                                    beneficiary.            Person, Income          Repository
DHCS   BESMGM2
                             Interface repository
                             for Blackberry
                             communications.      email, sms           Repository
DHCS   BMC Remedy                                 Incident Tickets,
       Database                                   Incident activity
                                                  tracking, contracts,
                                                  cost data,
                                                  inventory, planning,
                                                  process
                                                  management,
                                                  change
                                                  management,
                                                  alerts, workflow
                                                  routing,
                             Storage for Remedy performance
                             applications.        measurements         Repository
DHCS
                             Stores the budget
       Budget Utilization    and projection
       and Development       information for all
       System (BUDS) DBF     divisions.            Finance, budgets     Repository
DHCS   California Point Of
       Service (CALPOS)      Stores all rules,     beneficiary,
       online claims         poilcy, formulary,    eligibility, pharmacy
                             and claim data to     claim, history,
                             adjudicate online     provider, formulary,
                             medication claims.    drug reviews          Repository
DHCS

                                                   Access Control,
                                                   Medi-Cal and
                                                   Medicare eligibility,
                             Provides access       prescription drug
                             control for           plan information,
                             medication            diagnosis
                             information and       information and
       CAL SOLQ              MEDS eligibility.     medication history Repository
DHCS   Cancer Detection
       Program (CDP)
                          Stores enrollment
                          information for        Person, Health,
                          women applying for     Claims, eligibility,
                          BCCTP to receive       provider,
                          diagnosis treatment.   application,           Repository
DHCS   Case Management
       Information System Stores medical case    person, service
       (CMIS)             information for        requests, medical
                          medical service        case, approved
                          requests supported     services,
                          by IHO and MCM         correspondence,
                          programs.              provider               Repository
DHCS   Centers for
       Medicaid and
       Medicare Services Stores all finance
       (CMS) 64 System    information to
                          interface with CMS
                          for funds requests     Claim Payments,
                          for reimbursement      reports, federal
                          of matching funds.     matching funds         Repository
DHCS   CCMS
                          Stores change          Organization,
                          requests and status    change requests,
                          information.           status                 Repository
DHCS   CHDP Flat Files    Stores CHDP
                          enrollment and
                          eligibility            person, application,
                          information for        eligibility, provider,
                          Healthy Families.      coverage               Repository
DHCS   CMS-NET
                                              person, service
                          Stores medical case requests, medical
                          information for     case, approved
                          medical service     services,
                          requests supported correspondence,
                          by CMS programs. provider                     Repository
DHCS   CSA Database
                          Stores traffic       alerts, traffic,
                          information and      configuration,
                          remediation actions. remediation              Repository
DHCS   MARS database                           Alerts, routing
                           Security monitoring activity,
                           information and     configuration,
                           response actions.   response                Repository
DHCS   Medi-Cal FFS Claims
       Adjudication        Stores all rules,
                           policy, claims, and   Person, Providers,
                           activity around       Policy, claims,
                           processing "fee for   attachment, error
                           service" claims       codes, denials,
                           submitted by          suspense, reports,
                           providers.            rates, history        Repository
DHCS   COBRA               Stores financial
                           participation
                           accounting
                           information for
                           Medi-Cal.             claims, rules, reports Repository
DHCS
                           Tracking database
                           for outstanding
                           contracts working
       CTS DBF             through approval.     Contracts, vendors    Repository
DHCS   Work Alert                                Person                Repository
DHCS   CMHS
                           Stores RF-O-046 &
                           RF-F-134 data        Claims, county user,
                           output for counties. security             Repository
DHCS   CRM NICE            Stores recordings
                           for Medi-Cal call
                           center phone
                           interactions.        Voice Recording      Repository
DHCS   CRM
                           CRM data for
                           Provider Relations    Person, Providers,
                           interactions with     Policy,
                           providers, Medi-Cal   correspondence,
                           stakeholders and      call scripts, call
                           beneficiaries.        knowledge             Repository
DHCS                                                Claims, policy,
                                                    eligibility, rules,
                                                    provider,
                                                    beneficiary, reports,
                                                    rates, appeals,
                             FI data for all Denti- finance, denials
       Denti-Cal             Cal claim processing.                        Repository
DHCS
                           Stores asset
                           information for all
                           equipment and            Equipment, Office
                           software purchased       locations,
       Department IT       for DHCS FI CA-          Ownership,
       Equipments Tracking MMIS contract.           Software, assets       Repository
DHCS   Dimensions          Source control           Source Code,
                           databse.                 Documentation          Repository
DHCS   EMBER

                             Stores data for        Eligibles, FFS paid
                             fiscal forecasting     claims, encounters,
                             Medi-Cal budgets.      Regressions, Policy Repository
DHCS   EIMS                  Document
                             Management             Paper Claims,
                             storage for CA-        correspondence,
                             MMIS.                  claim attachments      Repository
DHCS                                                Person, Claims,
                                                    Provider, Cases.
                             Estate Recovery        Finance, estate
       Estate Recovery       tracking database.     information            Repository
DHCS
                             CA-MMIS history        Person, eligibility,
       Eligibility History   files for all claims   application, aid
       File (EHF)            back 10 years.         codes                  Repository
DHCS   FINALIST is an
       address
       standardization
       software package
       that is used by
       MEDS and some         Address matching
       other systems.        database.              Addresses              Repository
DHCS   Response File                                                       Repository
DHCS   FAME

                          Fiscal intermediary
                          eligibility access      Person, eligibility,
                          database. Duplicate     share of cost, aid
                          of MEDS.                code                   Repository
DHCS   Formulary OPUS     Update database
                          for formulary file.     Policy, Formulary      Repository
DHCS                      FPACT tracking          claims, person,
       FPACT Waiver       database.               eligibility            Repository
DHCS
                                                  access, employee
                                                  information,
                          Forensic tracking       computer id,
       FTK                database.               useage information Repository
DHCS   GDAIS DB                                   Document
                                                  Assignments        Repository
DHCS   HISDB File
                          medical equipment
                          tracking database Medical equipment, Repository
DHCS   Health Coverage
       Recovery                                Person                    Repository
DHCS   HISDB              Tracks healthy
                          family eligibiles.   Person                    Repository
DHCS   Health Insurance   Tracks private
       System (HIS)       health insurance for Person, insurance
                          beneficiaries.       coverage                  Repository
DHCS   HISCFM Carrier
       Master file
                          Carrier cross
                          reference for detail
                          information about
                          insurance carriers in
                          California.             Insurance Carriers     Repository
DHCS   HISCMFX Carrier    Cross references        cross reference to
       XREF File          benficiary with         person and
                          insurance carrier.      insurance carrier      Repository
DHCS   CAB Flat Files                             Labor Cost             Repository
DHCS   List File          Mass mailing lists.     Documents              Repository
DHCS
       LCTS DBF           Litigation database. Litigation Cases          Repository
DHCS   Livelink
                              Document             Documentation,
                              managemet            Contracts, Change
                              database for CA-     Control, projects,
                              MMIS.                correspondence        By Report
DHCS   Maximus                Databases for the
                              Maximus FI           Person, Managed
                              contract for Medi-   Care Enrollment,
                              Cal managed care     Managed Care
                              programs.            Contracts             Repository
DHCS   Application Tracking
                                                   Person, Application,
                              Tracks incoming      equipment,
                              applications for     purchase
                              eligibility.         information          Repository
DHCS   B137 Transaction       Tracks B137
                              transactions for
                              MEDS.              person, eligibility     Repository
DHCS   Birth Record           Eligibility birth
                              information for
                              MEDS beneficiary. Person, birth record     Repository
DHCS   Burman Alerts          Tracks Burman case
                              eligibiles.        Person, alerts          Repository
DHCS   CINXREF                                   Person                  Repository
DHCS   CINXREF/HF             Healthy Family
                              cross reference.   person, eligibility     Repository
DHCS   County XREF File       elgibility cross
                              reference to       county identifier,
                              counties.          person                  Repository
DHCS   DSHDB                                     Person                  Repository
DHCS   Environmental File
                                                                         Repository
DHCS   Healthy Families -


                              Contracted program
                              provofing specific
                              low cost health care
                              for Californians who
                              may not otherwise
                              qualify for welfare,
                              cats 2400 layout     statewide eligibles   Repository
DHCS   HIPP Cost             pays private health
       Avoidance - Health    insurance
       Insurance Premium     premiums for
       Payment Program       certain high cost
                             Medi-Cal
                             beneficiaries. Part
                             of TPL                   statewide eligibles    Repository
DHCS   KATMEDIN                                                              Repository
DHCS   MB13 Transaction                                                      Repository
DHCS                                            Claims, policy,
                                                eligibility, rules,
                             Data repository    provider,
                             associated data to beneficiary, reports,
                             adjudicate claims  rates, appeals,
       Medi-Cal Short        for the Department finance, denials
       Doyle MSD             of Mental Health.                        Repository
DHCS   MEDS Alert File                          Alerts, routing
       Layout                                   activity              Repository
DHCS   MEDS DB
                             Master database for      Person, eligibility,
                             Medi-Cal, Denti-Cal      application, aid
                             and Manage Cae           codes, share of
                             eligibles.               cost, care plan        Repository
DHCS   MMEF                                                                  Repository
DHCS   NOA Mail File                                                         Repository
DHCS   NOA Return File                                                       Repository
DHCS   Online Stats                                                          Repository
DHCS   TPL                                                                   Repository
DHCS   XREF - BIC
                             cross reference for
                             beneficiary bic card
                             identifier.          Person                     Repository
DHCS   XREF - CID                                 Person                     Repository
DHCS   XREF - HIC                                 Person                     Repository
DHCS   XREF - Name           Beneficiary name.    Person                     Repository
DHCS   XREF- CIN                                  Person                     Repository
DHCS   Medi-Cal
       Management            Decision support
       Infrmation System -   information for all
       Decision Support      eliibility, formulary,   Person, eligibility,
       System (MIS-DSS)      claims and               formulary, claims,
                             encounters. Seven        encounters,
                             years worth              Providers, Policy      Repository
DHCS   MCSS                 Subscription
                            database for
                            publication delivery publications,
                            services.            providers               Repository
DHCS   Meds Online Point
       of service Inquiry   Access logs for       statewide eligibles,
       (MOPI)               MOPI.                 provider               Repository
DHCS   MEDS41 -
                            A security-featured
                            logon to MEDS,
                            intended for circa
                            500 county users
                            only. Part of MANA
                            project.            logon user admin      Repository
DHCS   Ngenius Store        monitoring
                            database for        Bandwidth and
                            network             utilization reporting Repository
DHCS   Suspense
                            Claims in suspense
                            for correction and
                            re-submission.        Claims Suspense        Repository
DHCS

                            Storage system for
                            encounters, denials
                            and paid claims for
                            all claim processing
                            systems. Used to
                            load MIS/DSS and
                            feeds to other third
       Paid Claims          party liability
       Reporting            applications.        Claims, encounters      Repository
DHCS   PETS
                            Tracks all Medi-Cal   Verifone trouble
                            supplied point fo     tickets, provider,
                            service devices.      incident information Repository
DHCS   Provider             Provider              A&I referrals,       Repository
       Enrollment           Enrollment            provider, analyst,
       Tracking System      Tracking              appeal,
       (PETS)                                     application,
                                                  assignment,
                                                  cases,
                                                  classification,
                                                  driver coding,
                                                  correspondence
DHCS   Provider Master File
       (PMF)

                              Holds information
                              about CA-MMIS          rates, aid codes,
                              enrolled providers     provider
                              providing              information,
                              traatement to Medi-    sanctions,
                              Cal beneifciaries.     procedure codes        Repository
DHCS                          Security access for
                              applications running   Employee login
       RACF                   at DTS.                security               Repository
DHCS   RAIS

