The Detroit Wayne County Health Authority has begun using a web-based Medicaid enrollment service that will expedite the screening and enrollment of prospective Medicaid recipients. The new technology, called HelpEngen™, was developed by TriHealix, a health care technology firm based in Norwalk, CT. HelpEngen™ enables health care providers to connect uninsured patients to the right assistance program by facilitating the collection of patient information, providing an immediate assessment of whether the application might be approved for benefits, and generating all the appropriate application forms for potentially eligible patients. HelpEngen™ will be used by the Health Authority and will also be made available to health systems that it contracts with for Medicaid outreach.
“This is a major step forward in our drive to ensure that everyone who qualifies for health benefits is enrolled,” according to Chris Allen, CEO of the Detroit Wayne County Health Authority. “This tool not only provides a much more expedient enrollment process, but it indicates who is likely not to qualify for benefits. We can then find alternate resources to meet their needs.
“For health systems, this tool also means greatly expanded capability to manage the growing financial burden of caring for their uninsured patients. So it represents a true win-win for both patients and providers. We believe that HelpEngen™ will become a national model for improving access to health care through the enrollment process.”
The HelpEngen™ platform supports best practices in patient access and revenue cycle management, by allowing providers to:
- Accurately classify uninsured patients at the point of care to distinguish those who are eligible for government-sponsored health coverage or provider charity care, from those who are truly self-pay;
- Enroll eligible patients in the most appropriate program or programs, and then track the status of those patients;
- Easily share information across departments or facilities;
- Comply with charity care policies/regulations by capturing and reporting metrics on the delivery of charity care and community benefit.
HelpEngen™, like computer-based tax software, offers an outreach worker a cleanly designed online interview that can be filled out within 30 minutes. HelpEngen™ then tests information collected in the interview against requirements for Medicaid and other public programs and returns a real-time detailed assessment of likely eligibility organized by program type with full program description, benefit level, and the reason why the patient is or is not eligible. At that point, the outreach worker can generate completed official application forms which can be printed for signature then saved electronically.
Initially, the forms will be mailed to the state Medicaid office. Eventually, however, the Health Authority hopes to establish an online link to the department, offering direct transmission of forms. Key information captured in the electronic interview includes demographics, insurance status, and health care use patterns, as well as all information required to determine eligibility and apply for public health coverage programs, hospital charity care programs, and uninsured patient discount programs.
While the technology has the capacity to calculate potential eligibility for any means-tested program, the Michigan Department of Human Services (DHS) will continue to make the actual eligibility determination. This tool will make their job easier. The Health Authority plans to work with DHS and the Michigan Department of Community Health to electronically submit the applications directly to local offices for determination of eligibility and enrollment. This technology will allow the Health Authority to begin to identify and assess the truly uninsured and develop the appropriate safety net measures necessary to ensure access to quality care.
“Outreach workers will find this a very helpful tool in conducting their client interviews,” explains Faith Polk, Medical Program Administrator for the Health Authority. “It will give people so much more information about eligibility.” There are several categories of Medicaid eligibility. It’s difficult for anyone to understand and reference all of them during a client interview, she adds.
For more information, please download the HelpEngen overview, below.
HelpEngen Overview (