HHS Tech’s Member Management Solution, Discover your Member™ (DyM), is a cloud-based, Software as a Service (SaaS), Commercial off-the-Shelf (COTS) solution built to provide a single, self-service Intake Portal which serves as the single point of entry for resident documentation across multiple systems, supporting the ability to both receive and export data from multiple, disparate systems. HHS Tech’s DyM solution is built to support the ability to search participant data, export and import data across multiple legacy systems, and as the ‘single source of truth’ for participant information.
One of the key design features of DyM is to give the administrative staff the ability to have a single, yet comprehensive, view of information in order to help them understand the wider range of social, health and environmental barriers preventing individuals from obtaining steady employment and financial independence. To accomplish this DyM integrates administrative data, clinical data and social data in addition to the standard social services, career tracking, assessments and referrals to other agencies in a longitudinal view to gain further insight.
Discover your Member™ (DyM) Key Features
- Service using SaaS Deployment Model
- Enhances Business Agility
- Low cost of Ownership
- Longitudinal View of Participant
- Robust Master Data Management (MDM)
- Modern & Intuitive UI/UX Design
- Suite of third-party integration adapters
HHS Tech’s Provider Management Solution, Discover your Provider® (DyP®), is a Software as a Service (SaaS), Commercial-off-the-Shelf (COTS) solution built to provide wide-ranging functionality through the Provider Portal to include Provider Enrollment, Provider Self Service, and support for additional functionality.
DyP is a holistic, modular solution that supports the enrollment and maintenance of all provider types as well as the needs of internal users. Flexibility, 24/7 accessibility, and ease-of-use are the hallmarks of DyP. Not only does our Solution facilitate and promote greater Provider participation, but our use of leading-edge technology significantly streamlines once seemingly cumbersome internal processes, enhancing the provider’s experience, increasing staff productivity, and promoting the highest quality in customer service. DyP is built to be both modular and adaptable to meet state-specific needs and to conform to the guidance released by the Centers for Medicare and Medicaid Services (CMS), Medicaid Information Technology Architecture (MITA) Seven Standards and Conditions.
Discover Your Provider™ (DyP) Key Features:
- Software-as-a-Service (SaaS)
- Commercial-off-the Shelf (COTS)
- Provider enrollment functions
- Robust Self-Service functions
- Modern, intuitive Provider Portal
- Modern, intuitive Internal User Portals
- Roles based/rules based workflows
- Streamlined workflows using Smart Algorithm technology
- Open architecture principles to drive reuse
Purpose-built Financial Management Platform for Health and Human Service Engaging this multi-program transaction and payment processing system within your IT infrastructure, you will be able to track payments and perform bookkeeping at program, agency, stakeholder, citizen, and household levels. Financials lets your organization easily adapt to changes driven by the marketplace, policy, technology, and consumer expectations.
Financial Management Key Features:
- Core accounting engine
- General Ledgers, Sub Ledgers, and Trial Balance support
- Configuration of Cash and Accrual accounting methods
- Electronic Benefit Transfer (EBT) Card Management for replacing paper vouchers
- Invoice generation and delivery
- Advanced Reporting
Create, publish, and distribute business applications within minutes and days rather than months or years. Assist is your configurable, front-end tool that gives you the ability to build and publish domain-specific applications without the coding. For many organizations, the time lapse between identifying a need and a usable IT solution to address the need is too long. Capturing meaningful user information in a way that is both easy to use and effective for the organization is nearly impossible to do without multiple forms and intake platforms. “Simplifying” the intake process currently requires a lengthy development and procurement process that increases cost. The result: wasted time, wasted resources, and diminished return of investment.
Assist Key Features:
- Front-end tool for modernizing legacy systems for any form intake process
- Application Creation
- Application Management
- Integration with Backend Systems
- Intuitive, User-Friendly Experience
Assist Product Information Video
Assist Demonstration Video
Organization-wide, content management, search, and retrieval tool Content on Secure Document Network (SDN) is a software solution built on Blockchain that allows users to access, manage content wherever it resides within your organization, securely store and transfer various kind of documents. Content on SDN includes features such as advanced search and document management. More details
Content Key Features:
- Smart Intelligent Data Search Engine
- Modern and user-friendly design (GUI)
- Different repositories and mail servers support
- Repositories connecting through GUI
- Document indexing, classification, and set sharing
- Compatibility with third-party products
Highly effective communication begins with personalized, timely notifications. Notify is a service-oriented Enterprise Messaging System (EMS) solution that provides a unified platform to securely distribute accurate, personalized notifications to individual recipients in a heterogeneous application environment with minimum impact on message subscribers.
Notify Key Features:
- Personalized notifications to individual recipients
- Multiple delivery channels – Email, SMS, Printed Mail, Internal Mail
- Preconfigured templates (email, print mail, PDF/PDF forms, SMS, attachment)
- Role-based access control
- Email/SMS subscription management
Flexible, on-demand, SOA reporting tool Audit is a ready-to-use, fully encapsulated Service Oriented Architecture (SOA) solution designed to manage a wide range of audit-related processes on a single integrated platform. This solution captures critical business transaction data and system events in a large-scale, service-oriented enterprise.
Audit Key Features:
- Simple to use standards-based application programming interfaces (APIs) to track system events
- Reporting engine to access and analyze events
- Who/what/ where/when type auditing
- Big Data infrastructure to store and process system events and business transactions
A crisis management electronic health record.
