MMIS Solutions

Improve Medicaid program management and outcomes
for members, providers, and stakeholders

Modular Cloud-Based Solutions
For MMIS Modernization

Medicaid management is undergoing a seismic shift — adopting modern technologies to streamline operations, increase accuracy, improve productivity, and reduce costs, while enabling agencies to meet expansion requirements. Existing Medicaid Management Information Systems (MMIS) are archaic, inefficient, and inflexible, complicating basic functions such as confirming eligibility, enrollment, and provider management. Underfunded agencies need affordable solutions with the interoperability required to share information across siloed programs, while guarding against increasing threats of fraud or abuse.

Our cloud-based Medicaid Enterprise System (MES) solutions are powered by industry-leading technology and agile methodologies, allowing state agencies to easily modernize their MMIS. Complete interoperability makes healthcare data accessible, computable, and usable for better program management. National Association of State Procurement Officials (NASPO) certifications ensure streamlined workflows and simplified processes for provider management, third-party liability, and program integrity.

Discover your Provider® (DyP®)

Our SaaS-based provider management solution includes the fastest enrollment technology available. Through its provider portal, DyP offers Provider Enrollment, Provider Self-Service, and is highly configurable to support additional functionality. DyP offers:

  • Efficiently enroll and manage providers according to state-specific requirements.
  • Streamlines screening, credentialing, enrolling, and revalidating provider records.
  • Results in enhanced provider experience, increased staff productivity, and the highest quality in customer service.

Verify your Entity™ (VyE™)

Identify, verify, and manage enrollment, license verification and validation, and fraud prevention information across providers, hospitals, facilities, and pharmacies on a platform powered by millions of data points. With intuitive navigation, straightforward filtering, and configurable risk scoring.

  • Aggregates key content in an easy-to-understand format.
  • Automatically approve transactions meeting your organization’s risk threshold scores.
  • Quickly identify potential concerns if further analysis of individuals or businesses is needed.
  • Improves operations by supporting a consistent process and reliable results.

HTG FHIR – Fast Healthcare Interoperability Resources

Healthcare depends on timely information sharing between patients, payers, and providers spanning millions of people nationwide. HTG FHIR provides easy access to data, API management, and flexible configurations with an unlimited number of backend data sources. HTG’s FHIR Server solution provides complete healthcare data interoperability.

  • Fully configurable, role-based self-service portal.
  • SaaS technology and Provider Directory APIs to drive interoperability and simplified data exchange.
  • Fully compliant with Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) standards.
  • Flexible, interoperable end-user authentication aligned with OpenID Connect Core and OAuth 2.0 protocols.

Recover your Liability (RyL)

Ensure accurate, timely Third-Party Liability (TPL) action– from pre-payment cost avoidance to post-payment recovery. RyL enables states to reliably save Medicaid program dollars by precisely identifying known and potential third-party payment resources and ensuring that claims are paid only after all available third-party liabilities have been exhausted.

  • Aggregates key content in an easy-to-understand format.
  • Automatically approve transactions meeting your organization’s risk threshold scores.
  • Quickly identify potential concerns if further analysis of individuals or businesses is needed.
  • Improves operations by supporting a consistent process and reliable results.

Experience You Can Trust

Since 2007, HTG has served the needs of State and Federal Health and Human Services by delivering high-quality, cloud-based software and technical services with a specific focus on Medicaid Management Information Systems Modularity. HTG provides state-of-the-art, SaaS solutions to support states’ Medicaid modernization and interoperability strategies.

National Committee
for Quality Assurance (NCQA) 

Complies with Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) standards

National Association of State Procurement Officials (NASPO) ValuePoint Certification for Medicaid Third-Party Liability

End-to-end assurance that security, availability, processing integrity, confidentiality, and privacy are being rigorously managed.

“We are pleased to collaborate with HHS Technology Group to launch the PRESM system, we believe we now have one of the fastest, if not the fastest, Medicaid provider enrollment and re-enrollment systems and processes in the nation.”

Jesse Springer

Medicaid Technology and Business Operations Section Manager, Wyoming Department of Health.Freelancer