Skip to main content


Do More with What You Have

You’re fighting budget and labor limitations. Softheon gives states the tools they need to meet a growing benefit-eligible population. State agencies can get more done when guided through our automated eligibility verification process. Robust and state-specific data partnerships, easy-to-understand risk scores, and pre-established integrations help those in need receive their benefits quickly.

Get Started

Introduce challenge: Make smarter eligibility determinations, faster

Issues with eligibility verification delays care for residents in need. With a growing benefit-eligible population, agencies need to scale fast and at a low cost.

But preventing fraud and abuse is also a top concern. States can lose millions a year to benefit fraud. Relying on manual processes during busy times leads to incorrect eligibility determinations.

Medicaid Enhanced Eligibility

Tools Eligibility Specialists Need to Succeed 

Support eligibility specialists so they can get more done. Softheon gathers and organizes all the eligibility information they need to make an informed decision. 

Medicaid Enhanced Eligibility

Prioritize Efforts. Color-coded risk scoring helps staff identify and prioritize applicants that may need more thorough reviews. allows for fast approvals so more time can be spent on high-risk applicants.

Medicaid Enhanced Eligibility

See the Big Picture. A single, user-friendly reporting platform tells eligibility specialists and stakeholders what they need to know.

Access to All the Data States Need

Boost confidence and accuracy in eligibility determinations by getting the right data. Custom search parameters and a large network of data partners prevents benefit fraud and abuse. 

Medicaid Enhanced Eligibility

Expanding Data Network. A large and growing network of data partners enables easier and more accurate screenings for state funds. 

Medicaid Enhanced Eligibility

State-Specific Returns. Meet the unique demands of your state with county-specific data partners.

Faster Return Times for Faster Determinations  

Stop manually entering verification requests. And gain access to real-time web services calls and nightly batch file exports for faster eligibility decisions. 

Medicaid Enhanced Eligibility

Returns in Near-Real-Time. Return up to 60% of verifications in near-real-time through pre-established data pathways.

Medicaid Enhanced Eligibility

Quick Implementation Period. Receive hard-to-reach eligibility data in days, instead of weeks, with strong Service Level Agreements (SLAs).

Eligibility Verification RFP Guide for Government Agencies

Learn what your agency should look for in an eligibility verification partner, key areas to focus on, and questions you should ask.

See how smarter automation scales growth and cuts costs.

Get Started