The definition of services and plans is another key component in the complex interaction between public welfare agencies, the providers with whom they contract, and the consumers who receive care.
The MASTRR™ Solutions Service Structure Management module provides all of the tools necessary to maintain accurate, comprehensive information about the agency's services. The module allows the agency to create a service definition, associate the definition with a service group and service initiative, and specify the rules for measuring the service and reimbursing providers. In addition, the agency can associate each service with a set of external codes that providers will use to claim reimbursement, creating a standardized protocol for reporting service delivery. Plans incorporate the concepts of membership and eligibility, with rules governing who can receive and deliver services defined in the plan.