Capabilities
Social Interest Solutions brings expertise in systems design and development to improve access to services for individuals and families and to promote efficiency for program administrators.
Eligibility Determination
Applying for health and social services programs can be intimidating and cumbersome for individuals and families. It often means waiting in long lines, completing multiple paper forms, traveling to different locations, and navigating an incredibly complex maze of referrals and programs. Social Interest Solutions uses technology to help streamline the application process for families and program administrators by providing a single electronic application that collects and stores information, screens and delivers data electronically, and helps families enroll in a range of public and private programs.
TOOLS
One-e-App
One stop. One time. One application. Innovative One-e-App technology connects low-income families to programs and services ranging from Medicaid, CHIP, and subsidies for Qualified Health Plans purchased through health insurance marketplaces, to SNAP (Food Stamps), income tax credits, energy subsidies and more. One-e-App has facilitated the enrollment of more than 23 million people nationally into Medicaid and other federal, state, and local programs.
Enrollment Management
Our solutions provide customers with the capability to enroll and manage their program populations. Sophisticated rules engines, built-in user interface validations, and back-end systems verifications promote high-quality, error-checked electronic applications. Features such as workload management, document administration, generation of member identification cards and notification letters, and integrated consumer survey and reporting tools provide program administrators with a comprehensive enrollment management solution.
SOLUTIONS
County Indigent Programs
For more than 10 years, Social Interest Solutions has partnered with county agencies to help manage enrollment in their local adult medically indigent programs. We have helped these agencies better serve their clients by providing a one-stop process for eligibility determination and enrollment, first screening applicants for eligibility for federal and state programs before enrolling them in the county-funded program. Our solutions allow agencies to track and support enrollment activities across programs and in the community, and provide outreach management and retention tools.
Decision Support
Social Interest Solutions provides advanced, “quick results” decision support tools that help deliver high-quality, accurate eligibility determination and provide valuable information and predictive analysis tools that support enrollment decision-making. These solutions can be used by Health Insurance Marketplace test teams, state collaboratives, navigators, call center customer service representatives, and policy researchers.
TOOLS
Magi Cloud
MAGI Cloud is a powerful, software-as-a-service offering that provides detailed eligibility analysis for the Affordable Care Act’s health insurance affordability programs. MAGI Cloud’s Insight tool helps call centers and third-party assisters assess cost implications of year-to-year health plan rate changes, make decisions about auto-enrollment vs. re-determination, and anticipate when consumers should report changes back to the health insurance marketplace. MAGI Cloud also includes a test management platform, which is designed specifically to support ongoing Health Insurance Marketplace regression testing of eligibility rules, and a visualization tool that visually depicts relevant Marketplace and MAGI-related data through charts, graphs, and maps.
Services
Social Interest Solutions provides a full set of services to its customers, including software solutions, hosting and operations, and professional services.
Software Solutions
Social Interest Solutions offers custom software solutions to support consumers, and those that assist them (state, county, and community-based organizations) more effectively and efficiently apply for and obtain benefits offered by health and social services programs. Our solutions connect consumers to needed benefits, help government and assistor staff conduct eligibility and enrollment support and coordination across agencies, and guide and inform decision-makers.
IMPLEMENTATIONS
Affordable Care Act Solutions
Social Interest Solutions was intimately involved in the implementation of the Affordable Care Act (ACA), having authored Section 1561 of the legislation, which set the framework for streamlining access to coverage under the ACA. We conducted IT Gap Analyses in five states and have been involved in designing and implementing IT solutions to meet ACA requirements in Arizona and New York. Through these efforts, SIS solutions have processed new and renewal applications across insurance affordability programs as well as social services programs including SNAP, TANF, and a range of state and local programs.
Hosting & Operations
Social Interest Solutions offers comprehensive web, application and data hosting services, backed by state-of-the-art IT, Security, DR and Network operations management. SIS applies sophisticated storage-area network and clustering technologies to maintain a highly responsive, and a three/four nines uptime performance across physical and virtual systems. SIS’ technology solutions meet and maintain adherence to industry standards, including but not limited to, FISMA, NIST 800-53, HIPAA, HITECH, and MARSE. Understanding the sensitivity around customer data, SIS takes cyber security as a top priority and retains the technical expertise to implement systems that are secured up to the Classified Top Secret level. Through these services, SIS delivers a complete and high-quality technology solutions experience to its clients.
TOOLS
Co-Location Data Center
Social Interest Solutions operates its pre-production and production environments from a co-location data center in Sacramento. The hosting environment, located in seismically neutral Sacramento, California, hosts all of SIS’s solutions and offers a world-class designed and engineered N+1 (minimum) co-location facility. This facility offers the highest levels of 24×7 hands-on customer managed service from certified engineers and technicians working from a fully automated Network Operations Center (NOC). This capable facility, with the finest in physical and electronic security, uninterruptible detection/suppression systems, and SAS 70 certification, is extended to all our clients and partners. All of SIS’s customer environments, from development to Production, are hosted at this co-location facility in Sacramento, CA with the option of hosting a Disaster Recovery copy of Production at our Denver, CO backup facility.
Professional Services
Social Interest Solutions helps clients plan, design, implement, and manage their business and technology solution efforts to increase access to public health and human services programs. We have a team of professionals with deep knowledge and understanding of health and human service solutions, and we offer a range of services in support of these solutions including strategic planning, policy implementation support, operational planning and support, current state assessments, gap analyses, business process reengineering, requirements analysis, system design and development, implementation, data migration, data conversion, and post-implementation support. Through these services, SIS provides creative, sustainable solutions for our clients.
