Eligibility Determination is critical to any healthcare organization at all points of internal team processing and external consumer interaction. Medical providers and payers must be able to exchange accurate information on patients, health outcome data, and must have access to state and federal agencies that are often the final arbiter of eligibility.
We build systems that can interact with federal and state exchanges and data sources, CHIP eligibility and Medicaid eligibility.
UnivERS@Home Extends Your Reach For Eligibility Determination
UnivERS@Home works with your current Medicaid Eligibility Determination System and can act as a stand-alone component of a healthcare eligibility determination solution, or can be a replacement for outdated FAMAS systems. Essentially UnivERS@Home puts eligibility in the hands of the user and provides access to qualifying coverage based on the individual and plan elements.
Captures demographic, characteristic, medical, financial, and insurance information in a single entity for eligibility determination.
A built in feedback loop instantly transmits eligibility status and integrates with existing systems and any number of programs.
UnivERS® core component allows for a “duplicate check” of applicants and can link to Health Information Exchange (HIE).
The status feedback loop accurately informs the applicant of plan options available based on rules set forth by the department or agency.
Meeting the Needs Of An Expansive Low Literate and Non-English Population
Introducing AVAA™, Audio Visual Application Assistor, specifically designed for automating eligibility applications to those with low literacy rates and those who lack proficiency with English. AVAA™ intelligently guides an applicant through a series of simple questions written at a 5th to 6th grade level with simultaneous audio, providing both easy to comprehend text and spoken text. AVAA™ provides:
Ability to collect data for multiple programs including SOBRA Medicaid, Medicaid for low-income families and all children
Automated transmission to a Medicaid central server for processing via kiosk or web portal
English and Spanish interfaces designed to meet the needs of a diverse United States population
Reduces Racial and Ethnic Health Disparities identified by the U.S. Dept. of Health Human Services
AVAA™ was initially deployed as a locally installed product in county health departments but since has evolved into a robust cloud based online solution that can pervasively enroll patients in Medicaid and CHIP. Easy to deploy, AVAA™ provides health organizations a tool for enrollment of all individuals regardless of literacy or language challenges.
AVAA™ was developed by one of the MariChris AIM® Alliance partners, Polyglot systems.
RulesXpress – Easy To Use, Powerful Rules Based Automation
RulesXpress is a powerful, easy to use tool that allows administrators to build complex rule-sets that define any program, or benefit plan without requiring technical intervention. As plans change or as updates take place with new supplemental rules, you can respond quickly and efficiently without any affect on ongoing operations, eligibility submission and application processes. Set up can be complete in as little as fifteen minutes and administrators will have access to a simple, intuitive interface that allows them to easily add, modify or amend any rule in the system.
Automate Income Calculation for Healthcare Eligibility
mMAGI Calculator is an automated tool that directly interacts with providers and payers to determine eligibility based on household income claims. mMAGI Calculator takes the financial and characteristics information from the application and directly integrates with the Federally Funded Exchange (FFE) or State development exchanges to provide immediate answers for eligibility based on household income.
A state-of-the-art eligibility product, mMAGI can interface with a variety of systems, is completely interoperable and can leverage data to support population health outcomes. As with any of our technology solutions, MariChris brings significant healthcare experience to health care organizations of all types and sizes with expertise in the private health sector, public health sector, health exchanges, and health literacy organizations.