                              Stores all             Medication Claims,
                              medication claims      formulary, reports,
                              for analysis of drug   rebates, provider,
                              rebate collection.     drug companies         Repository
DHCS   RAIS-Datamart          Decision support
                              analysis of
                              medication claims      Medication Claims,
                              rebates.               eligibility, rebates   Repository
DHCS   R2W                    Stores all reports
                              for CA-MMIS for
                              distribution to end
                              users through the
                              web.                   CA-MMIS Reports        By Report
DHCS   SURGE
                              Stores all treatment   Person, Providers,
                              authorization          Policy, treatment
                              requests from          authorizations,
                              providers.             workflow, denials      Repository
DHCS   SOC
                              Stores the monthly
                              share of cost
                              running balance for Person, share of
                              beneficiaries.      cost                      Repository
DHCS   MEDS DB SDX
                              Federal SSN index
                              for eligibility editing. Federal SSN index    Repository
DHCS   SURS
                           Decision support
                           system for CA-
                           MMIS to produce
                           SUR reports against   Person, Providers,
                           paid claims and       Policy, paid claims,
                           denials.              eligibility, denials   Repository
DHCS   TRAC - Tracking     The front end to
       Recipients Across   WDTIP tracking
       California.         database.             statewide eligibles    Repository
DHCS   Welfare Data
       Tracking
       Implementation      Consortia tracking
       Project (WDTIP)     database.             statewide eligibles    Repository
    Technology    Model        Priority   Read Only
                 Available                  (Y/N)
                   /Tool
VSAM



                 No          Low          No
Sybase

                 No          Low          No
Sybase




                 No          Low          No
SQL Server




                 No          Medium       No
VSAM




                 No          High         No
VSAM




                 No          Medium       No
VSAM




                 No          Medium       No
Microsoft    No   Medium   No




SQL Server   No   Low      No
Borland




             No   Low      No
VSAM




             No   High     No




SQL Server   No   Medium   No
SQL Server




             No   Low      No
Oracle




             No   Medium   No
SQL Server




             No   Medium   Yes
SQL Server


             No   Low      No
VSAM




             No   Medium   No
VSAM




             No   Medium   No
SQL Server


             No   Low      No
Cisco


             No   Low      Yes
VSAM




             No   High     No
SQL Server




             No   Low      No
Borland




             No   Low      No
VSAM         No   Medium   No
Microsoft


             No   Medium   No
NICE


             No   Medium   Yes
Oracle




             No   Medium   No
IBM, Microsoft




                 No   High     No
DB2




                 No   Low      No
Oracle
                 No   Low      Yes
SQL Server




                 No   Medium   Yes
DB2


                 No   Medium   Yes
VSAM


                 No   Medium   No
VSAM


                 No   Low      No
VSAM




                 No   Medium   Yes
VSAM             No   Medium   No
VSAM




             No   High     No
SQL Server
             No   Medium   No
VSAM
             No   Low      No
VSAM




             No   Low      No
SQL Server
             No   Low      No
VSAM

             No   Medium   No
VSAM
             No   Medium   No
VSAM
             No   Medium   No
VSAM

             No   Medium   No
VSAM




             No   Medium   No
VSAM

             No   Medium   No
VSAM         No   Medium   Yes
Lsoft        No   Medium   Yes
Borland
             No   Medium   No
SQL Server




                 No   Low      Yes
IBM, Microsoft




                 No   High     No
DB2




                 No   High     No
VSAM

                 No   High     No
DB2

                 No   High     No
DB2
                 No   Medium   No
VSAM             No   High     No
VSAM
                 No   High     No
VSAM

                 No   High     No
VSAM             No   High     No
VSAM
                 No   Medium   No
VSAM




                 No   Medium   No
VSAM




                   No   Medium   No
VSAM               No   Medium   No
VSAM               No   Medium   No
SQL Server




                   No   High     No
Business Objects
                   No   Low      Yes
VSAM




                   No   High     No
Business Objects   No   Low      Yes
VSAM               No   Medium   No
VSAM               No   Medium   No
Business Objects   No   Medium   Yes
Business Objects   No   Medium   Yes
VSAM


                   No   High     No
VSAM               No   High     No
VSAM               No   High     No
VSAM               No   High     No
VSAM               No   High     No
NCR




                   No   Medium   Yes
Oracle


                   No   Low      No
VSAM

                   No   Medium   No
SQL Server




                   No   Medium   No


Ngenious           No   Low      No
Oracle


                   No   Medium   No
VSAM




                   No   Low      No
SQL Server


                   No   Low      No
Microsoft Access   No   Medium   No
VSAM




         No   High     No


IBM      No   Medium   No
Oracle




         No   Medium   Yes
Oracle


         No   Medium   Yes
DB2




         No   Medium   Yes
Oracle




         No   High     No
DB2




         No   High     No
VSAM

         No   Medium   No
Oracle




         No   Medium   Yes
VSAM

         No   Medium   No
VSAM


         No   Medium   No
Dept           CalBRM Reference*        Service
DHCS   086: General Insurance           Access for Infants and Mothers
                                        (AIM)
DHCS   127: Collections and Receivables Accounts Receivable Collections

DHCS   127: Collections and Receivables Accounts Receivable Collections

DHCS   142: Information Management      Active Directory and Server
                                        Management and Support



DHCS   142: Information Management      Active Directory and Server
                                        Management and Support



DHCS   142: Information Management      Active Directory and Server
                                        Management and Support



DHCS                                  Administration
       123: Workplace Policy Development and Management

DHCS                                  Administration
       123: Workplace Policy Development and Management

DHCS                                    All Divisions



DHCS                                    All Divisions
DHCS   247: Health Care Administration American Indian Infant Health
                                       Initiative (AIIHI)
DHCS   140: Information Security        ANTI-SPAM Technology Support

DHCS   136: System Development          Applications

DHCS                                  Assisted Education
       249: Health Care Research and PractitionerLiving Waiver Pilot
                                      Project (ALWPP)




DHCS   093: Program Monitoring          Audits and Investigation (A&I)
DHCS   093: Program Monitoring         Audits and Investigation (A&I)




DHCS   093: Program Monitoring         Audits and Investigation (A&I)




DHCS   093: Program Monitoring         Audits and Investigation (A&I)




DHCS   093: Program Monitoring         Audits and Investigation (A&I)




DHCS   247: Health Care Administration BabyCal

DHCS   247: Health Care Administration BIC - Beneficiary ID Card
DHCS   142: Information Management     Business Intelligence and
                                       Management Support




DHCS   217: Access to Care             California Children’s Services
                                       (CCS)
DHCS                                  California Education
       249: Health Care Research and Practitioner Mental Health Care
                                      Management Program
                                      (CALMEND)
DHCS   217: Access to Care            Cancer Detection Program - Every
                                      Women Counts (CDP-EWC)

DHCS   217: Access to Care             Cancer Detection Program - Every
                                       Women Counts (CDP-EWC)

DHCS   217: Access to Care             CCSAS - CA Child Support
                                       Automation System
DHCS   103: Enterprise Architecture    Chief Information Officer
DHCS   217: Access to Care              Child Health and Disability
                                        Prevention (CHDP)


DHCS   217: Access to Care              Child Health and Disability
                                        Prevention (CHDP)


DHCS   217: Access to Care              Child Health and Disability
                                        Prevention (CHDP)


DHCS   247: Health Care Administration Children Health Initiative (CHI)
DHCS   217: Access to Care              Children Medical Services (CMS)



DHCS   247: Health Care Administration CMSP - County Medical Services
                                       Program


DHCS   247: Health Care Administration CMSP - County Medical Services
                                       Program


DHCS   247: Health Care Administration CMSP - County Medical Services
                                       Program


DHCS   247: Health Care Administration CMSP - County Medical Services
                                       Program


DHCS                                  Community-Living Support Benefit
       249: Health Care Research and Practitioner Education
                                      Waiver Pilot Project (AB 2968)




DHCS   217: Access to Care              Comprehensive Perinatal Services
                                        Program (CPSP)
DHCS   146: Services Acquisition        Contracts and Purchasing
                                        Services Unit
DHCS   146: Services Acquisition        Contracts and Purchasing
                                        Services Unit
DHCS   247: Health Care Administration County Health Services (COHS)

DHCS   247: Health Care Administration County Health Services (COHS)

DHCS   247: Health Care Administration County Health Services (COHS)
DHCS   247: Health Care Administration County Health Services (COHS)

DHCS   247: Health Care Administration County Health Services (COHS)

DHCS   247: Health Care Administration County Health Services (COHS)

DHCS   247: Health Care Administration County Health Services (COHS)

DHCS   247: Health Care Administration County Health Services (COHS)

DHCS   247: Health Care Administration County Mental Health Program
                                       (CMHP)


DHCS   142: Information Management    Database Management and
                                      Support



DHCS   142: Information Management    Database Management and
                                      Support



DHCS   142: Information Management    Database Management and
                                      Support



DHCS   142: Information Management    Database Management and
                                      Support



DHCS   142: Information Management    Database Management and
                                      Support



DHCS   142: Information Management    Database Management and
                                      Support



DHCS   142: Information Management    Database Management and
                                      Support
DHCS   142: Information Management   Database Management and
                                     Support



DHCS   142: Information Management   Database Management and
                                     Support



DMH    217: Access to Care           Department Of Mental Health
DHCS   097: Legislation Tracking     Deputy Director

DHCS   098: Legislation Testimony    Deputy Director

DHCS   099: Proposal Development     Deputy Director

DHCS   104: Strategic Planning       Director
DHCS   217: Access to Care           Early and Periodic Screening,
                                     Diagnosis, & Treatment (EPSDT)

DHCS   262: Information Sharing      Email System Management and
                                     Support
DHCS   106: Workforce Planning       Employee and Resource
                                     Management
DHCS   140: Information Security     Encryption Technology Support
DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support
DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support
DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support
DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support
DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support
DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support
DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support


DHCS   138: System Maintenance       Enterprise Desktop Management
                                     and Support
DHCS   262: Information Sharing      Enterprise Faxing Support
DHCS   116: Debt Collection             Estate Recovery




DHCS   116: Debt Collection             Estate Recovery




DHCS   116: Debt Collection             Estate Recovery




DHCS   116: Debt Collection             Estate Recovery




DHCS   071: Advising and Consulting     Fair Hearing



DHCS   247: Health Care Administration Family PACT (FPACT)
DHCS   247: Health Care Administration Family PACT (FPACT)

DHCS   142: Information Management      FI - Data Entry Operations

DHCS                                      FICOD - Medi-Cal
       034: Key Asset and Critical Infrastructure Protection Network and
                                          Security Technologies
DHCS                                      FICOD - Medi-Cal
       034: Key Asset and Critical Infrastructure Protection Network and
                                          Security Technologies
DHCS                                      FICOD - Medi-Cal
       034: Key Asset and Critical Infrastructure Protection Network and
                                          Security Technologies
DHCS                                      FICOD - Medi-Cal
       034: Key Asset and Critical Infrastructure Protection Network and
                                          Security Technologies
DHCS                                      FICOD - Medi-Cal
       034: Key Asset and Critical Infrastructure Protection Network and
                                          Security Technologies
DHCS                                      FICOD - Medi-Cal
       034: Key Asset and Critical Infrastructure Protection Network and
                                          Security Technologies
DHCS                                      FICOD - Medi-Cal
       034: Key Asset and Critical Infrastructure Protection Network and
                                          Security Technologies
DHCS   247: Health Care Administration Field Office Automation Group
                                       (FOAG)
DHCS   247: Health Care Administration Field Office Automation Group
                                       (FOAG)



DHCS   101: Budget Formulation          Fiscal Forecasting

DHCS   104: Strategic Planning          Fiscal Forecasting & Data
                                        Management


DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)

DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)


DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)


DHCS                                     Fiscal Intermediary & Contracts
       076: Information Infrastructure Management
                                         Oversight Division (FICOD)
DHCS   126: Payments                  Fiscal Intermediary (FI) Denti-Cal




DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS   126: Payments                  Fiscal Intermediary (FI) Medi-Cal
                                      FFS CA-MMIS


DHCS                                   Fiscal Management
       259: Budget and Performance Integration
DHCS   091: Corrective Action         Fraud and Abuse Oversight
DHCS   217: Access to Care            Genetically Handicapped Persons
                                      Program (GHPP)
DHCS   247: Health Care Administration Gynecologic Cancer Information
                                       Program (GCIP)




DHCS   217: Access to Care            HAP - Homeless Assistance
                                      Payments



DHCS   217: Access to Care            HAP - Homeless Assistance
                                      Payments