IMPLEMENTATION SUPPORT
ACA Eligibility and Enrollment Systems
The State of Arizona engaged SIS to support the overhaul of its eligibility and enrollment systems for ACA implementation, and to facilitate horizontal integration for Medicaid, Long-Term Care, TANF, and SNAP programs. In supporting Arizona in this important effort, the SIS professional services team led a gap analysis and conducted planning, business re-design, and solution development, including solution requirements, design, data conversion, executive reporting, post-implementation support, and more.
Customers
Social Interest Solutions has a long and successful track record of helping national, state, county, and individual program stakeholders to effectively leverage technology solutions to automate and improve screening, eligibility, and enrollment processes.
Government Agencies
Our solutions help state and county agencies better serve their clients. SIS’s application solutions help agencies coordinate eligibility determination and enrollment across programs. They protect scarce local funds by screening clients first for federal and state programs. Our solutions also improve efficiency by eliminating the need for manual data re-entry, can interface to existing government systems without requiring changes to those systems, and improve the quality of applications (and minimize the need for follow-up) through a consumer-friendly, interview-style format and built-in error checking features. Our professional services can also help government agencies improve efficiency and effectiveness through IT technical assistance and business process reengineering.
IMPLEMENTATIONS
Affordable Care Act Solutions
Social Interest Solutions was intimately involved in the implementation of the Affordable Care Act (ACA), having authored Section 1561 of the legislation, which set the framework for streamlining access to coverage under the ACA. We conducted IT Gap Analyses in five states and have been involved in designing and implementing IT solutions to meet ACA requirements in Arizona and New York. Through these efforts, SIS solutions have processed new and renewal applications across insurance affordability programs as well as social services programs including SNAP, TANF, and a range of state and local programs.
Providers
Social Interest Solutions provides tools that can help hospitals and clinics protect scarce resources by identifying payers for their patients. This is especially relevant in addressing costs related to frequent repeat users of emergency and acute clinic services. Our solutions leverage and integrate with existing provider systems, including patient management and billing systems, thereby minimizing the need to capture and enter the same data from patients multiple times. Finally, we can help providers streamline and reduce the administrative barriers to providing accurate eligibility screening by reducing repetitive data entry and easing the collection of supporting documentation.
IN THE FIELD
Supporting Hospital Systems
For 15 years, Social Interest Solutions has supported hospital systems by helping them identify payers for their patients, preserving scarce grants and charity care funds for those patients who truly are not eligible for other coverage. Our solutions also help hospitals establish a medical home for patients, by incorporating the selection of a primary care provider into the screening process. Importantly, our solutions have helped increase the number of low-income patients with access to free or affordable health care coverage and preventive care services.
Community-Based Organizations
Social Interest Solutions can help community-based organizations better serve their clients by assisting them with enrollment in a broad range of health coverage and social services programs, including cash assistance, food support, low-income energy and auto programs, and more. Our solutions provide application management tools for efficient tracking of client cases and retention tools that help CBO’s assist their clients in retaining continuous coverage. We leverage and integrate with existing client management and tracking systems, minimizing the need to capture and enter the same data from the client multiple times.
TOOLS
One-e-App
One-e-App allows community-based organizations to assist their clients with their full set of needs. This technology connects low-income families to programs and services ranging from Medicaid, CHIP, and subsidies for Qualified Health Plans purchased through health insurance marketplaces, to SNAP, income tax credits, energy subsidies, and more. Using a one-stop process, community-based organizations can screen their clients for a complete set of services and generate and submit complete program applications in real-time.
Health Plans
Social Interest Solutions provides health plans with an automated, streamlined tool that supports the entire enrollment process, including eligibility determination, enrollment, provider selection, and premium collection. Our solutions ensure that complete and consistent information is supplied for every application, saving staff time that would otherwise be required to follow-up. We also streamline the re-enrollment process, reducing expensive churn that undermines continuity of care.
SOLUTIONS
Local Children’s Health Programs
For more than 10 years, Social Interest Solutions has partnered with health plans to help manage enrollment in their local children’s coverage expansion programs. We have helped plans better serve their clients by providing a one-stop process for eligibility determination and enrollment, first screening applicants for eligibility for federal and state programs before enrolling them in the locally-funded program. Our solutions allow plans to track and support enrollment activities across programs and in the community, as well as provide outreach management and retention tools.
Research & Policy Organizations
Social Interest Solutions partners with research and policy organizations to share best practices from our work in the field and advance our policy objectives. We serve as technical advisors on leveraging technology to streamline and improve eligibility determination and enrollment processes and provide tools that help policymakers and influencers assess the impact of key health reform policy decisions.
TOOLS
MAGI Cloud
MAGI Cloud is a powerful, software-as-a-service offering that provides detailed eligibility analysis for the Affordable Care Act’s health insurance affordability programs. MAGI Cloud’s Insight tool helps call centers and third-party assistors assess cost implications of year-to-year health plan rate changes, make decisions about auto-enrollment vs. re-determination, and anticipate when consumers should report changes back to the health insurance marketplace. MAGI Cloud also includes a test management platform, which is designed specifically to support ongoing Health Insurance Marketplace regression testing of eligibility rules, and a visualization tool that visually depicts relevant Marketplace and MAGI-related data through charts, graphs and maps.