Centric Consulting helps the Florida Agency for Healthcare Administration mitigate fraud and improve patient care with Electronic Visit Verification technology.
The Florida Agency for Healthcare Administration operates the Florida Medicaid program, which provides at-home medical care to eligible Medicare recipients.
The 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.
A Need to Enrich Patient Care and Achieve Compliance
As a state-run institution, 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.
To comply with these new regulations, the Agency knew they needed reliable software, and a partner to help implement it. Impressed with Centric Consulting’s demonstrated history of driving software implementations within the healthcare industry, they selected our Miami team for help.
A Large-Scale Approach
Centric’s methodology for this project was two-fold. First, we partnered with a technology provider to deliver EVV software. And second, we provided their resources to drive implementation, project management, quality control, training, and contract oversight.
For the software implementation, we worked exclusively with Tellus, LLC, 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. The EVV also deters fraudulent practices by offering an electronic billing interface, a PA-verified claim submission process, and report generation for services not delivered as authorized.
We hosted the EVV software in the cloud on Amazon Web Services (AWS), with numerous AWS components leveraged including S3 for storage, EC2 for computing, CloudWatch for monitoring, Route 53 for DNS and Elastic Bean Stalk to orchestrate it all. Additionally, since scalability was of importance, we implemented the Elastic Load Balancer and Elastic Block Store.
Centric’s primary role in the project was to deliver impeccable cradle-to-grave project management that included drafting and executing a 90-day implementation plan for the EVV technology. In support of the expected launch in the first region, Miami-Dade County, 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. In addition, Centric oversaw the establishment of a sound customer service program to address customer calls, questions, and complaints.
A Better Billing and Patient-Care Process
Under Centric’s guidance, the Florida Agency for Healthcare Administration successfully put its EVV system in place. With features including task validation and visit approval, mobile application, GPS triangulation, integrated billing and reporting, claims submittal, eligibility verification, and an interface to the Florida Medicaid Management Information System (FMMIS), the new system is an improvement. They 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, Centric is proud to be part of implementing a robust EVV system capable of improving patient care, reducing fraudulent billing, and helping the Agency achieve full compliance.