DHCS   104: Strategic Planning        HCO - Health Care Operations

DHCS   093: Program Monitoring        HCP - Health Care Plans

DHCS   066: Worker Safety             Health and Safety

DHCS   104: Strategic Planning        Health Care Policy

DHCS   217: Access to Care            Health Care Program for Children
                                      in Foster Care (HCPCFC)



DHCS   102: Capital Planning          Health Care Programs

DHCS   116: Debt Collection           Health Coverage Recovery

DHCS   086: General Insurance         Health Insurance Premium
                                      Payment (HIPP)


DHCS   086: General Insurance         Health Insurance Unit




DHCS   086: General Insurance         Healthy Families
DHCS   217: Access to Care               Healthy Families




DHCS   247: Health Care Administration Healthy Kids



DHCS   217: Access to Care               High Risk Infant Follow-Up (HRIF)



DHCS                                  Home and Community-Based
       249: Health Care Research and Practitioner Education
                                      Services for the Developmentally
                                      Disabled (HCBS-DD)


DHCS   250: HR Strategy                  Human Resources Branch
DHCS   251: Staff Acquisition            Human Resources Branch

DHCS                                    Human Resources Branch
       252: Organization and Position Management

DHCS   253: Compensation Management Human Resources Branch
DHCS   256: Employee Relations           Human Resources Branch
DHCS   120: Help Desk Services           Incident Management and Support




DHCS   247: Health Care Administration Indian Health Program (IHP)




DHCS   140: Information Security         Information Security Office (ISO)

DHCS   142: Information Management       Information Technology Services
                                         Division (ITSD)
DHCS   142: Information Management       Information Technology Services
                                         Division (ITSD)
DHCS   142: Information Management       Information Technology Services
                                         Division (ITSD)
DHCS   142: Information Management       Information Technology Services
                                         Division (ITSD)
DHCS   139: IT Infrastructure MaintenanceInfrastructure
DHCS   217: Access to Care             In-Home Operations (IHO)



DHCS   217: Access to Care             In-Home Supportive Services Plus
                                       (IHSS)


DHCS                                  Intermediate Care Facility for the
       249: Health Care Research and Practitioner Education
                                      Developmentally Disabled-
                                      Continuous Nursing (ICF/DD-CN)




DHCS   052: Legal Defense              Legal Services



DHCS   053: Legal Investigation        Legal Services



DHCS                                     Legal
       054: Legal Prosecution and Litigation Services

DHCS   055: Resolution Facilitation    Legal Services

DHCS                                   Legislative & Governmental Affairs
       100: Congressional Liaison Operations (Legislative)

DHCS   217: Access to Care             Long-Term Care




DHCS   138: System Maintenance         Mainframe Production Support

DHCS   140: Information Security       MANA - MEDS Access Network
                                       Automation



DHCS   140: Information Security       MANA - MEDS Access Network
                                       Automation



DHCS   262: Information Sharing        Mass Mailing Technology Support
DHCS   Medi-Cal - Beneficiaries



DHCS   Medi-Cal - Beneficiaries



DHCS   Medi-Cal - Beneficiaries



DHCS   Medi-Cal - Beneficiaries



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers



DHCS   Medi-Cal - Providers
DHCS                                    Medi-Cal - Providers



DHCS                                    Medi-Cal - Providers



DHCS                                    Medi-Cal - Providers



DHCS                                    Medi-Cal - Providers



DHCS                                    Medi-Cal - Providers



DHCS                                    Medi-Cal - Providers



DHCS                                    Medi-Cal - Providers



DHCS                                    Medi-Cal - Providers



DHCS   247: Health Care Administration Medi-Cal Benefits Waivers
                                       analysis & Rates
DHCS   217: Access to Care              Medical Case Management (MCM)



DHCS   217: Access to Care              Medical Case Management (MCM)



DHCS   247: Health Care Administration Medi-Cal Claims Adjudication

DHCS   247: Health Care Administration Medi-Cal Claims Adjudication

DHCS   247: Health Care Administration Medi-Cal Claims Adjudication

DHCS   247: Health Care Administration Medi-Cal Eligibility
DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)
DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)
DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS   247: Health Care Administration Medi-Cal Eligibility Unit (MCED)




DHCS                                    Medi-Cal Managed Care Division
       248: Health Care Delivery Services
                                        (MMCD)
DHCS                                    Medi-Cal Managed Care Division
       248: Health Care Delivery Services
                                        (MMCD)


DHCS                                    Medi-Cal Managed Care Division
       248: Health Care Delivery Services
                                        (MMCD)


DHCS                                    Medi-Cal Managed Care Division
       248: Health Care Delivery Services
                                        (MMCD)


DHCS   247: Health Care Administration Medi-Cal Policy
DHCS   247: Health Care Administration Medi-Cal Policy
DHCS   247: Health Care Administration Medi-Cal Policy

DHCS   247: Health Care Administration Medi-Cal Policy

DHCS   217: Access to Care             Medical Therapy Program (MTP)




DHCS   069: Research and Development Medi-Cal Waivers




DHCS   086: General Insurance          Medicare Buy-In Unit




DHCS   086: General Insurance          Medicare Buy-In Unit
DHCS   086: General Insurance     Medicare Buy-In Unit




DHCS   262: Information Sharing   Medicare Modernization Act
                                  (MMA) Unit
DHCS   262: Information Sharing   Medicare Modernization Act
                                  (MMA) Unit
DHCS   262: Information Sharing   Medicare Modernization Act
                                  (MMA) Unit
DHCS   262: Information Sharing   Medicare Modernization Act
                                  (MMA) Unit
DHCS   262: Information Sharing   Medicare Modernization Act
                                  (MMA) Unit
DHCS   262: Information Sharing   Medicare Modernization Act
                                  (MMA) Unit
DHCS   217: Access to Care        MMCD Systems Support Unit




DHCS   217: Access to Care        MMCD Systems Support Unit
DHCS   217: Access to Care              MMCD Systems Support Unit




DHCS   262: Information Sharing       Mobile Messaging Technology
                                      Support
DHCS   262: Information Sharing       Mobile Messaging Technology
                                      Support
DHCS                                  Multipurpose Senior
       249: Health Care Research and Practitioner Education Services
                                      Program (MSSP)




DHCS                                  Network Infrastructure
       263: System and Network Monitoring
                                      Management and Support
DHCS                                  Network Infrastructure
       263: System and Network Monitoring
                                      Management and Support
DHCS                                  Network Infrastructure
       263: System and Network Monitoring
                                      Management and Support
DHCS   217: Access to Care              Newborn Hearing Screening
                                        Program (NHSP)


DHCS   217: Access to Care              Nursing Facility/Acute Hospital
                                        (NF/AH)
DHCS   041: Foreign Affairs             Office of Binational

DHCS   071: Advising and Consulting   Office of Civil Rights
DHCS                                  Office of Education
       249: Health Care Research and Practitioner Clinical Preventive
                                      Medicine (OCPM)

DHCS   140: Information Security        Office of HIPAA Compliance
                                        (OHC)


DHCS   146: Services Acquisition        Office of Medi-Cal Procurement
DHCS   110: Product Outreach       Office of Multicultural Health
                                   (OMH)


DHCS   003: Social Services        Office of Women's Health (OWH)

DHCS   093: Program Monitoring     OHC - Other Health Care

DHCS   116: Debt Collection        Overpayments



DHCS   116: Debt Collection        Overpayments

DHCS   125: Funds Control          Payment Systems

DHCS   125: Funds Control          Payment Systems



DHCS   125: Funds Control          Payment Systems

DHCS   125: Funds Control          Payment Systems

DHCS   217: Access to Care         Pediatric Day Health Care (PDHC)

DHCS   217: Access to Care         Pediatric Nutrition Surveillance
                                   System (PedNSS)
DHCS   116: Debt Collection        Personal Injury (PI)



DHCS   116: Debt Collection        Personal Injury (PI)



DHCS   116: Debt Collection        Personal Injury (PI)



DHCS                                   Personnel
       255: Employee Performance Management Planning and
                                       Performance
DHCS   247: Health Care Administration Pharmacy Benefits
DHCS   247: Health Care Administration Pharmacy Benefits




DHCS   247: Health Care Administration Pharmacy Benefits




DHCS   247: Health Care Administration Pharmacy Benefits




DHCS   247: Health Care Administration Pharmacy Benefits




DHCS   102: Capital Planning            Policy & Program Support



DHCS   247: Health Care Administration Presumptive Eligibility for Pregnant
                                       Women (PE)




DHCS                                  Primary and Rural Health Care
       249: Health Care Research and Practitioner Education
                                      (PRH)


DHCS   217: Access to Care              Private Duty Nursing (PDN)
DHCS   104: Strategic Planning          Program Support Branch




DHCS                                 Project Management Office
       137: Lifecycle/Change Management
DHCS   217: Access to Care           Provider Enrollment
DHCS   217: Access to Care      Provider Enrollment




DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)



DHCS   108: Customer Services   Provider Relations Operations
                                (PRO)
DHCS   108: Customer Services         Provider Relations Operations
                                      (PRO)



DHCS   108: Customer Services         Provider Relations Operations
                                      (PRO)



DHCS   108: Customer Services         Provider Relations Operations
                                      (PRO)



DHCS   111: Public Relations          Public Affairs

DHCS   141: Record Retention          Records, Mail and Administrative
                                      Services Section


DHCS                               140 Remedy System Management and
                                      Support
DHCS                               140 Remedy System Management and
                                      Support
DHCS                               140 Remedy System Management and
                                      Support
DHCS   087: Formula Grants            Safety Net Financing



DHCS   140: Information Security      Security Investigations and
                                      Forensics Support


DHCS   140: Information Security      Security Investigations and
                                      Forensics Support


DHCS   140: Information Security      Security Threat Detection and
                                      Response Support

DHCS   140: Information Security      Security Threat Detection and
                                      Response Support

DHCS   140: Information Security      Security Threat Detection and
                                      Response Support


DHCS   140: Information Security      Security Threat Detection and
                                      Response Support
DHCS   140: Information Security       Security Threat Detection and
                                       Response Support

DHCS   140: Information Security       Security Threat Detection and
                                       Response Support

DHCS   217: Access to Care             Specialty Mental Health
                                       Consolidation Program (SMHC)
DHCS   247: Health Care Administration SSA Inquiry




DHCS   217: Access to Care             Subacute Care Program




DHCS   092: Program Evaluation         Surveillance and Utilization Review
                                       Section (SURS)
DHCS   092: Program Evaluation         Surveillance and Utilization Review
                                       Section (SURS)
DHCS   247: Health Care Administration Systems Of Care
DHCS   178: Central Property ManagementTelecommunications and Leased
                                       Facilities Unit


DHCS   091: Corrective Action          Third Party Liability & Recovery



DHCS   247: Health Care Administration Utilization Management

DHCS   136: System Development         WEB Services and Support

DHCS   136: System Development         WEB Services and Support

DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support
DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS   262: Information Sharing        WEB Services and Support



DHCS                                    Women, Infants and Children
       039: Food and Nutrition Assistance
                                        (WIC)


DHCS   116: Debt Collection            Workers Compensation Recovery
                                       Program (WCRP)



DHCS   116: Debt Collection            Workers Compensation Recovery
                                       Program (WCRP)



DHCS   116: Debt Collection            Workers Compensation Recovery
                                       Program (WCRP)
DHCS   116: Debt Collection   Workers Compensation Recovery
                              Program (WCRP)



DHCS   217: Access to Care    Working Disabled Program
Description                                                   Application                      Critical
Low-cost health coverage for pregnant women.                  Access for Infants and Mothers No
                                                              (AIM),
Collects all fees and money for the department.               Accounts Receivable System (ARS) No

Collects all fees and money for the department.               Collections Processing System   No
                                                              (CPS)
Provides network services support including LDAP like         Microsoft Active Directory      Yes
Directory services, KERBEROS based authentication and
DNS based naming and other network information.

Provides network services support including LDAP like         Symantec Antivirus              No
Directory services, KERBEROS based authentication and
DNS based naming and other network information.

Provides network services support including LDAP like         Symantec Backup Exec            No
Directory services, KERBEROS based authentication and
DNS based naming and other network information.

