Prevent Fraud and Abuse with Enhanced Eligibility
Medicaid agencies support their populations quickly and efficiently with Softheon’s multi-source Enhanced Verification System solution.
Agencies reduce costs and ensure program integrity because Softheon leverages robust data partners, risk scores, and integrations with State systems to ensure eligible individuals receive their benefits quickly.
Successful Past Performance in Professional State Integrations
Medicaid agencies have chosen Softheon as a leading vendor to deliver AVS into today’s established systems and for future Medicaid Management Information System (MMIS) transitions.
Softheon has successfully deployed our AVS solution in four state awards in the past three years.
A Flexible and Modular Solution that Easily Integrates in Established Eligibility Systems
Unlike consulting firms that often re-deploy aged, hard-coded technologies, Softheon’s innovative products offer seamless integrations that meet or exceed modern AVS requirements.
Increase data accuracy by with pre-built interfaces with agencies like the ones you can see on hover or tap below:
Social Security Administration (SSA)
National Database of New Hires (NDNH)
Internal Revenue Service (IRS)
Federal Data Services Hub (FDSH)
State Department of Revenue
State Department of Corrections
State Retirement system
Calculated Risk Scores Help States Prioritize Eligibility Determinations
Softheon helps your staff focus on their mission by providing a numerical risk score on applicant returns.
The risk scores prioritize and color code applications in an integrated solution, empowering your eligibility specialists to use this tool to focus on applicants whose reported assets do not match results.
Prioritization helps eligibility specialists spend their time wisely and focus where they are needed most.
States Can Expect High Data Quality and Fast Returns
Receive eligibility data real-time to days, instead of weeks, with Softheon’s strong Service Level Agreements (SLAs) and an expansive network of data partners. Eligibility workers can stop manually entering AVS requests. Instead, Softheon grants access to real-time web services calls and/or nightly batch file exports, facilitating fast and effortless eligibility returns.
Softheon’s robust data partner approach provides data more efficiently and timely than competitors who rely solely on limited API access while covering over 99% of banks in the United States.
Deploy Rapidly by Training while Softheon Builds Integrations
Softheon’s solution includes a training Portal in advance of the integrated solution. This two-phased approach provides an efficient on-time integration while reducing overall system risk.
Boost Data Accuracy with Configurable Search Parameters
Boost confidence and accuracy in eligibility determinations with custom search parameters to help cover all possible data partners, including financial institutions and real property vendors. Adjustable search parameters include:
Participating public support programs
Expanded searches that with names, recipients, or relatives
Open, closed, or both types of assets
Search state determined radius of applicants' addresses
Save Time Reviewing Analytics Using a Single Platform
Near-real-time access to data enables streamlined daily operations, data analysis, and the basis of reports presented during legislative briefings.
Softheon’s reporting and analytics suite offers intuitive state-of-the-art tools for non-technical users, including:
- Customizable filters
- Drill-down options
- Configurable, customized queries.
Users can analyze data in near-real-time reviewing transaction trends, member demographics, geography, financial information, and cost comparisons. All reporting is available to eligibility specialists on a single, user-friendly platform.