THE TELLUS DIRECTION FOR EVV SELF-DIRECTION Presented by: Michelle McCandless, Senior Vice President, Operations April 2019
About Us A leading software technology company driving the national expansion of Electronic Visit Verification (EVV) for Participants, Payers, Fiscal Agents and Providers
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) Compliance with Cures Act Implementation Value • Participant • Participant Control • Caregiver • Flexibility • Location • Data Integrity & Security • Service • Payroll and billing automation with Fiscal Agent/s • Check in & out • Authorizations management • Date • Provider Performance • FWA detection & prevention
Beyond the Mandate: Value Across the Ecosystem Reduces fraud, waste Enables one unified and abuse through approach for complex sophisticated rules and networks States MCOs business intelligence Creates provider network Reduces operational transparency and Provider costs and speeds accountability via a single Enterprises reimbursement centralized solution Providers Makes care delivery and In the driver’s seat for reporting simple with easy-to- care delivery Participants Caregivers use and intuitive mobile app
Enterprise EVV Platform CAPTURE MANAGE PROCESS Visit Verification, Data Point of Care check in, Real-time workforce Aggregation & check off & check out management by Participant Fraud-Waste-Abuse BI A comprehensive, yet flexible, platform that goes beyond EVV mandates to allow participants to control care, drive efficiency and speed reimbursements
Security Overview of Tellus Software People Infrastructure Data • • • Automated Source Code • All data encrypted in Zero trust approach. AWS Gov’t Web Hosting. • Scanning. • flight and at rest. Division of Segregated Virtual • • Automated Dynamic Automated File integrity responsibilities. Private Clouds. • • checking. Code Scanning. Level-2 Background Formalized Dev, QA, UAT, • • Regular code reviews. Automated Data Loss Screening. State, Prod, • • Formalized Software Prevention (DLP) Regular HIPPA and Demo/Training Configuration Solution. Security Awareness Environments. 3 rd Party Penetration • • Management (SCM) Automated Data Training. • Reconciliation Routines. Process. Formalized written Testing. • Kubernetes container- security, access, orchestration system acceptable use, breach, • Formalized source privacy, etc. policies. • control management. Regular compliance walkthroughs of the office.
Data Interchange Competency • 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.
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 Caregiver and Participant Participant submits Time Medicaid and chooses review, edit, approve and Sheet to Fiscal Agent for Self-Direction. submit Time Sheet. review and acceptance. Fiscal Agent reviews and Participant interviews and Both Caregiver and accepts Time Sheet. Fiscal hires Caregiver of their Participant sign approved Agent processes payment choice. visit. to the caregiver for the care provided. Fiscal Agent performs Caregiver provides background checks, services and uses the EVV verifies eligibility and Tellus Mobile App to processes hire complete visits. documentation.
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
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