Administers human resource policy, fiscal management and Airline System (AS)                  No
program support.
Administers human resource policy, fiscal management and CALSTARS Interface                   No
program support.
                                                            Electronic Perscrutation          No
                                                            Indagation Processing System
                                                            (ePIPS)
                                                            Reports to Web (R2W)              No
Provide extensive home visiting/case management services
to high-risk Indian families.
Provide support for Client and Server Antivirus protection. Antispam                          No

Development Group that maintains ITSD applications.

A Medi-Cal program that pays for a bundle of specific
Assisted Living benefits provided to eligible beneficiaries
residing in Sacramento, San Joaquin or LA Counties.
Researching plans for senior care that have better costs.

Audits utilization for fraud and proper usage. This division Audits and Investigations        No
does: internal audits; financial audits; investigations; case Production (AIP)
administration and development; sanctions; appeals/legal;
and internal audits.
Audits utilization for fraud and proper usage. This division Denti-Cal                        Yes
does: internal audits; financial audits; investigations; case
administration and development; sanctions; appeals/legal;
and internal audits.

Audits utilization for fraud and proper usage. This division Maximus                          Yes
does: internal audits; financial audits; investigations; case
administration and development; sanctions; appeals/legal;
and internal audits.

Audits utilization for fraud and proper usage. This division Medi-Cal Elgibility Data System Yes
does: internal audits; financial audits; investigations; case
administration and development; sanctions; appeals/legal;
and internal audits.

Audits utilization for fraud and proper usage. This division Medi-Cal Management              No
does: internal audits; financial audits; investigations; case Information System - Decision
administration and development; sanctions; appeals/legal; Support System (MIS-DSS)
and internal audits.

The BabyCal campaign is aimed at combating low birth
weight and decreasing infant mortality.
Facilitates beneficiary access to Medi-Cal
Business intelligence group that support function for        CoSort for Windows             No
mainframe sort and data migration projects; data
warehouse staging, integration, and ETL; database reorgs;
business intelligence; field-level privacy; and, application
development.
Treatment for children with chronic/life threatening health Medi-Cal Elgibility Data System Yes
conditions/diseases.
Evidence based care tracking for decision tools.
Developmentally Diasbled waiver to stay home.

Program to provide cancer detection and treatment for all   Breast Cancer & Cervical          No
women in California.                                        Treatment Plan (BCCTP)

Program to provide cancer detection and treatment for all   Medi-Cal Elgibility Data System Yes
women in California.

Receives and stores data needed in the pursuit of non-
custody parents for child support payments.
Oversees all Information Technology for the department.
Preventive health program for low-income children and         Child Health and Disability        Yes
youth. This program has about 2.5 million claims per year.    Prevention (CHDP)

Preventive health program for low-income children and         Medi-Cal CHDP Gateway              Yes
youth. This program has about 2.5 million claims per year.

Preventive health program for low-income children and         Medi-Cal Elgibility Data System Yes
youth. This program has about 2.5 million claims per year.

Look for children care alternatives.
Provides specific services for children by approving          Childrens Medical Services Yes
providers for the services and granting eligibility to        Case Management - CMS-NET
qualified children.
Provides health coverage for low-income, indigent adults in   California State On-Line Query (Cal- Yes
thirty-four, primarily rural, California counties.            SOLQ)

Provides health coverage for low-income, indigent adults in County Mental Health System          No
thirty-four, primarily rural, California counties.          (CMHS)

Provides health coverage for low-income, indigent adults in Maximus                              Yes
thirty-four, primarily rural, California counties.

Provides health coverage for low-income, indigent adults in Medi-Cal Elgibility Data System Yes
thirty-four, primarily rural, California counties.

DHCS to provide a new Medi-Cal community-living support
benefit to increase access to needed health-related and
psychosocial services for persons residing in the City or
County of San Francisco.

Comprehensive family planning services to eligible low
income men and women.
Manages the purchasing services and contract                  Contract Tracking System           No
management for department.
Manages the purchasing services and contract                  Health Inventory System (HIS)      No
management for department.
County services to grant eligibility, grant health services   California State On-Line Query (Cal- Yes
and handle inquiries for service.                             SOLQ)
County services to grant eligibility, grant health services   County Mental Health System          No
and handle inquiries for service.                             (CMHS)
County services to grant eligibility, grant health services   Maximus                              Yes
and handle inquiries for service.
County services to grant eligibility, grant health services   Medi-Cal Elgibility Data System Yes
and handle inquiries for service.
County services to grant eligibility, grant health services   Provider Claims Encounter System No
and handle inquiries for service.                             (PCES)
County services to grant eligibility, grant health services   SOC (Share Of Cost) - Core MEDS Yes
and handle inquiries for service.
County services to grant eligibility, grant health services   TRAC                            No
and handle inquiries for service.
County services to grant eligibility, grant health services   WDTIP                           No
and handle inquiries for service.
Counties create pre-adjudicated TAR's.                        Service Utilization Review,      Yes
                                                              Guidance, and Evaluation (SURGE)

Query building support that enables users to create reports CSA                               No
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

Query building support that enables users to create reports DB2 QMF for Windows               No
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

Query building support that enables users to create reports Ecora                             No
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

Query building support that enables users to create reports IBM’s DB2 for z/OS                Yes
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

Query building support that enables users to create reports Idera Suite                       No
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

Query building support that enables users to create reports MS SQL 2000                       Yes
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

Query building support that enables users to create reports MS SQL 2005                       Yes
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.
Query building support that enables users to create reports Robo FTP Client                      No
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

Query building support that enables users to create reports Visual Studio                        No
that has the ability to display data from multiple data
sources in a large number of intuitive formats and images.

                                                               Medi-Cal Short Doyle (MSD)        Yes
Deputy Director of Department handling legislative
initiatives.
Deputy Director of Department handling legislative
initiatives.
Deputy Director of Department handling legislative
initiatives.
Director of Department.
Part of IHO.                                                   Case Management Information       Yes
                                                               System (CMIS)

E-mail and office application support for unified              Email                             Yes
communications across the Enterprise


An enterprise wide support for encrypting data.                Email Encryption                  Yes
Enterprise support for application installation/roll out for   Device Lock                       No
all desktop applications.
Enterprise support for application installation/roll out for   Guardian Edge Encryption Plus     No
all desktop applications.                                      Hard Disk
Enterprise support for application installation/roll out for   SMS - Microsoft Systems           No
all desktop applications.                                      Management Server 2003
Enterprise support for application installation/roll out for   Symantec Antivirus                No
all desktop applications.
Enterprise support for application installation/roll out for   Symantec Ghost Solution Suite     No
all desktop applications.
Enterprise support for application installation/roll out for   Tier 1 (software and settings     No
all desktop applications.                                      common to all workstations)
Enterprise support for application installation/roll out for   Tier 2 (software and settings     No
all desktop applications.                                      common to all workstations in a
                                                               program)
Enterprise support for application installation/roll out for   User Manager Pro                  No
all desktop applications.
Support for network based faxing solutions.                    Faxing                            No
Recovers Medi-Cal expenditures from the estates of certain Estate Recovery System (ERS)     No
deceased Medi-Cal beneficiaries for services received on or
after the individual’s 55th birthday.

Recovers Medi-Cal expenditures from the estates of certain Medi-Cal Management              No
deceased Medi-Cal beneficiaries for services received on or Information System - Decision
after the individual’s 55th birthday.                       Support System (MIS-DSS)

Recovers Medi-Cal expenditures from the estates of certain Provider Claims Encounter System No
deceased Medi-Cal beneficiaries for services received on or (PCES)
after the individual’s 55th birthday.

Recovers Medi-Cal expenditures from the estates of certain SURS Prospector                  No
deceased Medi-Cal beneficiaries for services received on or
after the individual’s 55th birthday.

Complaints about how benefits/services are/were handled, Appeals                            No
or if services have been denied or modified.

Family Planning, Access, Care and Treatment                 FPACT Waiver (FPR)              No
Family Planning, Access, Care and Treatment                 Medi-Cal Elgibility Data System Yes

Section that inputs all paper claims and Treatment          Key Data Entry - OCR            No
Authorizations.
Responsible to oversee network, system security and         Device Lock                     No
redundancy for business continuity.
Responsible to oversee network, system security and         EventSentry                     No
redundancy for business continuity.
Responsible to oversee network, system security and         Guardian Edge Encryption Plus   No
redundancy for business continuity.                         Hard Disk
Responsible to oversee network, system security and         Imanage                         No
redundancy for business continuity.
Responsible to oversee network, system security and         SMS - Microsoft Systems         No
redundancy for business continuity.                         Management Server 2003
Responsible to oversee network, system security and         Symantec Antivirus              No
redundancy for business continuity.
Responsible to oversee network, system security and         Symantec Ghost Solution Suite   No
redundancy for business continuity.
Faicilities across state to handle treatment requests for   Enterprise Image Management     Yes
medical services. This group determines medical necessity   System (EIMS)
to grant authorization for medical services.
Faicilities across state to handle treatment requests for   Service Utilization Review,      Yes
medical services. This group determines medical necessity   Guidance, and Evaluation (SURGE)
to grant authorization for medical services.

Analyzing Medi-Cal programs past paid claims and            Enhanced Medi-Cal Budget          No
predictive modeling for future forecasting.                 Estimate Redesign (EMBER)
This division manages the budgeting and forecasting for     Budget Utilization and            No
Med-Cal, Denti-Cal and Managed Care services.               Development System (BUDS)

Division that oversee the FI contracts.                     CRM NICE                          No


Division that oversee the FI contracts.                     Customer Relationship             Yes
                                                            Management (CRM)

Division that oversee the FI contracts.                     Denti-Cal                         Yes


Division that oversee the FI contracts.                     DHCS Inventory Management         No


Division that oversee the FI contracts.                     Dimensions                        No


Division that oversee the FI contracts.                     eReports                          No


Division that oversee the FI contracts.                     Livelink                          No


Division that oversee the FI contracts.                     Maximus                           Yes


Division that oversee the FI contracts.                     Medi-Cal Enterprise Information   No
                                                            System (MENTIS)

Division that oversee the FI contracts.                     Medi-Cal Management               No
                                                            Information System - Decision
                                                            Support System (MIS-DSS)
Division that oversee the FI contracts.                     Medi-Cal Telephony                No
                                                            Communications Systems - Call
                                                            Manager
Division that oversee the FI contracts.                     Planview                          No
Dental Services are currently provided as one of the many
benefits under the Medi-Cal program. The beneficiary
services department within the Medi-Cal Dental Program
offers a variety of Services for program beneficiaries.

Contractor that operates, implements changes, and           DHCS Inventory Management          No
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Contractor that operates, implements changes, and           Dimensions                         No
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Contractor that operates, implements changes, and           eReports                           No
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Contractor that operates, implements changes, and           FEMR                               No
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Contractor that operates, implements changes, and           FEVR                               No
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Contractor that operates, implements changes, and           Fiscal Intermediary Access to Medi- Yes
provides services for the California Medi-Cal Management    Cal Eligibility (FAME)
Information System (CA-MMIS).
Contractor that operates, implements changes, and           Gentran                            Yes
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Contractor that operates, implements changes, and           Livelink                           No
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Contractor that operates, implements changes, and           Medi-Cal Enterprise Information    No
provides services for the California Medi-Cal Management    System (MENTIS)
Information System (CA-MMIS).
Contractor that operates, implements changes, and           Medi-Cal Telephony                 No
provides services for the California Medi-Cal Management    Communications Systems - Call
Information System (CA-MMIS).                               Manager
Contractor that operates, implements changes, and           Planview                           No
provides services for the California Medi-Cal Management
Information System (CA-MMIS).
Budgeting and Fiscal Management.
Evaluates, reviews and researches utilization of
Department services to determine if misuse is occuring.
Treatment for specific genetic diseases.                      Medi-Cal Elgibility Data System Yes

Was established in statute (California Health and Safety
Code 138.4) within the Office of Women's Health to
increase awareness and education regarding gynecologic
cancers. Requires providers to provide required
information for analysis. Women's Health.

