CNSI’s enterprise solutions and customizable IT products drive real technological and business transformation for a number of diverse markets. Our commitment to public service and to our client’s success spans two decades. The markets we serve include:
CNSI is an industry leader in developing, implementing and operating cutting-edge technological solutions that modernize health care administration systems.
CNSI was the first company to implement a Web-centric Medicaid Management Information System (MMIS) and today we continue to lead the way in addressing the many challenges that exist in the health care landscape by being the first in the nation to embark on developing a completely automated real-time and cloud enabled MMIS.
At CNSI we continue to revolutionize the way we manage health care through technological innovations which include mobile applications that provide easy access to health benefits, cloud based systems that provide for more efficient processing of medical claims, and cutting edge technology that can eradicate improper billing and waste leading to better care, better health and lower costs.
CNSI has supported over 80 percent of the cabinet-level departments of the federal government. From our first contract with the National Security Agency in 1996 to our most recent work with the U.S. Census Bureau at the Commerce Department and the U.S. State Department, Department of Defense and the Department of Health and Human Services.
Our collaborative delivery model enables us to drive solutions that help our clients achieve their mission and create real and sustainable business outcomes. The capabilities we employ range from envisioning and innovating, to agile and process-oriented systems implementation, and operational support.
U.S. Department of Agriculture - Food and Nutrition Services Amtrak U.S. Department of Housing and Urban Development U.S. Census Bureau State of Maryland - State Highway Administration U.S. Department of Labor Federal Aviation Administration National Nuclear Security Administration
Developing and maintaining telecommunications infrastructure, system engineering and beyond, CNSI’s IT/telecommunications solutions support the federal agencies whose mission is defending and securing our national security interests.
Over the past 20 years, CNSI has supported multiple federal departments, representing various agencies within the U.S. Departments of Energy, Defense, State and Homeland Security in the area of telecommunications.
CNSI offers vetted solutions and proven expertise to improve the reliability of our national security agencies and Armed Forces’ mission-critical intelligence networks and security systems. Our work enables clients to leverage enhanced telecommunication infrastructure and advanced technical security systems to expedite critical decision making demands. CNSI’s National Security Program Division is comprised of complex level engineering, detailed system architecture & design and automated integrated logistical expertise. CNSI leads the industry as an accredited turn-key system integrator and service provider, in the fields of Physical Security, Telecommunications, Networks, Data Centers and Facility Maintenance industry initiatives.
Expertise in Telecommunications U.S. Navy U.S. Coast Guard - Boating Accident Report Database U.S. Department of State U.S. Department of Energy - Los Alamos National Laboratory
ID/IQ Contracts Government Wide Acquisition Contracts CONTACT
John H. Cousins III, Esq.
VP of Contracts and Corporate Counsel
Government agencies are under increasing pressure to deliver a higher level of services and information to the public. As a result, agency decision makers must carefully evaluate the return on investment for their technology dollar.
CNSI helps government agencies align IT with their business objectives and missions. Whether we’re supporting national defense or civilian agency endeavors, the CNSI Contract Management team follows a consistent, established formula: providing an integrated partnership that produces reliable delivery and measurable results. We will help you complete procurements in an efficient, timely and cost-effective way or leverage pre-existing contract relationships.
CNSI offers an extensive portfolio of contract vehicles, including government-wide acquisition (GWAC) contracts, indefinite delivery/indefinite quantity (IDIQ) contracts and state contracts. For more information, explore our contract vehicles portfolio or contact our Contracting Office directly. We will help you pick the right vehicle to satisfy your requirements.
CNSI offers a comprehensive suite of Health IT solutions to help payers build a robust health care IT infrastructure. These solutions eliminate duplicate and administrative inefficiencies, promote collaboration with key stakeholders and ensure mechanisms of enhanced transparency. They include:
Claims Payment & Processing Management
Enhance visibility, ensure transparency and implement flexible benefit plans that evolve with your services. Our eCAMS Benefit System provides a robust and comprehensive framework for the design and implementation of benefit plans for your members.
Medical Billing & Recovery
Leveraging advanced algorithms and trusted industry data sources, CNSI provides a comprehensive process of identifying, validating and verifying the coordination of benefit opportunities. By identifying overlaps in coverage, CNSI’s solutions help recover claims dollars, auto-redirect bills to responsible parties and limit future payments.
Our services and solutions provide tools to intelligently link client records with other sources, integrating address and third-party benefit verification with the focus on improving data quality and consistency.
Implementing best-practices for business process steps enables the CNSI services team to identify coverage before claims are submitted or paid. This comprehensive approach helps payers improve their overall recoupment/recovery dollars in the most cost effective manner.
