CAPMAN Project

CAPMAN Project

California Department of Healthcare Services (DHCS) Capitation Payment Management System (CAPMAN) Project 

The CAPMAN system processes beneficiary enrollment and payment information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) by transmitting HIPAA-compliant 834 Enrollment and 820 Remittance Advice transactions. In addition, CAPMAN manages beneficiary management, contract management, invoice generation, supplemental eligibility intake and payment processing, and retroactive enrollment, recoupment, & adjustment of capitated payments dating back five years.

OnCore is responsible for ongoing maintenance and operation of the CAPMAN system along with designing, developing, testing, and implementing enhancements prompted by legislative or policy changes.

Feature-CS-CAPMAN