澳门金沙官网 helps the 佛罗里达州医疗管理局 mitigate fraud and improve patient care with Electronic Visit Verification technology.
的 佛罗里达州医疗管理局 负责佛罗里达医疗补助计划, which provides at-home medical care to eligible Medicare recipients.
的 Agency houses and maintains important recipient and provider information, such as benefit plans and billing data that use the Florida Medicaid Management Information System. This system helps to generate prior authorization (PA) for home services, prompting providers to deliver their services following designated schedules and units.
作为一个国营机构, the Agency must adhere to state regulations and statutes regarding home health services, including a recent update requiring the development and implementation of an Electronic Visit Verification System (EVV). This critical technology tracks the frequency and duration of home care visits, verifying the accuracy of billed services against actual visits made, and ensuring patients receive the care they need.
遵守这些新规定, 中情局知道他们需要可靠的软件, 还有一个合作伙伴帮助实施. Impressed with 澳门金沙官网’s demonstrated history of driving software implementations within the 医疗保健 行业,他们选择了我们 迈阿密 团队的帮助.
Enter Centric: An Approach to Enrich Patient Care and Achieve Compliance
我们这个项目的方法是双重的. First, we partnered with a technology provider to deliver EVV software. 和第二, we provided their resources to drive implementation, 项目管理, 质量控制, 培训, 和合同监督.
For the software implementation, we worked exclusively with 忒勒斯,有限责任公司, a leading provider of claim processing technology for Home Health and Long-Term Care markets. Tellus’ modern EVV system works by identifying the delivery of services and processing claim data. 的 EVV also deters fraudulent practices by offering an electronic billing interface, pa验证的索赔提交过程, and report generation for services not delivered as authorized.
我们把EVV软件托管在云端 亚马逊网络服务 (AWS), with numerous AWS components leveraged including S3 for storage, EC2计算, 监测监控, Route 53 for DNS and Elastic Bean Stalk to orchestrate it all. 另外, 因为可伸缩性很重要, we implemented the Elastic Load Balancer and Elastic Block Store.
Our team’s primary role in the project was to deliver impeccable cradle-to-grave 项目管理 that included drafting and executing a 90-day implementation plan for the EVV technology. In support of the expected launch in the first region, 迈阿密戴德县, we trained Agency staff and medical providers on the EVV system and claims submission procedures. We also developed materials and manuals, outlining EVV guidelines, and procedures. 除了, Centric oversaw the establishment of a sound customer service program to address customer calls, 问题, 和投诉.
的 Impact: A Better Billing and Patient-Care Process
在我们的指导下, the 佛罗里达州医疗管理局 successfully put its EVV system in place. With features including task validation and visit approval, 移动应用程序, GPS三角, 综合帐单和报告, 要求提交, 资格认证, and an interface to the Florida Medicaid Management Information System (FMMIS), 新制度是一种改进.
的y integrated the software state-wide in all Counties and trained providers and employees to use the technology effectively.
While the reporting and analysis of the component continue, our team is proud to be part of implementing a robust EVV system capable of improving patient care, 减少欺诈计费, and helping the Agency achieve full compliance.