THE TELLUS DIRECTION FOR EVV SELF-DIRECTION Presented by: Michelle - - PowerPoint PPT Presentation

THE TELLUS DIRECTION FOR EVV SELF-DIRECTION

Presented by: Michelle McCandless, Senior Vice President, Operations

April 2019

A leading software technology company driving the national expansion of Electronic Visit Verification (EVV) for Participants, Payers, Fiscal Agents and Providers

About Us

Why Tellus

• Focused Leader in EVV with a vision that’s driven by delivering value, not

meeting a mandate

• Comprehensive, Modular toolset that easily integrates with existing

infrastructure

• Sophisticated & Flexible business rules engine for insight across a

complex system

• Prospective Analysis of data pre-claim to increase claim quality
• Simplicity for ideal user experience that drives higher adoption rates
• Designed to solve tomorrow’s problems

Why Tellus EVV Self-Directed Option (SDO)

• Participant
• Caregiver
• Location
• Service
• Check in & out
• Date
• Participant Control
• Flexibility
• Data Integrity & Security
• Payroll and billing automation

with Fiscal Agent/s

• Authorizations management
• Provider Performance
• FWA detection & prevention

Compliance with Cures Act Implementation Value

Beyond the Mandate: Value Across the Ecosystem

Reduces fraud, waste and abuse through sophisticated rules and business intelligence

States

Enables one unified approach for complex networks

MCOs

Creates provider network transparency and accountability via a single centralized solution

Provider Enterprises

Reduces operational costs and speeds reimbursement

Providers

Makes care delivery and reporting simple with easy-to- use and intuitive mobile app

Caregivers

In the driver’s seat for care delivery

Participants

CAPTURE

Visit Verification, Data Aggregation & Fraud-Waste-Abuse BI Point of Care check in, check off & check out Real-time workforce management by Participant

A comprehensive, yet flexible, platform that goes beyond EVV mandates to allow participants to control care, drive efficiency and speed reimbursements MANAGE PROCESS

Enterprise EVV Platform

• All data encrypted in

flight and at rest.

• Automated File integrity

checking.

• Automated Data Loss

Prevention (DLP) Solution.

• Automated Data

Reconciliation Routines.

• AWS Gov’t Web Hosting.
• Segregated Virtual

Private Clouds.

• Formalized Dev, QA, UAT,

State, Prod, Demo/Training Environments.

• 3rd Party Penetration

Testing.

• Automated Source Code

Scanning.

• Automated Dynamic

Code Scanning.

• Regular code reviews.
• Formalized Software

Configuration Management (SCM) Process.

• Kubernetes container-
• rchestration system
• Formalized source

control management.

• Zero trust approach.
• Division of

responsibilities.

• Level-2 Background

Screening.

• Regular HIPPA and

Security Awareness Training.

• Formalized written

security, access, acceptable use, breach, privacy, etc. policies.

• Regular compliance

walkthroughs of the

• ffice.

Infrastructure Data Software People

Security Overview of Tellus

• We consider system integration to be a strategic core competency.
• Dedicated integration team.
• Dedicated data interchange platform.
• Supports industry standards (EDI, HL7, etc.)
• All interfaces documented & standardized (can also support custom).
• Batch & transactional messaging supported.
• All Tellus-standard interfaces include a flat file and XML option (also support other

formats such as JSON).

• Support message- and/or transport-level encryption.
• All data interchange managed via a single pane dashboard.
• Data interchange solution under same business process controls as product

software.

Data Interchange Competency

Self-Directed Option (SDO) at Tellus

• Focus: Tellus Self-Directed eVV Solution is designed specifically for

the self-directed marketplace

• Portals specific to participant/employer, payer and fiscal agent
• Flexibility: Tellus Self-Directed eVV Solution includes a powerful

rules engine

• Well suited for the wide variability in requirements from participants, state Medicaid

programs, payers, providers and fiscal agents

• Some states have specific requirements for Tellus eVV for SDO that are in

development.

• We’re here to listen to ensure features and functions that are imperative

for this community are included and flexible for future enhancement.

Tellus Vision for Self-Directed

• Participant Portal
• Fiscal Agent Portal
• Caregiver Portal
• Caregiver Mobile App

The Self-Directed Option Process

Participant is enrolled in Medicaid and chooses Self-Direction. Participant interviews and hires Caregiver of their choice. Fiscal Agent performs background checks, verifies eligibility and processes hire documentation. Caregiver provides services and uses the EVV Tellus Mobile App to complete visits. Both Caregiver and Participant sign approved visit. Caregiver and Participant review, edit, approve and submit Time Sheet. Participant submits Time Sheet to Fiscal Agent for review and acceptance. Fiscal Agent reviews and accepts Time Sheet. Fiscal Agent processes payment to the caregiver for the care provided.

Participant Portal — Scheduling

• Schedules are managed by participant
• Can plan recurring visits
• Can manage unscheduled visits in real-time
• Can begin a visit in one location and complete a visit in a different location
• GPS utilized only at check in and at check out
• Geofencing is not necessary (although available if needed)

Participants or their responsible party will be able to do the following:

• Control the “Who, When and Where” for services
• Get an at-a-glance view of warnings for missed check-ins or outs.
• See services provided during the visit.
• Create, edit or delete visit information.
• Review, sign, accept and submit time sheets for payroll processing to the Fiscal Agent.

Participant Portal — Time Sheet

The Time Sheet In Progress will be automatically created as a draft based on completed Visit Data. Participants will be able to do the following:

• Control the “Who, When and Where” for services
• Get an at-a-glance view of warnings for missed check-ins or outs.
• See services provided during the visit.
• Create, edit or delete visit information.
• Review, sign, accept and submit time sheets for payroll processing to the

Fiscal Agent.

Caregiver Portal — Home Page

At-a-glance view of important information

• Work schedule
• Assigned participants
• Messages and alerts
• Up-to-date PTO information
• Hours worked for day, week, month

Fiscal Agent Portal — Time Sheets

The Time Sheet In Progress will be automatically created as a draft based on completed Visit Data.

• Fiscal Agent will be able to do the following:
• Get an at-a-glance view of warnings for missing clock-ins or outs.
• See, at-a-glance, services provided during the visit.
• View only the visit information.
• Review, accept and reject time sheet for payroll processing.

What is NEVVA? The National Electronic Visit Verification Association (NEVVA) is a not-for-profit organization dedicated to serving as the single source for Electronic Visit Verification industry-related information for states, managed care organizations and

• providers. NEVVA provides expertise, news and information,

advocacy and support to all of these constituents, enabling them to continuously deliver the highest quality of care possible to those who depend on it.

You are cordially invited:

Let’s Talk!

sales@4tellus.com Chris Jensen chris.jensen@4tellus.com (561) 571.5528 Michelle McCandless michelle.mccandless@4tellus.com (954) 951.2960