Medicaid Eligibility and Enrollment

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.

• 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 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.