Health & Human Services

Softheon offers a full product suite that enables Health and Human Service agencies to efficiently deliver support services to their low income and otherwise vulnerable constituents. With our MITA-aligned and Modular services, agencies can ensure the appropriate public benefits are provided to the right people. Softheon also supports the prevention of fraud waste and abuse.

Verify

Enhanced Eligibility Verification platform

Softheon’s Verify AVS, is the only system approved for use in both Health (Medicaid, LTSS) and Human Service (SNAP, TANF, Cash Allowance, etc.) programs. Verify is a MITA Aligned, one stop solution for a wide range of services (See below for services provided), dedicated to preventing fraud and ensuring qualified applicants receive the support they need. Verify is offered through a standalone, user-friendly, web-based AVS Portal with direct MMIS Integration capabilities and API suite provided. In order to meet new CMS mandates, Softheon Verify AVS is available for immediate procurement through a state Reseller Agreement through a NASPO contract.

Real Property and Liquid Assets

Health and Human Service agencies can easily perform checks on Real Property, Banking Assets, and Motor Vehicles through Softheon’s Verify AVS in order to facilitate easy and accurate Eligibility determinations.

Identity Proofing

Softheon’s Identity Proofing utilizes our secure, vast database of Personally Identifiable Information to ensure your applicants are who they say they are.

Income & Employment Verification

Softheon utilizes the nation’s largest data collection sets, enabling fast and simple eligibility determinations in order to ensure applicant income and employment attestations are accurate, reliable and complete.

Criminal History

Softheon works with the nation’s largest local, state, and federal background check institutions, providing the best picture of an applicant’s criminal history.

SSN Fraud Detection

Softheon’s extensive network of financial institutions and background check partners will make sure that all Social Security Numbers run through our system to make sure there are no unauthorized or fraudulent claims made through a fake or stolen SSN.

Verify goes far beyond simple credit bureau data to minimize fraud, offering an industry-leading approach designed to help states develop, improve, and refine processes that achieve significant savings. A model that includes the most data sources with the largest number of identities is the only viable approach to achieve a gold-standard. By performing effective pre-enrollment asset and eligibility verification, you’ll have a proven mechanism to deter fraud, save valuable funds, and bring your state’s Medicaid program into compliance with Social Security Act §1940.

Benefits:

  • Medicaid and SNAP verification with future deliveries of TANF, Cash Allowance, and Long Term Care (LTC)
  • A comprehensive network of Financial Institutions (FIs)
  • Web-based Asset Verification System (AVS) portal with secure access to the world’s largest database of public records
  • The ability to assign asset and eligibility risk scores at the applicant and beneficiary level
  • Customized tracking and reporting tools

Foundry

Data Analytics and Reporting

Softheon’s data analytics and reporting platform, Foundry, captures and tracks every member touchpoint, analyzing both their interactions and behaviors. Foundry’s reporting capabilities provide you with all the tools necessary to access and parse data from a high-level population overview down to an individual applicant.

Foundry BI, the solution’s business intelligence component, features configurable, state-of-the-art tools for non-technical users. Providing the ability to “slice and dice” data in near real-time, the reporting and business intelligence suite offers comprehensive analysis of transaction trends and key performance indicators (KPIs), including member demographics, geography and more.

Benefits:

  • Extract, Transform & Load (ETL) from multiple data sources to create custom reporting and analytics
  • Comprehensive ready to use out-of-the-box reporting
  • Compliance with HHS data submission and HIPAA requirements
  • Recovery: Back-up, restore, version, and recover capabilities
  • Service-level agreement (SLA) monitoring tools

Michael Sasko

Vice President of Government Solutions

Mike Sasko is a specialist in health care IT and Health Insurance Exchanges. Mike leads all strategic government partnerships. He joined Softheon in 2017, after working as a project lead, client lead, and business architect lead for several major State, Federal, and Medicaid healthcare projects. Throughout his career, he has also served various leadership roles within Accenture, Pfizer, and early stage IPO organizations. He can be reached by phone at (631) 662-5101 or email msasko@softheon.com

Clients

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