Looking for hCentive? hCentive state-based insurance exchange and Medicaid eligibility technology are now part of Optum.
Our flexible, services-based platform scales to meet your state's needs. Across the enterprise, our solution provides a single online application for all programs, and staff with visibility into client enrollment across programs. We help reduce administrative inefficiencies and improve client experiences.
Intake Assessment Module
Clients use a single online application for all HHS programs, including Medicaid, SNAP, TANF, CHIP and state insurance exchange qualified health plans (QHPs). Our user-friendly registration and change-of-circumstance processes save time and reduce errors, while creating a streamlined eligibility experience for clients.
This module offers real-time processing and enrollment management, including overrides, redeterminations, renewals and more. It also integrates with QHPs unique to each state. This eliminates the need to build a separate state insurance exchange.
Eligibility Determination Module
This configurable rules engine is pre-loaded with federal rules for HHS programs, including Medicaid, SNAP, TANF, CHIP and state insurance exchange QHPs. This module offers benefit screening and full eligibility determination.
Benefit Management Module
Benefit managers work through a single, configurable dashboard and workflow tool. Our agency portal enables staff to view case and client application details and manage the complete lifecycle of the case. That includes determination, change of circumstance and more.
State Insurance Exchange QHP Shopping and Plan Management Module
This module provides the additional functionality to fully administer and manage state insurance exchanges as an integrated part of your eligibility infrastructure. There is no need to build a separate website or back-end system to manage QHPs. Our module also provides marketplace shopping for consumers to identify and compare plans.
Reporting and Analytics Module
Our solution integrates data from all agencies, programs and state insurance exchanges. This enables states to gather and report analytics to help improve processes and services and better understand multiprogram service use and costs.