A longitudinal patient records solution supporting compliance with the latest federal data-sharing regulations
HHS Tech’s MediBook is a cloud-based, blockchain-powered patient record solution that enables health plans and managed care organizations to manage and share complete longitudinal patient records across multiple, disparate systems. Leveraging blockchain technology’s inherent decentralization, verification and trust, MediBook provides a self-service member portal and serves as the single source of truth for patient documentation, supporting the ability to search member data, as well as import and export from many legacy systems.
MediBook supports full compliance with recent patient data-sharing rules from CMS and ONC that require health insurers to implement and maintain a Patient Access API in accordance with HL7 FHIR version 4.0.1 standards. Under these new rules, payers must allow access to third-party applications that have been approved by patients to retrieve their own data such as adjudicated claims, provider encounters and lab results.
Among MediBook key features is its ability to assist health plans and providers with patient data-sharing during crises such as natural disasters. By allowing patients to access and share an immutable record that follows them wherever they go, MediBook enables providers to quickly and seamlessly review medical information for patients they’ve never before treated, facilitating the arrangement of medical services when patients’ own providers may not be available. Patient EHR data is accessed through blockchain digital wallet, providing full-time access, security and integrity of data.
Medibook Key Features:
- Cloud-based, blockchain-powered
- Manage and share complete longitudinal patient records across systems
- Full compliance with recent patient data-sharing rules from CMS and ONC
- Ability to assist health plans and providers with patient data-sharing
Augmented analytics for Public and Private health organizations. “Discover your Data™” uses augmented analytics that leverage enabling technologies such as machine learning and artificial intelligence to assist with data preparation, insight generation and insight explanation in order to augment how healthcare organizations explore and analyze their data. Further, the “Discover your Data™” analytics platform will assist healthcare organizations in managing the transition from fee-for-service payments to value-based contracting, while also detecting and minimizing fraud, waste and abuse. Additional features include the ability to:
- Ensure that only qualified, approved providers deliver care to beneficiaries
- Required claims to include complete documentation for services
- Implement prepayment review to prevent improper payments
- Identify and recover erroneous payments
- Streamline suspected fraud investigations
- Provider Utilization analysis
- Member cohort insights by condition or chronic illness
Discover Your Data™ (DyD™):
- Augmented analytics
- Manage the transition from fee-for-service payments to value-based contracting
Recover your Liability™ (RyL) was built to address the growing budgetary constraints of states as they encountered continued growth in the number of citizens eligible for Medicaid, CHIP, and other public programs. States face a constant struggle to reduce Medicaid program costs without eliminating services. As membership in programs grow, states have been diligent in enforcing providers and members alike to supply information on third parties that should accept responsibility for payment before Medicaid.
RyL was specifically built for states to have an end-to-end solution to ensure accurate, timely action is taken across all necessary TPL activities – from pre-payment cost avoidance to post-payment recovery. RyL supports the precise identification and recovery of all known and potential third-party payment resources. Actions taken in RyL ultimately results in real world Medicaid program dollars being saved for their intended use, with claims only being paid after all available third-party liabilities have been exhausted.
RyL is an easy-to-use TPL System Module. It supports all TPL activities as a stand-alone module as part of the overall MMIS system. Data needed by TPL Specialists is easily accessible via web services or interfaces to perform research, usage, updating, managing, accounting, and reporting functions. The web-based solution also makes it easier for staff to conduct their daily jobs, open and close cases, update data, enter collection information, manage the TPL workload, send letters, and obtain reports of their results.
Some of the many features and specific capabilities of RyL include, but are not limited to:
- Authorized users have the capability to resolve TPL edit errors online
- Parameters to identify paid claims for tracking and potential recovery are entered online
- Data related to carriers, policies, and client coverage are accessible online, with extensive search capabilities
- Correspondence, such as letters and Medical Service Questionnaires, can be generated via online web pages
- Workflow component within RyL to track all activity and correspondence related to a recovery case – from inception to final disposition
- Full compliance with all Federal TPL and HIPAA requirements
- Built-in alignment with CMS MITA standards as a modular, flexible, and adaptable technology
- Manages and supports all Federally-required TPL activities such as estate recovery, liens, accident/trauma and tort/liability recovery, post-payment recovery case management, and financial accounting for recovered funds
- Maintains all necessary client, provider, and carrier information
- Provides all necessary information for eligibility verification, claims processing, cost avoidance editing, and timely TPL carrier billing
- APIs available to support TPL data exchange with external sources (e.g., State, Federal, private contractor, etc.)
- Manages post-payment recovery activities (such as billing and collection) and promotes integrity and efficiency throughout the work process
- Generates correspondence to support TPL recovery activities
- Contains authorized user-configurable tables so that TPL Specialists can quickly adjust tables and update edits and matrices
- Produces a wide range of accurate and timely reports to support ongoing TPL operations and demonstrate the effectiveness of TPL activities conducted
- Reports include, but are not limited to, cost avoidance savings, recovery results, status of cases pending recovery, routine operations activities for TPL Specialists and Medicaid agency management, and all required Federal reports
RyL: The Right Solution for TPL Administration
- Modular, flexible and adaptable SaaS module
- Compile with all Federal, CMS MITA standards, and HIPPA requirements
- Adaptable and configurable to align with State-specific policies, business rules, and security requirements
- User configurable rules via the TPL Matrix
- Workflow-driven TPL processes
- Strong reporting and dashboard capabilities
- Public and private APIs to share data to and from external systems
- Uses a Microservices Architecture to enhance RyL’s scalability, granularity, usability, flexibility, and maintainability
RyL End-to-End TPL Support System