HAP - Homeless Assistance Payments                            Homeless Assistance Payments /     Yes
                                                              Family Planning Access to Care &
                                                              Treatment (HAP/FPACT)

HAP - Homeless Assistance Payments                            Homeless Assistance Payments /     Yes
                                                              HOMEless (HAP/HOME)

Division that manages all the Health Care Operations for     Maximus                             Yes
DHCS.
Interaction with state contracted health care providers like Maximus                             Yes
HMO's, PPO's, managed care plans
Provides health and saftey oversight for department.

Division that manages all the Health Care Policy for DHCS.

Part of CHDP - Provides public health nurse expertise in
meeting the medical, dental, mental and developmental
needs of children and youth in foster care.

Chief Deputy Director for all policy and operations for
Department of Health Care Services (DHCS)
Collection of Medi-Cal claim fees against other insurance     Health Recovery System (RCV)       No
policies for beneficiaries.
Program that pays private health insurance premiums for       HIPP (TPL)                         No
certain high cost Medi-Cal beneficiaries.

The Health Insurance Unit identifies and maintains private
other health coverage records for Medi-Cal eligibles and to
assure full utilization of such coverage.

Low cost insurance for children and teens. It provides        Healthy Families                   Yes
health, dental and vision coverage to children who do not
have insurance and do not qualify for free Medi-Cal.
Low cost insurance for children and teens. It provides          Medi-Cal Elgibility Data System Yes
health, dental and vision coverage to children who do not
have insurance and do not qualify for free Medi-Cal.

A low-cost health care program available in many counties
for children who are not eligible for full Medi-Cal or
Healthy Families.
Discharge from Neonatal intensive care unit provides
limited diagnostic services for children up to three years of
age.
A Waiver program that authorizes home and community-          Home and Community Based             Yes
based services for developmentally disabled persons who Waiver System (HCW)
are Regional Center consumers.

Oversees the human resources for the department.                Cost and Billing Assistant (CBA)   No
Oversees the human resources for the department.                Position Vacancy Reports (PVR)     No

Oversees the human resources for the department.                Personnel Inventory Management No
                                                                System (PIMS)
Oversees the human resources for the department.                Cost and Billing               No
Oversees the human resources for the department.
A service group that handles incident and problem               BMC Remedy Incident                No
solutions for the department, prevent future incidents          Management
from occurring, while improving IT staff efficiency.

Improve the health status of American Indians/Alaska            Indian Health Program (IHP)        Yes
Natives (AI/AN) living in urban, rural, and
reservation/rancheria communities throughout California.
Based on treaties.
Responsible for information security for all data stored and
transferred in the department
Division that manages internal applications and                 Change Cycle Management System No
infrastructure for the department.                              (CCMS)
Division that manages internal applications and                 Project Inventory Report (PIR) No
infrastructure for the department.
Division that manages internal applications and                 Test Data Management System      No
infrastructure for the department.                              (TDMS)
Division that manages internal applications and                 Total Access for Development and No
infrastructure for the department.                              Analysis (TADA)
Provides infrastructure services for email, desktop, servers,
and network.
A section oversees the development and implementation Case Management Information                   Yes
of home- and community-based programs under Medi-Cal. System (CMIS)

Personal care and domestic services to persons who are            In-Home Health Services System    Yes
aged, blind or disabled and who live in their own homes.          (IHSS)

Intermediate Care Facility for the Developmentally
Disabled-Continuous Nursing - Pilot Project - The waiver
requires the Department to commit to maintaining access
to care, provision of quality services, adhering to cost
effectiveness, and open access to emergency services for
the target population eligible for services under the waiver.

Provide legal defense for the department for medical cases
and department legal issues, including contracts.

Provide legal investigation services for the department for
medical cases and contract negotiations.

Prosecute legal cases for the department.                         Litigation Case Tracking System   No
                                                                  (LCTS)
Provide arbitration services for the department for appeals
and contracts.
Interface with government officials and legislative activities.

Manages operations for all Long Term Care operations.
Increases the number of middle-income Californians who
have quality long-term care insurance that prevents or
delays their dependence on Medi-Cal.

System that provides functionality for mainframe operating        RACF                              Yes
systems
A web-based, single point of contact for authorized MEDS          Centers for Medicaid and          Yes
Coordinators to: Submit MEDS41 forms and requests for             Medicare Services (CMS) 64
Password Resets, Receive Results, Check Status,                   System
Search/Get Reports on MEDS Users
A web-based, single point of contact for authorized MEDS          Medi-Cal FFS Check-Write          Yes
Coordinators to: Submit MEDS41 forms and requests for
Password Resets, Receive Results, Check Status,
Search/Get Reports on MEDS Users
Support for special usage of e-mail that allows for               Mass Emailing                     No
widespread distribution of information to many users.
This is a public health insurance program which provides     Appeals                           No
needed health care services for low-income individuals and
families.
This is a public health insurance program which provides     Customer Relationship             Yes
needed health care services for low-income individuals and   Management (CRM)
families.
This is a public health insurance program which provides     Medi-Cal Elgibility Data System Yes
needed health care services for low-income individuals and
families.
This is a public health insurance program which provides     Medi-Cal Portal                   Yes
needed health care services for low-income individuals and
families.
This is the approved providers that provides needed health   Appeals                           No
care services for low-income individuals and families.

This is the approved providers that provides needed health Automated Eligibiity Verification   Yes
care services for low-income individuals and families.     System (AEVS)

This is the approved providers that provides needed health California Point Of Service         Yes
care services for low-income individuals and families.     (CALPOS)

This is the approved providers that provides needed health Cancer Detection Program (CDP)      Yes
care services for low-income individuals and families.

This is the approved providers that provides needed health Claims Processing                   Yes
care services for low-income individuals and families.

This is the approved providers that provides needed health Common Application Transaction      No
care services for low-income individuals and families.     System (CATS)

This is the approved providers that provides needed health Customer Relationship               Yes
care services for low-income individuals and families.     Management (CRM)

This is the approved providers that provides needed health HIPAA EDI Activation Testing        No
care services for low-income individuals and families.     System (HEATS)

This is the approved providers that provides needed health Listserv                            No
care services for low-income individuals and families.

This is the approved providers that provides needed health Medi-Cal FFS Check-Write            Yes
care services for low-income individuals and families.
This is the approved providers that provides needed health Medi-Cal Portal                    Yes
care services for low-income individuals and families.

This is the approved providers that provides needed health Medi-Cal Short Doyle (MSD)         Yes
care services for low-income individuals and families.

This is the approved providers that provides needed health Medi-Cal Subscription Services     Yes
care services for low-income individuals and families.     Systems (MCSS)

This is the approved providers that provides needed health Medi-Cal Web - Internet Bulletin   No
care services for low-income individuals and families.     Board System (IBBS)

This is the approved providers that provides needed health MEDS41                             Yes
care services for low-income individuals and families.

This is the approved providers that provides needed health Point Of Service (POS)             Yes
care services for low-income individuals and families.

This is the approved providers that provides needed health Provider Telecommunications        Yes
care services for low-income individuals and families.     Network (PTN)

This is the approved providers that provides needed health Targeted Case Management (TCM) Yes
care services for low-income individuals and families.

Develops Waiver programs by working closely with CMS to
serve specific citizen profiles.
Provides short-term case management for Medi-Cal        Case Management Information           Yes
recipients which require medically intensive services.  System (CMIS)

Provides short-term case management for Medi-Cal           Service Utilization Review,      Yes
recipients which require medically intensive services.     Guidance, and Evaluation (SURGE)

Section that provides manual adjudication of suspended     Automated Transaction Generator No
claims.
Section that provides manual adjudication of suspended     Enterprise Image Management        Yes
claims.                                                    System (EIMS)
Section that provides manual adjudication of suspended     Online Claims Correction (OLCC)    No
claims.
Manages the policy and oversight of the beneficiary
eligibility for the Department.
Analyst act as liaisons between the counties and the ITSD    (Medicare) Buy-In (BYN), Title XVI   No
providing MEDS Network training to county and state staff.   (16) - Core MEDS
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Able Bodied Adult Without            No
providing MEDS Network training to county and state staff.   Dependents (ABAWD)
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Alternate Health System (AHS)        No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Application Tracking                 No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    BENDEX                               Yes
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Beneficiary Identification Card (BIC) No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Denti-Cal                            Yes
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Extended History                     No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    FileMatch                             No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Fiscal Intermediary Access to Medi- Yes
providing MEDS Network training to county and state staff.   Cal Eligibility (FAME)
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Income and Eligibility Verification   Yes
providing MEDS Network training to county and state staff.   System (IEVS)
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Local Education Agency (LEA)          No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Maximus                               Yes
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Medi-Cal Elgibility Data System Yes
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Medi-Cal Eligibility Quality Control Yes
providing MEDS Network training to county and state staff.   (MQC)
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Medi-Cal Management                   No
providing MEDS Network training to county and state staff.   Information System - Decision
This unit has update capabilities to make a variety of       Support System (MIS-DSS)
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Medicare Buy-In (BYN), Title XVI   Yes
providing MEDS Network training to county and state staff.   (16)
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    MEDS Central Database (CDB)        Yes
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Ramos/Craig                        No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Social Security Number monitor     Yes
providing MEDS Network training to county and state staff.   (SSN)
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    State Data Exchange (SDX)          Yes
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Statewide Client Index (SCI)       Yes
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Systematic Alien Verification to   Yes
providing MEDS Network training to county and state staff.   Entitlement system (SAVE)
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Analyst act as liaisons between the counties and the ITSD    Test                               No
providing MEDS Network training to county and state staff.
This unit has update capabilities to make a variety of
changes to SSI/SSP records as well as updating SSN-VER
codes on any record.
Contracts for health care services through established       Encounter Data Processing          No
networks of organized systems of care, which emphasize
primary and preventive care.
Contracts for health care services through established           Encounter Data Unit (EDU)         No
networks of organized systems of care, which emphasize
primary and preventive care.
Contracts for health care services through established           Maximus                           Yes
networks of organized systems of care, which emphasize
primary and preventive care.
Contracts for health care services through established           Medi-Cal Management               No
networks of organized systems of care, which emphasize           Information System - Decision
primary and preventive care.                                     Support System (MIS-DSS)
Sets federal and state policy for Medi-Cal programs.             Denti-Cal                         Yes
Sets federal and state policy for Medi-Cal programs.             Maximus                           Yes
Sets federal and state policy for Medi-Cal programs.             Medi-Cal Elgibility Data System   Yes

Sets federal and state policy for Medi-Cal programs.             Reference File Subsystem -        Yes
                                                                 Policy
Works with CCS to provide Occupational Therapy (OT) and
Physical Therapy (PT) for children with eligible conditions in
public schools. Medical Therapy Units (MTU)

Programs that demonstrate and evaluate new health care           Medi-Cal Management               No
delivery systems. These programs focus on reducing costs         Information System - Decision
and providing services in a community based setting.             Support System (MIS-DSS)

The Medicare Buy-In Unit administers the Buy-In           BENDEX                                   Yes
agreement between California and the Federal Social
Security Administration. This Unit is responsible for
maintaining Buy-In information on the MEDS Network
Database, as they receive it from the federal
government. They act as a liaison between the county
and federal government in resolving problems
involving a recipient's Medicare eligibility/entitlement.

The Medicare Buy-In Unit administers the Buy-In           Medi-Cal Elgibility Data System Yes
agreement between California and the Federal Social
Security Administration. This Unit is responsible for
maintaining Buy-In information on the MEDS Network
Database, as they receive it from the federal
government. They act as a liaison between the county
and federal government in resolving problems
involving a recipient's Medicare eligibility/entitlement.
The Medicare Buy-In Unit administers the Buy-In           Medicare Buy-In (BYN), Title XVI           Yes
agreement between California and the Federal Social (16)
Security Administration. This Unit is responsible for
maintaining Buy-In information on the MEDS Network
Database, as they receive it from the federal
government. They act as a liaison between the county
and federal government in resolving problems
involving a recipient's Medicare eligibility/entitlement.

