Modernize your eligibility systems for greater care delivery
States depend on modern eligibility systems to manage complex benefit administration. Systems must be capable of process application handling, data verification, eligibility assessments, benefit distribution and financial management.
Outdated, fragmented systems can complicate policy updates and make system enhancements labor-intensive. Obsolete technology and siloed data sources challenge the ability to meet current operational needs and derive valuable analytics and insights.
We can help you modernize your eligibility system. Streamlined processes and systems allow you to continue delivering essential benefits and quality care to all eligible individuals, efficiently and effectively.
Streamline benefits determination
Streamlined access with a single platform
Our client portal is a single front door for timely eligibility determinations. Designed with a mobile-first approach and grounded in human-centered design, it simplifies processes and saves time.
Through one online application, your clients can access all health and human services programs. These include Medicaid, SNAP, TANF, CHIP and qualified health plans.
Efficient case management from start to finish
Efficiently manage cases from determination to change of circumstance. Our solution offers:
- Advanced case maintenance tools and summary views
- Effective workflow management
- Streamlined benefit issuance and recovery
- Comprehensive financial management
- Rigorous quality assurance and audit reviews
- Robust document management
- Detailed reporting capabilities
Flexibility to meeting changing rules
A flexible business rules engine helps you adapt to changing regulations. Preloaded with current federal rules, it allows for quick configuration to meet state-specific program and rule requirements.
AI-enabled and user-centric customer service experience
Give clients a better eligibility experience with an AI-enabled call center. Designed with a user-centric approach, it dynamically adjusts to meet the needs of your clients and staff. This results in improved customer experiences and operational efficiency.
Improved engagement for your clients and staff
Improve the user experience and staff efficiency with more services, such as:
- Secure authentication and authorization processes
- Outreach programs addressing social determinants of health (SDOH)
- Efficient financial processing
- Advanced AI and process automation
- Comprehensive policy and compliance support
Key benefits
Flexible, integrated eligibility services scale to meet your state’s needs and improve client experiences.
Client centric
A single application simplifies access to care and offers 360-degree benefit management of a client’s entire range of state programs.
Lower total cost of ownership
Centralized benefit management, a cost-effective SaaS model, robust integration services and a flexible rules engine reduce agency costs.
Visibility across all programs
Advanced analytics track metrics and outcomes, detect fraud, compare caseloads, and analyze use and costs across all agency programs.
Improve outcomes
Analytics drive smarter program design and advanced identity management across agencies. A unified data entry point minimizes errors.
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