Glossary


South Carolina Medicaid terminology: SC Web Tool, Screening Requirements, Credit Balance Reporting, Third-Party Liability, Adjustments

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M

Management and Administration Reporting System

(MARS) - A significant component of the Administrative Services Program.  This MMIS (Medicaid Management Information System) subsystem creates financial reports for fiscal planning, management, control, and state/federal reporting reporting requirements.

Mechanized Claims Processing

Mechanized claims processing and information retrieval system or system means the system of software and hardware used to process Medicaid claims from providers of medical care and services for the medical care and services furnished to recipients under the medical assistance program and to retrieve and produce service utilization and management information required by the Medicaid single state agency and federal government for program administration and audit purposes.  The system consists of (1) required subsystems specified in the State Medicaid Manual (2) required changes to the required system or subsystem that are published in accordance with 433.123 of this subpart and specified in the State Medicaid Manual; and (3) approved enhancements to the system.  Eligibility determination systems are not part of mechanized claims processing and information retrieval systems or enhancements to those systems.

Medicaid

The joint Federal/State entitlement program, enacted in 1965 as Title XIX of the Social Security Act, that pays for medical care on behalf of certain groups of low-income persons.

Medicaid Insurance Verification Service

(MIVS) - implemented and designed to give the Medicaid program information that can be used to verify or re-verify private health insurance coverage for Medicaid beneficiaries.

Medically necessary

Related to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care .

Moodle

Moodle (abbreviation for Modular Object-Oriented Dynamic Learning Environment) is a free and open-source e-learning software platform, also known as a Course Management System, Learning Management System, or Virtual Learning Environment (VLE).