Data exchanges involving BENDEX, Buy-In, MMA                   BENDEX                                Yes
enrollment file and the Finders File.
Data exchanges involving BENDEX, Buy-In, MMA                   Denti-Cal                             Yes
enrollment file and the Finders File.
Data exchanges involving BENDEX, Buy-In, MMA                   Income and Eligibility Verification   Yes
enrollment file and the Finders File.                          System (IEVS)
Data exchanges involving BENDEX, Buy-In, MMA                   Maximus                               Yes
enrollment file and the Finders File.
Data exchanges involving BENDEX, Buy-In, MMA                   Medi-Cal Elgibility Data System Yes
enrollment file and the Finders File.
Data exchanges involving BENDEX, Buy-In, MMA                   Medicare Buy-In (BYN), Title XVI      Yes
enrollment file and the Finders File.                          (16)
Controls Health Care Plan (HCP) information, which affects     Maximus                               Yes
Medi-Cal eligibility. The enrollment or disenrollment of a
Medi-Cal eligible in an HCP affects delivery of services for
that eligible. HCP information is submitted directly from
the carriers once a month for automated data processing.
However, if changes are effective during a month that
affects the next month's eligibility, Systems Support has
the responsibility of processing these cases.


Controls Health Care Plan (HCP) information, which affects     Medi-Cal Elgibility Data System Yes
Medi-Cal eligibility. The enrollment or disenrollment of a
Medi-Cal eligible in an HCP affects delivery of services for
that eligible. HCP information is submitted directly from
the carriers once a month for automated data processing.
However, if changes are effective during a month that
affects the next month's eligibility, Systems Support has
the responsibility of processing these cases.
Controls Health Care Plan (HCP) information, which affects Medi-Cal Management                 No
Medi-Cal eligibility. The enrollment or disenrollment of a   Information System - Decision
Medi-Cal eligible in an HCP affects delivery of services for Support System (MIS-DSS)
that eligible. HCP information is submitted directly from
the carriers once a month for automated data processing.
However, if changes are effective during a month that
affects the next month's eligibility, Systems Support has
the responsibility of processing these cases.


Wireless data communication business service.                   Blackberry Enterprise Server   No

Wireless data communication business service.                   Mobile Messaging               No

The waiver is targeted to those medically fragile individuals
over the age of sixty-five and is administered through
MSSP sites throughout the state, under the California
Department of Aging. Routes to assisted centers instead of
LTC Senior Nursing Facilities (SNF)

Network management group that assists in the monitoring CiscoWorks                             No
and maintenance of network hardware.
Network management group that assists in the monitoring HPOpenview                             Yes
and maintenance of network hardware.
Network management group that assists in the monitoring Ngenius                                No
and maintenance of network hardware.
Helps identify hearing loss in infants and guide families to
the appropriate services needed to develop
communication skills.


Works with Mexico to improve healthcare coverage for
aliens.
In charge of civil rights for health care services.
Strives to promote collaboration and understanding
between public health authorities and health care
providers.
Interface with Centers for Medicare and Medicaid Services       Gentran                        Yes
to manage APD projects to adhere to HIPAA standards.

Manages the contract preparation, bid oversight, and
contract award management. This is done for services and
goods contracts.
Reduce gaps in health status among and improve the
quality of life of California's diverse populations. Looks to
outside funding sources.
Improving the status of women's health.

Identify all insurances belonging to Medi-Cal beneficiaries

The primary function of the Overpayments Unit is to             Medi-Cal Management                No
recover funds due the Medi-Cal program.                         Information System - Decision
                                                                Support System (MIS-DSS)
The primary function of the Overpayments Unit is to             SURS Prospector                    No
recover funds due the Medi-Cal program.
This unit manages warrants, CMS draw drawns, budgeting          Cash Control                       No
for Medi-Cal, and funds management.
This unit manages warrants, CMS draw drawns, budgeting          Centers for Medicaid and           Yes
for Medi-Cal, and funds management.                             Medicare Services (CMS) 64
                                                                System
This unit manages warrants, CMS draw drawns, budgeting          Consolidated Omnibus Budget        No
for Medi-Cal, and funds management.                             Reconciliation Act (COBRA)
This unit manages warrants, CMS draw drawns, budgeting          Medi-Cal FFS Check-Write           Yes
for Medi-Cal, and funds management.
Part of IHO.                                                    Case Management Information        Yes
                                                                System (CMIS)
Part of CHDP

The Unit is responsible for the recovery of Medi-Cal            Casualty Insurance Collection (CIC) No
expenditures in personal injury actions involving Medi-Cal
beneficiaries.
The Unit is responsible for the recovery of Medi-Cal            Medi-Cal Management                No
expenditures in personal injury actions involving Medi-Cal      Information System - Decision
beneficiaries.                                                  Support System (MIS-DSS)
The Unit is responsible for the recovery of Medi-Cal            SURS Prospector                    No
expenditures in personal injury actions involving Medi-Cal
beneficiaries.


Manages the policy, oversight and utilization of the        Denti-Cal                              Yes
pharmacy services for the Department. Manages the rates,
formularies, policies, adjudication services, and oversight
of the pharmacy medication services.
Manages the policy, oversight and utilization of the        Formulary and Online Pharmacy   No
pharmacy services for the Department. Manages the rates, Update System (OPUS)
formularies, policies, adjudication services, and oversight
of the pharmacy medication services.

Manages the policy, oversight and utilization of the        Rebate Accounting and           No
pharmacy services for the Department. Manages the rates, Information System (RAIS)
formularies, policies, adjudication services, and oversight
of the pharmacy medication services.

Manages the policy, oversight and utilization of the        Reference File Subsystem -      Yes
pharmacy services for the Department. Manages the rates, Policy
formularies, policies, adjudication services, and oversight
of the pharmacy medication services.

Manages the policy, oversight and utilization of the        SURS Prospector                 No
pharmacy services for the Department. Manages the rates,
formularies, policies, adjudication services, and oversight
of the pharmacy medication services.

Chief Deputy Director for all policy and program support
for Department of Health Care Services (DHCS)

Allows Qualified Providers to grant immediate, temporary
Medi-Cal coverage for ambulatory prenatal care and
prescription drugs for conditions related to pregnancy to
low-income, pregnant patients, pending their formal Medi-
Cal application.
Improve the health status of special, targeted population
groups living in medically underserved urban and rural
areas of California.
Part of IHO.
Oversees the Records, Mail, Administrative Services
Section, Contracts and Purchasing Services Section,
Telecommunications and Leased Facilities Unit, and Health
and Safety.
Oversees IT projects for the department
Manages operations for enrolling providers to provide       Provider Enrollment Tracking    No
health care services for the Department programs. Handles System (PETS)
the provider applications to accredit and approve providers
to provide medical services for Medi-Cal. Checks
credentials and business status.
Manages operations for enrolling providers to provide       Provider Master File (PMF)           Yes
health care services for the Department programs. Handles
the provider applications to accredit and approve providers
to provide medical services for Medi-Cal. Checks
credentials and business status.

Section that provides support services for Medi-Cal           CRM NICE                           No
providers and beneficiaries. Provide manuals, applications,
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Customer Relationship              Yes
providers and beneficiaries. Provide manuals, applications,   Management (CRM)
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Enterprise Image Management        Yes
providers and beneficiaries. Provide manuals, applications,   System (EIMS)
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           HIPAA EDI Activation Testing       No
providers and beneficiaries. Provide manuals, applications,   System (HEATS)
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Listserv                           No
providers and beneficiaries. Provide manuals, applications,
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Medi-Cal CHDP Gateway              Yes
providers and beneficiaries. Provide manuals, applications,
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Medi-Cal Portal                    Yes
providers and beneficiaries. Provide manuals, applications,
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Medi-Cal Subscription Services     No
providers and beneficiaries. Provide manuals, applications,   Systems (MCSS)
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Medi-Cal Web - Internet Bulletin   No
providers and beneficiaries. Provide manuals, applications,   Board System (IBBS)
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Online Claims Correction (OLCC)   No
providers and beneficiaries. Provide manuals, applications,
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Provider Equipment Tracking       No
providers and beneficiaries. Provide manuals, applications,   System (PETS)
support for claim submission, outreach programs,
education, and other services.
Section that provides support services for Medi-Cal           Publications (PUBS)               No
providers and beneficiaries. Provide manuals, applications,
support for claim submission, outreach programs,
education, and other services.
Responsible for the overall communications and outreach
activities.
Provides administrative support, management of state
warehouse, mail services, asset management, and support
for forms and records.
                                                              BMC Remedy Asset Management       No

                                                              BMC Remedy Change Management No

                                                              BMC Remedy Service Level          No
                                                              Management
Provides financial assistance to California hospitals to      Disproportionate Share Hospital   No
subsidize emergency care centers providing unreimbursed
medical care.
Computer forensic investigation technology support for        EnCase                            No
conducting large-scale and complex investigations.

Computer forensic investigation technology support for        FTK (Forensics Tool Kit)          No
conducting large-scale and complex investigations.

Network group that provides real-time detection of            Cisco Intrusion Detection         Yes
suspicious network activty and suggests remedition
alternatives.
Network group that provides real-time detection of            Cisco Security Agent              Yes
suspicious network activty and suggests remedition
alternatives.
Network group that provides real-time detection of            Cisco Security Monitoring Analysis Yes
suspicious network activty and suggests remedition            and Response System (MARS)
alternatives.
Network group that provides real-time detection of            ELM                               No
suspicious network activty and suggests remedition
alternatives.
Network group that provides real-time detection of            Symantec Security Information         No
suspicious network activty and suggests remedition            Manager (SSIM)
alternatives.
Network group that provides real-time detection of            Websense                              No
suspicious network activty and suggests remedition
alternatives.


Inquiry SSN verification/Title 2/Title 16 info to establish   California State On-Line Query (Cal- Yes
eligibility as required by Federal policies in the            SOLQ)
administration of federally-funded health maintenance
programs
Specific reimbursement rates have been developed for
providers of subacute care who have been licensed and
certified by the DHCS’ Licensing and Certification program.

Evaluates healthcare services utilization and reviews         SURS Prospector                       No
provider utilization.
Evaluates healthcare services utilization and reviews         Surveillance and Utilization          No
provider utilization.                                         Review Section (SURS)

Provides support for department telecommunications,
leased facilities, and automation.

Ensures Medi-Cal complies with 3rd party health care          HIS/OHC (Health Insurance             Yes
service liability laws.                                       Insurance / Other Health
                                                              Coverage) - Core MEDS
Oversees the utilization of medical services for case
management, and medical necessity.
Group that develops, integrates and supprts the Web pages SAS IntrNET                               No
and interfaces for the department.
Group that develops, integrates and supprts the Web pages Team Foundation Server                    No
and interfaces for the department.
Supports the applications used to organize, maintain, and AJAX                                      Yes
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and     GlobalScape                           No
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and     Internet Information Services (IIS)   Yes
present the web pages, data, and other information.
Supports the applications used to organize, maintain, and   ISA Server                        No
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and   Microsoft BizTalk                 Yes
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and   Microsoft Content Management      Yes
present the web pages, data, and other information.         Server (CMS) 2002

Supports the applications used to organize, maintain, and   Microsoft Office SharePoint Server No
present the web pages, data, and other information.         (MOSS)

Supports the applications used to organize, maintain, and   Rational WatchFire WebXM          No
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and   SFTP                              No
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and   Verisign Managed PKI              No
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and   Web Application Manager (WAM)     No
present the web pages, data, and other information.

Supports the applications used to organize, maintain, and   WEB Trends                        No
present the web pages, data, and other information.

Nutrition program that helps pregnant women, new
mothers and young children eat well and stay healthy.

Responsible for identifying and recovering Medi-Cal         Case Identification/Recovery (CIR) No
expenditures made on behalf of beneficiaries whose
injuries are covered by Workers Compensation liability.

Responsible for identifying and recovering Medi-Cal         Medi-Cal Management               No
expenditures made on behalf of beneficiaries whose          Information System - Decision
injuries are covered by Workers Compensation liability.     Support System (MIS-DSS)

Responsible for identifying and recovering Medi-Cal         Provider Claims Encounter System No
expenditures made on behalf of beneficiaries whose          (PCES)
injuries are covered by Workers Compensation liability.
Responsible for identifying and recovering Medi-Cal          SURS Prospector   No
expenditures made on behalf of beneficiaries whose
injuries are covered by Workers Compensation liability.

