MITA Business Areas
The Medicaid Information Technology Architecture Framework 3.0 (May 2014 Update) describes 76 business processes across 9 business areas. Each process pairs a Business Process Template, which lays out its steps, triggers, and results, with a Business Capability Model that defines five maturity levels for 837 capability questions in all. These are the documents a State Self-Assessment scores against.
Transcribed from the CMS appendix PDFs by Nick Aretakis in MITA Open Blueprint (MIT License). Every process page cites the PDF pages it came from.
Standards Management
Authorization Determination · Case Management
Contract Management · Contractor Information Management · Contractor Support
Member Enrollment · Provider Enrollment
Fiscal Management · Accounts Payable Management · Accounts Receivable Management
Claims Adjudication · Payment and Reporting
Compliance Management
Plan Administration · Health Benefit Administration · Health Plan Administration · Health Plan Management
Provider Support · Provider Information Management