1. 2010 MMIS Conference Interoperability Showcase Presented by the Technical Architecture Committee (TAC)

2. Watch the Transaction Flow for MITA Inquire Member Eligibility
PROVIDER DESKTOP
Direct Internet Connection
Schedule Appointment
Standalone Eligibility
MITA-Based MMIS
PMS
Operations
Management
Program
Management
CAQH CORE II
Adapter
Program
Integrity
Management
Contractor
Management
Care
Management
Business
Relationship
Management
Internet
CORE with NHIN SAML Adapter
Member
Management
Provider
Management
PROVIDER EMR
HIE/NHIN Connection
Integrated Eligibility Verification
Standalone Eligibility
IME
Medicaid-NHIN
CONNECT Gateway
EMR
Administrative NHIN Service
CHIC (MN) - NHIN
CONNECT Gateway
Administrative NHIN Service
PROVIDER EMR
HIE/NHIN Connection
Integrated Eligibility Verification
Standalone Eligibility
EMR

3. Watch the Transaction Flow for MITA Authorization Service
Incorporating Clinical Data from NHIN
PROVIDER DESKTOP
Direct Internet Connection
Schedule Appointment
Standalone Eligibility
Prior Authorization Process
MITA-Based MMIS
Prior Auth
PMS
Operations
Management
Program
Management
CAQH CORE II
Adapter
Program
Integrity
Management
Contractor
Management
Care
Management
Business
Relationship
Management
Internet
CORE with NHIN SAML Adapter
Member
Management
Provider
Management
PROVIDER EMR
HIE/NHIN Connection
Integrated Eligibility Verification
Standalone Eligibility
Prior Authorization Process
Medicaid-NHIN
CONNECT Gateway
EMR
Administrative NHIN Service
CHIC (MN) - NHIN
CONNECT Gateway
Administrative NHIN Service
PROVIDER EMR
HIE/NHIN Connection
Integrated Eligibility Verification
Standalone Eligibility
Prior Authorization Process
EMR

4. Medicaid-NHIN CONNECT Gateway Medicaid-NHIN CONNECT Gateway
MITA Authorization Service – MITA Business Service Details
MITA-Based MMIS
Provider
Management
Contractor
Member
Program
Business
Relationship
Integrity
Care
Internet
EDI
Prior Auth Business Process
Operations
Management
incorporate clinical data
review of clinical documents
Medicaid-NHIN CONNECT Gateway
Clinical
NHIN Services
Note: Requires support for long running transactions
Medicaid-NHIN CONNECT Gateway
Clinical
NHIN Services
EMR

5. PA Flow Diagram OR Authentication Service Provider Desktop PA Adapter
(EDI to XML)
Perform Auditing
SAML Assertion
Transform Request
User Token Data
CAQH CORE 278 Request (w/ User Security Header or X 509 Transport)
Perform Authorization
Internet
278 Request / 278 ACK Response
CAQH CORE Connectivity
Orchestrator
Perform Auditing
PA Service
Invoke Business Service (XML, Input/Output)
278/278 (w/ SAML Header)
Perform Authorization
Submit Request
Perform Auditing
Requires Manual Review?
NHIN Gateway
Perform Auditing
PA Adapter (XML to EDI)
Perform Auditing
Perform Authorization
NHIN Administrative Request (w/ CAQH CORE 278 Request)
Transform Request
No (service returns response) OR
Perform Authorization
Perform Authorization
NHIN Gateway
Yes (service returns ACK)
Convert Approval Data To 278 XML Response
Workflow Engine
NHIN Administrative Request
(w/ CAQH CORE 278 Request)
NHIN Clinical Query (Patient Discovery, Document Query, Document Maintenance)
Notification (Client Polling, Web Device Callback, , etc…)
Perform Auditing
Audit Response (Options)
SAML Assertion
HIE System
Response
Audit Service
Authorization Service
Manual Review
Database, CEF Flat File, etc…
Database, LDAP Flat File, etc…
Approve/Deny
HIE Desktop
Approval Application

6. The TAC welcomes participation from all states, vendors and individuals. Please let us know of your interest, especially if you would be interested in helping to define and deploy services that are consistent with the goals of the TAC. Please contact Dave Walsh at Kimberly Ellison-Taylor at or Julie Walsh at