Healthcare Compliance Automated
Medicaid EVV submission, eligibility verification, and regulatory search.
The Problem
A healthcare services provider was manually submitting Electronic Visit Verification (EVV) records to the state Medicaid portal, checking Medicaid eligibility one patient at a time, and searching regulatory updates across multiple state portals. Compliance staff spent more time on data entry than on actual compliance oversight.
Our Approach
We automated the entire compliance pipeline: batch EVV submission to the state portal with validation and error handling, real-time Medicaid eligibility checking integrated into the intake workflow, and a regulatory search engine that monitors state portals for policy changes. Each system feeds a unified compliance dashboard with audit trails.
The Result
EVV submissions that took two full-time staff members now run automatically overnight. Eligibility checks happen at intake instead of after service delivery, eliminating claim denials from coverage gaps. The compliance team now focuses on edge cases and audits instead of data entry.