Agile System Development & Web Applications
With our iVision 360 management processes, CNSI has refined the PMBOK processes that connect customers with the product at a much earlier point in the System Development Life Cycle (SDLC), building greater trust and collaboration opportunity between the client and vendor.
Telecom Infrastructure & Information Exchanges
Our team offers a trusted, comprehensive and proven design, integration and installation service platform. Our management and support staff have extensive experience performing telecommunication and data system projects across a widely spread foreign geographical footprints. We hold active security clearances, are familiar with third world travel and diplomacy, day-to-day facility operations and sensitivity within the working environment.
CNSI places tremendous emphasis on project planning, tracking and real time status reporting. We employ proven industry standard methodologies (PMI-PMP) and metrics to ensure the proper advance planning, accurate design, comprehensive bill of material (BOM) and a realistic production schedule is developed based on proper risk mitigation techniques. We deploy our teams with a complete inventory of proper tools, test equipment and monitors, and with quality, safety and security instructions.
CNSI takes an active role in work planning and site coordination, to reduce any delays or disruptions to services and fully understands the importance and sensitivity associated with performing these types of services, offering the most reliable source for telecommunications integration, test and acceptance.
Health Insurance & Information Exchange
CNSI’s eCams Connected Healthcare Services and eCams Benefit Systems provide the solutions that allow state health agencies to keep up with the latest regulations, so that health data can be shared across regions, providers, payers, public health agencies and with other stakeholders in the health care continuum.
CNSI’s approach to case management is to bring together content, processes and people for improving the overall business process efficiency. With its health care domain expertise, CNSI brings out-of-the-box case templates and integration APIs that give access to both structured and unstructured information, provides alerts and reminders based on critical business events and enables businesses to streamline complex workflows. When intelligently combined with analytics and visualization tools, Case Management provides insights and actionable dashboards to help improve health outcomes when used for care-coordination and improve the overall recoveries when used in TPL and/or Program Integrity business areas.
With the shifting delivery landscape (more than 75 percent of beneficiaries in Managed Care by 2015), changing demographics (Medicaid expansion population) and ever increasing focus on value health care, the program integrity needs a shift from the traditional ways of identifying waste, abuse and fraud. CNSI’s comprehensive end-to-end approach to program integrity helps you gain new insights into your claims and encounter data and prevents inaccurate payments to be made in the first place.
CNSI’s innovative solutions and services, which improve data quality (Provider Credentialing Service), predict and prevent wrong payments from leaving the door (Claims Sure), conduct powerful post-payment analytics (Audit Studio ++) and hold the ability to learn from these models and patterns, is the most comprehensive solution portfolio in the marketplace. CNSI also offers services to handle the business processes to verify claims and encounter data for accuracy, completeness and medical review.
CNSI believes that mobile technologies promise to transform health care by making access to vital information easier and, like other industries, disrupt the traditional business process such as that of production of eligibility cards.
CNSI mobile application development is focused on reducing complexity by developing intuitive, context-aware mobile apps to simplify information access and thereby allow for innovation in health care delivery.
Realizing the vision of an unwired information flow, CNSI with its understanding of health care data, its usage by different stakeholders, can help deliver secure, reliable and powerful mobile applications. CNSI offers design thinking, a secure mobile application framework to help implement mobile initiatives across the payer marketplace – quickly and cost-effectively.
Identity & Access Management
CNSI specializes in aligning technology solutions and business needs to overcome the challenges of building innovative systems to exacting specifications. Increased security objectives, along with mandates and regulations, have made successful completion of Identity and Access Management (IAM) projects a high priority for many agencies.
Leveraging our knowledge base of more than 1,000+ policy rules and mining more than 100 million transactions, CNSI has implemented proven predictive models to help recognize and fight improper payments before they get paid. A robust and powerful analytics package of solutions and services offers unique insights and provides visibility and trends that help payers identify and understand cost drivers to facilitate better decision-making.
With our deep domain understanding of health care data, CNSI has experience in implementing enterprise data warehouses, creating visualization enablement platforms, bringing innovation in form of fusion data sets (clinical and administrative) and facilitating action from insightful analytics.
Our experience with guiding big data initiatives at an enterprise level to help identify real life business process improvements makes CNSI a solid partner in helping you in your health care analytics needs.
Solutions & Products
CNSI's enterprise solutions and IT products increase programmatic efficiency and drive business value. Not every company can say it changed an industry, but we can. Here are a few examples of how CNSI drives business value:
Processing platform designed specifically to meet the large-scale needs of Medicaid
eCAMS is CNSI’s Medicaid platform designed and tuned specifically to meet the volume and performance requirements of large-scale claims processing applications, with the flexibility to adopt new reforms, payment models and regulations while being mobile-ready allowing for seamless integration of digital health care ecosystems.
eCAMS provides end-to-end visibility into Medicaid organization and real-time monitoring and management of business operations. A fully services-oriented platform, eCAMS dramatically reduces total cost of ownership for state agencies by seamlessly integrating with industry-leading COTS products to leverage and increase the value of existing applications and systems.
