Project Description
Within the Department of Health Care Services (DHCS) the Provider Enrollment Division (PED) is primarily responsible for the enrollment and re-enrollment of fee-for-service (FFS) health care service providers. Among other functions, PED manages approximately 160,000 active Medical provider files. It receives on average 1,800-2,400 provider applications each month.
The new Provider Application & Validation for Enrollment (PAVE) system was developed using Agile Methodology and is PED’s remedy for the agency’s outdated legacy system. A requirement to meet Affordable Care Act (ACA) stipulations also ushered in the automated system.
With PAVE, PED is deploying an enterprise-wide web-based provider enrollment portal outfitted with business process workflows that automate provider management activities. This lays the groundwork for other departmental enrollment processes to be built and aligns with the MITA maturity continuum elevating DHCS to a Level 3 for Provider Management at full deployment.