ACA / PA Technological Changes Update June 2015 Update (tentative) - - PowerPoint PPT Presentation

1

ACA / PA Technological Changes Update

June 2015 Update (tentative)

2

• Introductions
• Purpose
• Summary of ACA Enhancements
• Changes Coming This Year: How it Benefits You
• Questions

Agenda

2

3

Introductions and Purpose

Explore all ACA related changes tentatively coming in June 2015

• Enhanced Self-Service capabilities
• System and work flow changes
• Compliance with CMS guidelines

Discuss the impacts

• Increase efficiencies with job functions and tasks
• Expedited benefit delivery
• Increased customer satisfaction
• Reduction in paper expenditures

Today we will: A look back:

• Enhanced Renewal Processing
• Real Time Information Verification

Conceptual Design Discussed December 2013 ACA / PA Technological Changes Update January 2014 ACA / PA Technological Changes Update June 2014 Present Day November 2014 ACA / PA Technological Changes Update July 2014

4

Summary of Functional Core Areas

• COMPASS Online Eligibility
• Enhanced Renewals
• FFM Intake Eligibility
• Real-Time Verification
• COMPASS Mobile

5

COMPASS Online Eligibility

Functionality Change

• Nature of Required Services document: Question 2, Page 3 under CAO Efficiencies
• Eligibility in future phases, including COMPASS Import, Application Processing (AP) and Case Processing will be accomplished directly

(systematically or automatically) by the Commonwealth COMPASS/eCIS/CIS systems. In other words, the Commonwealth will be utilizing our COMPASS system to process real-time eligibility for benefits and the system will do the processing from importing, to benefit authorization, through notice generation. MAGI and Presumptive Eligibility programs will be the first programs to use this

• technology. Additional programs will be added over the next several phases.

Implementation Phase (tentative)

• June 2015 Release (Tentative)
• COMPASS technology upgrade
• COMPASS Home Page redesign
• Redesign of Community Partners Dashboard
• Enhanced Self-Service capabilities
• Automatic email correspondence from COMPASS to applicants who complete a healthcare telephone application
• Acknowledges our receipt of their application
• Informs the client on how to register for a My COMPASS Account

Benefits

• Increased use of COMPASS and My COMPASS Account (MCA)
• Informs client that we acknowledge receipt of COMPASS application submitted via telephone (ACA Law)
• More features on Community Partners Dashboard to better serve the client
• Expanded access to benefit information

Impacts

• CAO will have additional time to work on client applications and case processing tasks
• Increase use of My COMPASS Account may result in an increase in eNotices (mailing cost reduction) and reporting changes (call volume

reduction)

6

Enhanced Renewals

Functionality Change

• Nature of Required Services document: Question 2, Page 3 under CAO Efficiencies
• Renewal packets will be system created and generated. Ex Parte renewals will automatically occur for MAGI MA where the system will use

real time data sources as verification and determination of ongoing eligibility. Over the next several phases, other programs may be included into the Ex Parte renewal automatic process.

Implementation Phase (tentative)

• June 2015 (tentative)
• No update

Benefits Impacts

7

FFM Intake Eligibility

Functionality Change

• Nature of Required Services document: Question 2, Page 3 under CAO Efficiencies
• Determinations for FFM account transfers, MCI clearances, case open and notices will be accomplished by the system as the

Commonwealth will be using the COMPASS Online Eligibility features described above.

Implementation Phase (tentative)

• June 2015 (tentative)
• No update

Benefits Impacts

8

Real-Time Verification

Functionality Change

• Nature of Required Services document: Question 2, Page 3 under CAO Efficiencies
• Integration with Department of Labor and Industry data to support income verification related to Wage (real time

interface), Unemployment Compensation (quarterly batch,) and New Hire data. Real time interface with available data sources including, but not limited to, initiatives such as TALX, Imaging Integration, National New Hire, PennDOT, Criminal Justice System, Deceased Persons Match, Housing and Urban Development, Disqualified Recipients, Department of Revenue, PA Lottery, and IEVS exchanges 4 & 5 (Federal Tax Information currently available to the commonwealth). Automated case eligibility actions will occur on cases where the verification data can be ascertained through a real time data source and interface.

Implementation Phase (tentative)

• November 2014 Release Update
• Claims Validation Process to support Benefit Package assignment
• Voluntary Health Screening for benefit determination
• Medicare Part B will be automatically added during the LTC COLA run in January 2015
• June 2015 Release (Tentative)
• EDX Expansion allowing Real-time information verification
• Real-time data from additional sources for the Criminal History Data Match (DX10)
• Automated case actions (Age Alerts for MAGI MA Only cases; Claims Determination Process; client reported to contact information

changes via MCA, DLI UC, DPM and CJIS Incarceration hits)

Benefits

• Access to real-time data to assist in processing applications and case maintenance
• Utilizing additional DX Income verification to support Real Time Eligibility for COMPASS applicants and for the Enhance Renewal

Process

• Adjusting client’s benefits in real time will insure client is receiving appropriate health care benefits
• Clients Health Care Benefit package automatically adjusted based upon previous medical needs
• Reduction in the number of pending verifications

Impacts

• Higher volume of online eligibility determinations
• Reduction in pending verifications for data
• Manual process for Voluntary Health Screening
• Retrieve verification data more efficiently
• CAO will have additional time to work on client applications and case processing tasks
• Enhanced renewal processes

9

COMPASS Mobile

Functionality Change

• Natured of Required Services document: Question 2, Page 4
• The Commonwealth will be implementing a COMPASS mobile application with one of the ACA phases to improve customer service

which will allow more of our customers to be able to manage their account, to apply for and renew their benefits, report changes and upload picture images of any required and requested verifications

Implementation Phase (tentative)

• June 2015 Release (Tentative)
• First phase of mobility for our clients
• COMPASS technology upgrade –more accessibility for clients/citizens to making our COMPASS website mobile
• Self-service features for clients as seeing an increase in using tablets, gaming systems, smart phones
• Empowers Community Partners to assist clients
• First phase at this time may not allow clients to utilize the ASD functionality on some devices

Benefits

• Technology upgrade
• Expanded benefit access from phone and tablet devices
• View Benefits
• See e-Notices
• Report changes
• On select devices, can submit a full application or renewal

Impacts

• Better customer service experience
• Reduction in call volume to the CAOs
• Reduction in client visits to the CAOs
• Increase in reported changes coming through COMPASS
• Increase in e-Notices

10

Questions?