Are you facing these challenges with your Medicaid system?
- Slow and manual or paper-based processes
- Compliance issues or not able to keep up with changing regulations
- Lack of integration with other systems or programs
- Configurable to meet EE 1–27 Eligibility & Enrollment standards.
- Meets CEF 1–22 Conditions for Enhanced Funding.
- Aligned with MITA, CMS guidance, and federal standards.
Our core platform architecture also separates the business and technology layers, making it simple to push features, rule changes, and capabilities making your system compliant with regulations.
The system can be launched quickly due to the unique layered architecture and preconfigured eligibility and enrollment modules. The platform can also scale according to changing volumes.
The in-built integration layer uses standard protocols and data formats, such as RESTful APIs and JSON, to ensure that services can interact seamlessly with various external systems.
The Business Rules engine enables policies and other operational decisions to be defined, tested, executed, and maintained separately from the application code – this provides configurable rules making the system flexible to change.
Reduces manual effort, improves accuracy, and accelerates determination through automation and real-time data integration.
- Complies with HIPAA standards for health information.
- FedRAMP High certified data center and build out for client solutions.
- Follow NIST 800-53 control catalog at the moderate security baseline.
The platform also includes built-in security features, role-based security, and easy integration with other security platforms as required.
Holistic and Integrated Portals
The system includes robust capabilities for Member Portal, Provider Portal, and Agency Portal for different user interactions.
AI Enabled and Supported
A secure framework layer that allows Medicaid agencies to integrate Large Language Models (LLMs) directly into their business processes. This design ensures we can expand functionality while maintaining the highest standards of compliance, accountability, and data protection.
Easy Integrations
Integrations with external systems for exchange of data such as SSA for Social Security Number verification.
Automated Workflows
Workflows, correspondence templates and batch jobs effectively accomplish the various functions of a Medicaid Enterprise System.
Scalable and Continuously Evolving
A future-ready foundation to support additional Medicaid Enterprise and Health and Human Services (HHS) modules – such as MMIS, Provider Enrollment, and Financial Management – without replacing the core platform.
Improve Software Efficiencies to Better Serve Your Community
Engage with hard-to-reach Medicaid members, document services provided, and close gaps in care.
Supercharge Your Care Team with Digital Copilot
HealConnect, a HITRUST-certified digital engagement platform, helps MCOs engage with hard to read members.
Boost Member Completion Rates with Sagitec’s Digital HRA Solution
See how HealConnect helps reduce the administrative burden and improve health compliance.