Allows certain individuals to become eligible for Medi-Cal
by paying low monthly premiums based on countable
income.
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      Application
#     Name               Description                              Type of Data                 Depts




                         Owned by DSS, but DHCS maintains
      Aid to Children in it, controlling access to MEDS via
    1 Emergency (ACE) Meds network. No data container             Unknown                      DHCS

                         AEVS is an Interactive Voice
                         Response (IVR) system and Web
                         Interface that is used by the provider
                         community. AEVS gives information
      Automated          about recipient eligibility, Share of    beneficiary, provider,
      Eligibiity         Cost, Medi-service reservation,          eligibility determination,
      Verification       FPACT HAP Cards, DUR conflict            dates of coverage,
    2 System (AEVS)      messages, POS reject co                  authorization id             DHCS

                         One of 4 data exchanges under
    3 BENDEX             MMA (Medicare Modernization Act) Person, Income                       DHCS

                         CALPOS was designed to perform on-       beneficiary, eligibility,
      California Point   line, real time prospective drug use     pharmacy claim, history,
      Of Service         review as well as on-line, real time     provider, formulary, drug
    4 (CALPOS)           adjudication of pharmacy claims.         reviews                      DHCS

      California Point
      Of Service
    4 (CALPOS)                                                                                 DHCS

      California Point
      Of Service
    4 (CALPOS)                                                                                 DHCS

      California Point
      Of Service
    4 (CALPOS)                                                                                 DHCS
                     California State On-Line Query (Cal-
                     SOLQ) provides real-time access to
                     the Federal Social Security            Access Control, Medi-Cal and
                     Administration’s SSN, Title II and     Medicare eligibility,
                     Title XVI information. California      prescription drug plan
  California State   Medicare Modernization Act Query       information, diagnosis
  On-Line Query      (Cal-MMA) provides authorized          information and medication
5 (Cal-SOLQ)         users with an integrated               history                        DHCS

                   All enrollment data is input into the
                   system by Primary Care Providers
                   (PCPs) only and is done through a
                   Web- based form originally
                   developed for electronic billing for
                   Breast Cancer Early Detection            Person, Health, Claims,
  Cancer Detection Program. Case management fees are        eligibility, provider,
6 Program (CDP)    only reimbursable for                    application,                   DHCS
                   The CMS64 Accounting System is
                   developed to automate many of the
                   accounting and reporting
                   requirements of the DHS
  Centers for      Accounting/Medical Care Services
  Medicaid and     Section. It is designed to provide for
  Medicare         a single point of entry for all
  Services (CMS)   Checkwrite and Handfiled Claim           Claim Payments, reports,
7 64 System        Sched                                    federal matching funds         DHCS
  Centers for
  Medicaid and
  Medicare
  Services (CMS)
7 64 System                                                                             DHCS

                   All children enrolling through the
                   CHDP Gateway who appear eligible
                   for no-cost Medi-Cal as a result of
                   the screening process qualify for
  Child Health and Accelerated Enrollment (AE) and
  Disability       access to Healthy Families (HF). The
  Prevention       child is provided with immediate     person, application, eligibility,
8 (CHDP)           temporary Medi                       provider, coverage                DHCS
  Child Health and
  Disability
  Prevention
8 (CHDP)                                                                                  DHCS


                   Medical Case Management system
                   for Children Services. Manages the
                   approved providers, eligible
  Childrens        beneficiaries, and services allowed.
  Medical Services These are for specialized services to   person, service requests,
  Case             children. Creates Service               medical case, approved
  Management -     Authorizations for claim payment        services, correspondence,
9 CMS-NET          approval. Run under an out              provider                     DHCS
  Childrens
  Medical Services
  Case
  Management -
9 CMS-NET                                                                               DHCS
  Childrens
  Medical Services
  Case
  Management -
9 CMS-NET                                                                               DHCS
                     Processes Provider medical Fee For
                     Service and Crossover
                     electronic/paper claims for Medi-
                     Cal. The Claims Processing
                     subsystem is divided into four (4)         Person, Providers, Policy,
                     main modules: 1) Input Preparation;        claims, attachment, error
                     2) Daily Adjudication; 3) Weekly           codes, denials, suspense,
10 Claims Processing Adjudication; and 4) Reporting Mod         reports, rates, history         DHCS




10 Claims Processing                                                                            DHCS




10 Claims Processing                                                                            DHCS


10 Claims Processing                                                                            DHCS

10 Claims Processing                                                                            DHCS
                       The Customer Relationship
                       Management (CRM) System is a
                       technology-based information
                       system that uses established
                       databases to capture, track, and
   Customer            trend customer information from
   Relationship        start to finish. PR Organization staff   Person, Providers, Policy,
   Management          members use different components         correspondence, call scripts,
11 (CRM)               of CR                                    call knowledge                  DHCS


                       Manages the claim processing for
                       eligible beneficiaries using providers Person, Providers, Policy,
                       approved for dental services through Audits, Claims, Reports,
12 Denti-Cal           Denti-Cal.                             eligibility                       DHCS
                    EIMS replaced the Image
                    Management System and
                    MaxRetriever software by
   Enterprise Image integrating both applications into       Paper Claims,
   Management       one image repository by                  correspondence, claim
13 System (EIMS)    consolidating into IBM OnDemand.         attachments                   DHCS

   Fiscal             Backup for MEDS as in query server.
   Intermediary       Also processes initial card
   Access to Medi-    swipes/access. Eligibility interface
   Cal Eligibility    application to support Fiscal        Person, eligibility, share of
14 (FAME)             Intermediary MMIS systems.           cost, aid code                  DHCS

   Fiscal
   Intermediary
   Access to Medi-
   Cal Eligibility
14 (FAME)                                                                                  DHCS

                      Gentran is a COTS product marketed
                      by Sterling Commerce. It is used at
                      Medi-Cal to translate between ANSI
                      X12 formatted transactions and
                      Medi-Cal proprietary data layout for
                      both inbound and outbound
15 Gentran            transactions.                        Unknown                         DHCS

                    Healthy Families - Contracted
                    program providing specific low cost
                    health care for Californians who may
16 Healthy Families not otherwise qualify for welfare    person, eligibility               DHCS

   HIS/OHC (Health
   Insurance          HIS (Health Insurance System) (OHC)
   Insurance /        (Other Health Coverage) the
   Other Health       identification of all health insurance
   Coverage) - Core   belonging to Medi-Cal beneficiaries;
17 MEDS               maintaining the automated HIS.         Person, insurance coverage    DHCS
   Homeless
   Assistance
   Payments /
   Family Planning
   Access to Care &
   Treatment
18 (HAP/FPACT)                                            Unknown                DHCS
   Homeless
   Assistance
   Payments /
   HOMEless         Homeless Assistance Payments -
19 (HAP/HOME)       Core Meds                             Unknown                DHCS

                    Verifies a beneficiary’s income and
                    asset information. Submits inquiry
   Income and       transactions to other state and
   Eligibility      federal computer systems
   Verification     attempting to locate income and
20 System (IEVS)    asset data. Core MEDS                 Unknown                DHCS
   Indian Health
21 Program (IHP)                                          Unknown                DHCS

                    Manages the enrollment process for
                    beneficiaries enrolling in the
                    managed care plans for Medi-Cal.
                    Service contract for Managed Care.
                    No software or hardware owned by
                    DHCS. Managed Care contracts are Person, Managed Care
                    awarded to various Payors by DHCS Enrollment, Managed Care
22 Maximus          to provide healthcare              Contracts                 DHCS

22 Maximus                                                                       DHCS

                    Through CHDP, children can obtain
                    preventive health assessments to
                    prevent current and potential health
                    problems. The primary function of
                    the CHDP subsystem is to provide
                    the necessary information and
   Medi-Cal CHDP    management controls to ensure
23 Gateway          appropriate health care              Unknown                 DHCS
                         MEDS processes eligibility
                         applications and tracks all eligibility
   Medi-Cal              for beneficiaries AID codes and           Person, eligibility, application,
   Elgibility Data       eligible periods for Fee For Service      aid codes, share of cost, care
24 System                and Managed Care.                         plan                              DHCS
   Medi-Cal
   Elgibility Data
24 System                                                                                          DHCS
   Medi-Cal
   Elgibility Data
24 System                                                                                          DHCS

   Medi-Cal
   Eligibility Quality
25 Control (MQC)                                                   Unknown                         DHCS

                         Processes Provider Fee For Service
                         claims to be paid and sends to SCO.
                         Produce Warrants for all paid claims
   Medi-Cal FFS          to be forwarded to the CMS 64 and
26 Check-Write           post paid warrants from SCO.         Unknown                              DHCS
   Medi-Cal FFS
26 Check-Write                                                                                     DHCS

                         The My Medi-Cal Portal allows for a
                         common entry point to the
                         applications that are the most
                         useful. The portal is a dynamic and
                         user configurable entry point based
                         on user's needs. The portal interface Web pages, documents, links,
                         uses an intuitive windows interface policy information, Medi-Cal
27 Medi-Cal Portal       that allows user                      portal entrance              DHCS

                    Medicare Buy-In, Title XVI - A
   Medicare Buy-In monthly data exchange between
   (BYN), Title XVI DHCS and CMS producing 2 extract
28 (16)             files of MEDS db                               benficiary, SSA income          DHCS
                      County Welfare Offices within the
                      State of California have online MEDS
                      Network access that allows them to
   MEDS Central       update information on the Food
29 Database (CDB)     Stamp/CDB portion of the database. Unknown                            DHCS

                      A security-featured logon to MEDS,
                      intended for circa 500 county users
30 MEDS41             only. Part of MANA project.           logon user admin                DHCS

                      The Medi-Cal POS dial-up and leased-
                      line network is designed to accept
                      electronically submitted transactions
                      related to the delivery of services to
                      California Title XIX (Medicaid)
                      recipients by providers of those
   Point Of Service   services. Electronic transaction
31 (POS)              submittal                              Network routing                DHCS

                   The Provider Subsystem identifies
                   the providers for Medi-Cal and all
                   other health programs using CA-
                   MMIS, as well as the services they
                   are certified/authorized to provide.
                   The Provider Subsystem duties        rates, aid codes, provider
   Provider Master include the maintenance of Provider information, sanctions,
32 File (PMF)      Master File (PMF                     procedure codes                     DHCS

   Provider Master
32 File (PMF)                                                                               DHCS
                   Through a POTS line, providers can
   Provider        access check-write info, claim status,
   Telecommunicati TAR status, drug continuing care,
   ons Network     procedure codes, formulary, and        ivr scripts, login information,
33 (PTN)           operators.                             provider, logging                 DHCS
                     The Reference File Subsystem
                     collects and maintains the files that
                     are used to price and pay claims (i.e.,
                     the procedure, formulary, and
                     diagnosis files), as well as the edits
   Reference File    and audits criteria tables file that are
   Subsystem -       used to apply program policies.
34 Policy            These                                    policy, rules, error codes, rates DHCS
   Reference File
   Subsystem -
34 Policy                                                                                     DHCS

                     E-TARs or paper TARs contain data
                     that is made available to the State
     Service         staff responsible for TAR
     Utilization     adjudication in the Medi-Cal field
     Review,         offices for review through the
     Guidance, and   Service Utilization, Review, Guidance Person, Providers, Policy,
     Evaluation      and Evaluation (SURGE) database, a treatment authorizations,
35   (SURGE)         subsystem of CA-MMIS                  workflow, denials                  DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                                  DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                                  DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                                  DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                     DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                     DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                     DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                     DHCS
     Service
     Utilization
     Review,
     Guidance, and
     Evaluation
35   (SURGE)                                                                     DHCS

   SOC (Share Of   Amount paid by client in month
   Cost) - Core    before Medi-Cal coverage starts.
36 MEDS            Determined by county welfare depts. Person, share of cost     DHCS
   Social Security
   Number monitor                                      social security number,
37 (SSN)                                               beneficiary               DHCS
                    The Social Security Administration
                    (SSA) updates their computer file
                    called the State Supplemental
                    Register (SSR) and send extracted
                    information to create the State Data
                    Exchange (SDX) file. The SDX file is
   State Data       sent to the State daily and is used to
38 Exchange (SDX)   update t                               Federal SSN index               DHCS

