Indiana

Health IT

“Universal Caseload System” Smoothes Out Medicaid Eligibility in Indiana

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Indiana

A tech solution helps patients understand their Medicaid coverage faster and more efficiently.

The State of Indiana has an innovative universal caseload system that automatically connects program clients to eligibility caseworkers, and provides caseworkers with an up-to-date electronic virtual case file. The new method improves the traditional one-caseworker-to-one-client human services model by bringing caseworkers, clients and case files together at the same time, all the time.

“Our system organizes the work and distributes it for us, based on the established program timelines”

“The efficient workflow management system and the electronic filing system allow caseworkers to dedicate more time to client services,” said Maria Teresa Velez, Marion County Regional Manager, Indiana Division of Family Resources (DFR).

The Indiana DFR is a division of the Indiana Family and Social Services Administration, and manages eligibility and benefit delivery for Medicaid, Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits.

“The new system allows for tremendous visibility. I now have the ability to quickly see the workload in each office as well as very specific and up-to-date data. Our system organizes the work and distributes it for us, based on the established program timelines. This allows workers more time to focus on customer service, payment accuracy and timely benefit delivery.”

Moving to paperless processing has increased the speed with which cases can be worked. Documents needed to determine eligibility are now scanned and stored electronically, and the state manages workflows automatically according to set priorities and business rules. Previously, a client was dependent on the availability of one caseworker assigned to their case based on the client’s location. Now, any caseworker in any office can assist a client.

“I like that a client can always reach a real person during business hours and that the caseworker can look at the case and actually give helpful information”

“Tasks are rotated to the next available county worker and are generated by the system in order of priority,” said Jennifer Lepsky, Marion County Local Office State Eligibility Manager.

Clients are also better served by the system. Individuals can submit paperwork via the Internet and fax or call a toll-free customer service center that provides immediate, personalized service; applications and requests are now processed more quickly.

“I like that a client can always reach a real person during business hours and that the caseworker can look at the case and actually give helpful information,” said State Eligibility Consultant Nonis C. Spinner. Outside of business hours, an interactive voice response system replaces caseworkers.

The transformed eligibility process is already producing results. According to a published case study, Indiana’s eligibility process modernization has reduced SNAP error rates by 50 percent, raised decision timeliness across all programs from 75 percent to 93 percent, reduced backlogs by two-thirds and virtually doubled its service capacity.

 

This article originally appeared in the Summer 2013 issue of the Xerox HealthFocus magazine.