July Update for CaseVue HPE

Taylor Phillips

Over the past month, we have been working hard to improve your overall CaseVue experience. 

That means addressing site load times, giving you access to view your data, as well constantly adjusting our outputs to satisfy the request from states.

New:

  • Reporting- CaseVue now provides users with access to reports to view what is happening on the account. The higher your permission is set, the more information you can analyze.

  • Fine Tuned Tax Screen- You now have the ability to make those little tweaks to a patient's tax situation and improve your capacity to make an accurate decision.

Updated:

  • IMPORTANT!  The state of Mississippi DOM requires that the date that is printed on the HPE Application form be the date that the decision was made. That means that the date you choose to approve or deny the patient is the date that is printed on the form. We understand that this is a concern of many, but it is imperative that you make a determination ASAP in or to cover the patient.

  • To that end, we have opened the user roles to allow all CERTIFIED users to make a case decision. (NOTE: some states require training and/or a test to become certified. Contact your state Medicaid office or contact us at hpehelp@casevue.com and we will help get to the bottom of any question you may have. )

  • AutoComplete had been disabled to not display old cases in your dropdown as an effort to increase patient data protection even further.

  • Server Upgraded- we have made several substantial changes to the way we deliver CaseVue to your browser. That means increased site speed across the board, access to even more security features, and the ability to analyze site errors(including downtime) often before you have time to report it to us. 

BugFixes:

  • Fixed the occurrence of an unborn child not counting correctly.

  • Fixed a very particular instance in which MS parent/caretaker category was being too tough to qualify.

  • Income rounding in MS follows the DOM request for rounding to the hundredths not thousandths (for example, it was 4.333, now it is 4.33). All states now follow their states recommended rounding rate.

  • Text changes to the My Cases page, the scoring screen, and several emails.

As always if you ever need help or have a question, we are here for you! Send us an email to hpehelp@casevue.com




CaseVue Best Practices

Solara Cochran

Successful "real world" examples from our Long-Term Care Customers

Healthcare organizations hire AutoGov to help improve in their admission processes. We can help them by providing a decision assistance tool that will predict the probability of a Medicaid approval in an extremely successful and timely format. Because of our software, AutoGov clients save millions of dollars in write-offs annually.

Customer examples:

One client story begins with a resident referral coming in from the hospital. The Business Office Manager (BOM) utilizes CaseVue with nearly every potential admission. The BOM immediately runs a CaseVue score with the information provided from her referral source. Depending on the admission process (including the CaseVue risk score), that referral can be accepted or denied inside of their policy-based 15-minute time frame. The patient's CaseVue score was helpful in determining that the potential resident would need to address just a few assets before the state would grant an approval. The CaseVue risk score was 56%. Standing in the way of approval, CaseVue uncovered some property in a completely different state. The resident would not qualify for Medicaid without selling the property and beginning a spend-down plan. The family didn't realize their mother owned any property, let alone in another state. Without CaseVue, the state would have denied the residents Medicaid application. In this state, a denial usually takes about 6 months. CaseVue saved everyone involved in the case time and money!!

CaseVue is also helpful in detecting potential fraud. A resident referral was sent to a Long-Term Care Nursing Home by a community resource. The potential resident admitted to being Medicaid Pending and as part of their admission process, the facility administrator ran a CaseVue score. CaseVue returned a score of 0% but verified the Social Security Number to be that of an actual person, one who was deceased. The nursing home was able to avoid potential losses in the hundreds of thousands. Admission was denied due to fraud.

CaseVue, helping real-people make real-world admission decisions!




Pull Back the Curtain, a Spotlight on CaseVue

Solara Cochran

So what is CaseVue?

CaseVue employs predictive data analytics to provide its healthcare clients with a risk mitigation product designed to assist in Medicaid eligibility determination.  

In English please…

With CaseVue, you will be able decide whether or not to admit a patient who is Medicaid pending with just a touch of a button. Your write-offs will vanish and your census will increase.

CaseVue uses predictive modelling to assign each patient a risk score.  The CaseVue risk score predicts the probability that a patient will be approved by Medicaid.

Modelling?  What is predictive modelling?

Here's how Wikipedia defines Predictive Modelling: (Link)

Predictive modelling is the process by which a model is created or chosen to try to best predict the probability of an outcome.  In many cases the model is chosen on the basis of detection theory to try to guess the probability of an outcome given a set amount of input data, for example given an email determining how likely that it is spam.  

Examples of companies that effectively use Predictive Modelling in their markets; big box retailers similar to Target, Nordstrom's, and Best Buy, insurance companies when calculating premiums for motor vehicle, life, or health insurance, and meteorologist when predicting the weather.  Internet search engines use predictive modelling to discernibly predict everyone's every move.  

Looking for more information?  Go to www.CaseVue.com or call (866) 368-3753 for a product demonstration.




What is CaseVue?

Taylor Phillips

CaseVue is simply your admissions professionals best friend.




With CaseVue your facilities will dramatically increase the quantitative measures by which the admission decisions are made.  You will see a profound decrease in Medicaid write-offs and an increase in census as your operation becomes more efficient.

The CaseVue software is part of a comprehensive platform used by government agencies and healthcare providers to furnish decision support solutions with a base in predictive analytics (Big Data).  The software takes your patient applications, fuses hundreds of pieces of data from trusted sources, and provides your facilities with fast, accurate Medicaid eligibility support right to your desktop or tablet in seconds. 

Visit http://www.casevue.com

Call for a demo: 1-866-368-3753




States Required to Implement Medicaid Asset Verification System

Gregg Phillips

Federal law compels states to work with banks to check bank accounts for assets when applying for Medicaid long term care. 


The law is clear and unambiguous - states shall implement a system for verifying the existence and balances of checking and savings accounts owned by individuals applying to receive Medicaid benefits for long term care. 

The law, Section 1940 of the Social Security Act (http://www.ssa.gov/OP_Home/ssact/title19/1940.htm) compels the US Department of Health and Human Services to ensure all states have implemented a Medicaid Asset Verification System by September of 2013. The penalty for not installing an AVS solution could be the loss of all Medicaid funding. 

So far, states have been slow to implement the required AVS solution. Florida was first to install AVS with Maryland right on their heels. 

Pilots indicate there could be as high as 17% of Medicaid cases with undisclosed banking assets.

AutoGov is at the forefront of delivering an AVS solution in Maryland that is integrated with an existing eligibility support solution driven by big data analytics and verification solutions from the industry's most effective data providers. 




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