   Statewide Client Tracks a unique ID across many
39 Index (SCI)      statewide welfare data bases.         beneficiary, benefits tracking   DHCS

                    TPL
                                                                               Interface Counts

Web Services                        Flat File                                   Other

Counts/Data Volume   Counts/Data Volume         Frequency   Technology/Counts/Data Volume   Frequency




                                                            EDI/50 thousand/150 bytes       Day


                     1/ 1.1 million/100 mb      Month




                                                            EDI/57 million/300 bytes        Year




                     18/20 mb                   Day




                     5/ 100 mb                  Month




                     2/ 10 mb                   Week
200/300 bytes/Month




                                        EDI/200/200 bytes   Day




                      6/ 10 mb   Week
1/ 5 mb             Week




7/ 150 mb           Month




1/ 10 mb            Quarter




                              EDI/1,800/200 bytes   Day




1/1,500/100 bytes   Day




                              EDI/4,100/300 bytes   Day
                      EDI/100 million/400 bytes   year




10/ 20 mb   Month




13/ 1 mb    Day


9/ 25 mb    Week

1/ 3 mb     Quarter




                      EDI/ 15,000/350 bytes       Day
          EDI/ 1,500/800 bytes        Day




          EDI/50 thousand/150 bytes   Day




          EDI/100 million/400 bytes   Year




2/ 2 mb
                  EDI/800/400 bytes       Day




                  EDI/500/500 bytes       Day

10/ 20 mb   Day




                  EDI/780,000/500 bytes   Year
1/ 1 mb      Month


2/ 24 mb     Day


                       EDI/100,000/400 bytes   Day




10/ 100 mb   Week

1/ 10 mb     Request




                       EDI/3,000/500 bytes




2/100 MB     Month
                 EDI/29 million/500 bytes   Month




1/ 3 mb   Week


2/ 2 mb   Day




                 EDI/300/150 bytes          Day
20/ 3 mb   Day


10/ 2 mb   Week




                  EDI/267,000/300 bytes   Month




5/ 10 MB   Week




2/ 10 MB   Day




4/ 2 mb    Day
2/ 20 mb   Day




20/ 3 mb   Day




2/ 2 mb    Day




                 EDI/180,000/1500 bytes   Month




                 EDI/600/150 bytes        Month
1 week
s

    How does it function comment?

                                                                             Month




    Uses direct screen access through the MEDS interface.                    Day




    The Other transactions can come through an Interactive Voice
    Response system, computer systems connected to the department,
    Point of Service devices at the point of care, or through the Medi-Cal
    portal.                                                                  Quarter
    Exchange of information between MEDS and Social Security
    Administration (SSA) through the federal exchange mechanism to
    validate income.                                                         Week


    The other transactions come from Providers in real-time from the
    Point Of Care through Point of Service devices to adjudicate Pharmacy
    claims.                                                                  Request


    These flat files load Pharmacy formulary files for processing of
    Pharmacy claims from First Data Bank.                                    Year

    These flat files load Pharmacy Drug Utilization Review files for
    processing of Pharmacy claims. All but one are actually CD's that are
    read directly by the application.




    Selected claims sent to Fair Isaacs for analysis. FTP
This is an exchange point for MEDS users to validate SSN information
with Social Security Administration (SSA) and MIS/DSS medication
history. This is the first application to begin using an Enterprise Bus
and web services (defined by Bold) to exchange data scheduled early
2009. SSA Inquiry is the core service that communicates with SSA’s
SOLQ-I application and returns the SSA search result.
SOLQ Audit Service logs all SSA inquires in an audit database and
provides audit reports upon request.
SSN Verify checks if the SSN used in the SSA search exists in MEDS as
the proof of business case.
Active Directory Service is an external DHCS utility for identifying the
user and permission group info.
SSA Inquiry Proxy provides user credential for mainframe users.
SOLQ Code Table performs table lookups.
MEDS ID Search searches MEDS by an ID and fill in all necessary
information required by SSA Inquiry. For each inquiry, Active Directory
Service is called to identify user and permission info, SOLQ Audit
Service is invoked to log this inquiry, and SSN Verify service is used to
prove if the requester has valid business reason to search this
individual. Since mainframe users don’t use Windows authentication
to log in, mainframe calls are handled by SSA Inquiry Proxy service.
Proxy service uses Active Directory Service to identify user and




This comes through the AEVS interface for treatment authorization.




Paid claims files to be sent to the Federal CMS for matching funds
reimbursement. These come from Med-Cal, Denti-Cal, Managed Care,
staffing costs, and reimbursed items. FTP
Interface to CALStars. FTP




Interface with SCO to process paid claim warrants for Medi-Cal
Providers. Tape


Creates an extract of CHDP Providers for reporting purposes and
potential claim protests. FTP




Service requests sent to be processed through OCR, Fax, or electronic.




SAR's approved to be paid sent to Denti-Cal or Medi-Cal for payment.
FTP




Interface to validate MEDS information with central elgibility system.
Medi-Cal Providers and Federal CMS send claims to be adjudicated
throug paper, submmitted CMC batches, and interface files.
Processed through batch after receipt.
Provides Diagnosis code2 to Blue Cross. Provides Chronic Renal
Dialysis file to ITSD. All paid claims to paid claims encounter system
(PCES). County claim files. Dental HUMR information. Disabled
payment history. Denti-Cal claims sent to FI Dent-Cal. All CHPD Paid
claims to all counties. FTP

Formulary files from First Data Bank. Conlan lawsuit files to MEDS for
eligibility verfication. Disproportionate eligibility transactions to
MEDS. Daily eligibillity matching for claims processing. FTP
Provider licenses for verification of new Providers. Beneficiary
eligibility for validating claims. Beneficiary information for claims and
helath insurance. FTP

Case file to department of development services. FTP




All applications used by the call agents are in different tabs to access
information pertinent to any call. In the future, an integrated CTI
system is needed to simplify as a single login solution.

Providers send paper (OCR), fax (OCR) and electronic dental claims to
be adjudicated. EDI The paid claims, provider information and
reference data is sent to ITSD for loading to MIS/DSS. Monthly FTP
MEDS eligibility transactions are sent for validation. EDI Paid claims
are sent to SCO on tape for payment to providers weekly. Tape
Online corrections and attachments are linked to applications for
viewing. All claims are scanned or electronically stored for review.


The Other transactions can come through an Interactive Voice
Response system, computer systems connected to the department,
Point of Service devices at the point of care, or through the Medi-Cal
portal.




Medi-Cal and Denti-Cal access eligibility changes to update their local
eligibility information for adjudication of claims through the DTS and
EDS DS3 inter-connections.




Converts the incoming claims into internal formats for claim
processing.




Interface to Sub Contractor for approved eligibles to receive insurance
subsidy.




Part of MEDS application
Part of MEDS application




Part of MEDS application




Exchange to other states and the federal repositories to validate
beneficiary and associated income.

Part of MEDS application




MEDS eligibility verification for managed care beneficiaries.
Beneficiary application requests for acceptance to an approved
benefits plan.




Applications and reports for CHDP health care. Interfaces through the
Medi-Cal Portal gateway to the Claims and eligibility applications.
Eligibility information to hospitals for disproportionate share
calculations. FTP


Elgibility matching for Medi-Cal and Denti-Cal. FTP

The real-time other transactions come from Providers for approval of
benefits.




Part of MEDS application




Paid claims to be be paid by SCO broken out by Medi-Cal programs.
Selected paid claims sent to Fair Isaacs for analysis. Tape

Expenditure report for CCS/GHPP. FTP




Claims supported access to the Medical claims system.


Files extracted from MEDS and returned from CMS to determine
subsidy income to calculate Medicare insurance premium. Use the
Federal communication system.
Part of the MEDS and FAME application.




Just provides login to the MEDS application.




Provides the linkage for the Point of Service devices, dial-in access and
dedicated lines for the Provider Netowrk. Interfaces with AEVS,
CalPOS, and claims processing.




Selected Providers sent to Fair Isaacs for analysis. FTP


Provider informatin for TAR adjudication. FTP




Provider IVR system interface to request approval for a beneficiary
elgibility, SOC, fPACT, CDP/EWC, Medi Reservation.
Reference tables for use in TAR adjudication procesing. FTP


Extracted reference tables for utilization in ITSD. FTP




These come from Providers and Field Office personnel for treatment
approval requests. These can be faxed (goes through OCR
automatically), paper that is OCR'd, or electronic.




Appeals interface that exchanges status and requested information.
FTP




MEDS interface to request address information and validation of
beneficiaries. FTP




Approved TAR requests to be used in claim adjudication processing.
Internal FTP.
Scanned attachments for adjudication of TAR's. FTP




Reference tables for use in TAR adjudication procesing. FTP




Provider informatin for TAR adjudication. FTP




Electronic review of claims data for review of TAR's to the SURS
Prospector data store.




Electronic interface to MapQuest for mileage calculations for TAR
transportation.

This is a transaction that comes through the AEVS interface to update
share of cost and is included in the AEVS counts and is supplied by the
counties and Providers.


Part of the MEDS application.
Part of the IEVS interface.

Provided through the MEDS system to identify citizens using different
welfare plans. Updated by the different welfare plans.

Eligibility information for third party liability.

Most files beween DTS and EDS/Maximus use PKZIP and SFTP. All files
are either encrypted DVD's, CD's, SFTP, or tapes. Real-time links are
through firewalls and dedicated circuits.
Dept   #      Repository              Description                                        Type of Data

DHCS        1 CAB Flat Files                                                             Labor Cost
DHCS        2 Centers for Medicaid    Stores all finance information to interface with   Claim Payments, reports,
              and Medicare Services   CMS for funds requests for reimbursement of        federal matching funds
              (CMS) 64 System         matching funds.

DHCS        3 CRM NICE                Stores recordings for Medi-Cal call center         Voice Recording
                                      phone interactions.
DHCS        6 EMBER                   Stores data for fiscal forecasting Medi-Cal        Eligibles, FFS paid claims,
                                      budgets.                                           encounters, Regressions,
                                                                                         Policy
DHCS       10 MARS database           Security monitoring information and response       Alerts, routing activity,
                                      actions.                                           configuration, response

DHCS       11 Medi-Cal Management     Decision support information for all eliibility,   Person, eligibility, formulary,
              Infrmation System -     formulary, claims and encounters. Seven years      claims, encounters,
              Decision Support        worth                                              Providers, Policy
              System (MIS-DSS)

DHCS       13 MMEF and alerts



                                      The MEDS Worker Alert Record is
                                      provided in an electronic format to
                                      counties and consortium systems.
                                      Critical and Urgent Alert Records
                                      are downloaded into the MEDS
                                      Worker Alerts Reporting System
                                      (MARS) application on Business
                                      Objects. The Medi-Cal Eligibility
                                      Data System (MEDS) Monthly
                                      Extract Files (MMEF) is a “snap
                                      shot” of MEDS at Renewal.
                                      Renewal is when the Medi-Cal
                                      Eligibility of eligible clients is rolled
                                      into the next month on the data
                                      base. This file is used often for ad
                                      hoc reports on the mainframe for
                                      counts and/or to find clients of a
                                      particular set of eligibility criteria. It eligibility, person,
                                      is also loaded onto Business               alerts, status, routing,
                                      Objects for the same purpose.              activity
DHCS       15 RAIS                    Stores all medication claims for analysis of drug Medication Claims,
                                      rebate collection.                                formulary, reports, rebates,
                                                                                        provider, drug companies

DHCS       16 RAIS-Datamart           Decision support analysis of medication claims     Medication Claims,
                                      rebates.                                           eligibility, rebates
DHCS   17 SURS    Decision support system for CA-MMIS to           Person, Providers, Policy,
                  produce SUR reports against paid claims and      paid claims, eligibility,
                  denials.                                         denials
DHCS   18 TPL
DHCS   18 ePIPS   Report writer for multiple applications stored in Person, Providers, paid
                  Business Objects Crystal Report.                  claims, eligibility
No. of Reports       Security Comment
                     (Optional)
                   9 Yes



                  21 Yes

                  61 Yes


                 115 Yes


                 170 Yes




                 278 Yes




                  30 Yes



                 103 Yes

Adhoc Only           Yes
91 Yes
96 Yes


89 Yes

				
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