Learn more about CNSI’s eCAMS platform here.
Comprehensive and Cohesive Project Management Platform
As-One ES® is a one–stop solution for enterprise tool from CNSI, offering an array of modules to address the many aspects of project management. It is a web-based tool which provides a comprehensive and cohesive project management platform. As-One is packed with many capabilities to enable the customer to accomplish their delivery goals, giving the flexibility and ease-of-use across several modules.
- Risk Portal: The Risk module provides online interface for managing project risks including risk rating, risk assignments and risk tracking through its lifecycle.
- Action Portal: The Action Item module allows action item assignments in a collaborative setting to one or more individuals.
- Change Log Portal: Change logs can be used to document contract modifications, engineering change proposals and baseline changes.
- Work Products Portal: The Work Products module allows online tracking and management of formal (i.e. customer deliverables, product artifacts) and informal work products from inception through approval and beyond.
- Discrepancy Portal: The Discrepancy module is a complete tracking tool for tracking discrepancies in any form such as bugs, issues, deviations in work products, project deliverables or software systems.
- Events Portal: The Events module can be used to view events, such as milestone reviews, vacation time, meetings or teleconferences, in a monthly calendar, weekly calendar, daily calendar, or listing format.
Assimilating and integrating fused Electronic Health Record data
CNSI’s Electronic Fusion Repository Management (eFRM™) and connected cloud services assemble a patient’s comprehensive, electronic health records (EHR) from multiple sources to improve health care delivery and patient outcomes.
Enabling terminology standardization from diverse EHR systems, eFRM™ is capable of assimilating and arranging data from various sources that generate administrative and clinical information for a patient. Not only does eFRM™ comprehensively store fused data; it provides a structured approach to arranging a patient’s clinical and administrative data in an analytical model, enabling a platform for data analytics.
To achieve the highest impact of patient safety and quality of care, patient information from across the health care continuum must be integrated and presented to clinicians at the point of care. eFRM™ supports creation of a Patient Health Record and leverages CNSI’s eFRM™ and cloud-based integration services along with a master person index, record locator service and an easy-to-use web viewer, providing patient data exactly when and where it is needed.
Learn more about eFRM™ here.
Automate Business Processes from Fraud Detection to Recovery
Audit Studio is a web-based product with various user-friendly features that is designed to satisfy all the CMS Program Integrity certification requirements. Audit Studio, with its integrated Case Management capability, supports the overall fraud and abuse lifecycle from detection of potential fraud and abuse to creation of fraud cases to recoupment of excess payments. It also produces visualizations with drill-down capabilities and an integrated set of reports that provide utilization data for analyzing medical care and service delivery.
- Surveillance and Utilization Review System (SURS): SURS establishes standard utilization norms for providers and members and thereby tracks the providers and members who are most likely to be abusing the Medicaid program.
- Fraud and Abuse Detection System (FADS): FADS employs advanced statistical techniques to identify anomalous behavior of providers and members.
- Reporting and Analytics: For evaluation, Audit Studio can create standard and ad-hoc reports, dashboards and data visualization tools, a SURS/FADS data mart and COGNOS BI tools.
- Case Management: Audit Studio is capable of automated case initiation, built-in case activities, case workflow automation and workload management.
Solving eligibility, enrollment and casework on the cloud
Electronic Medicaid Eligibility Determination System (eMEDS) is CNSI’s solution for Medicaid modernization adaptation. It is a cloud-based eligibility determination, enrollment and caseworker portal solution that helps states address requirements for expanded coverage acquisition and access to a range of health care programs for citizens.
eMEDS, when implemented, drives benefits to both the citizens applying for coverage and states seeking to increase enrollment. Consumers will be able to submit their online application and enroll under a plan in real-time basis. This is a breakthrough in simplifying the entire coverage acquisition process for the citizens. Meanwhile, The Case Portal, being driven by business process workflows, is customized to accommodate state targets to ensure timely processing of Medicaid applications.
Configure, Map, Review and Certify Systems
ReqCertify is a simple but powerful certification tool that is designed to support a standard or non-standard certification process for your business. It is built on a well-organized hierarchical structure that enables enterprise level application certification. ReqCertify features inbuilt customizable components to establish a standard or non-standard (proprietary) certification process.
- Configuration: ReqCertify supports both pre-configured certifications toolkits and any new non-standard based certification setup using a generic template checklist and criteria based structure.
- Compliance: ReqCertify allows end users to map requirements and link system implementation components to the criteria. In addition, it also allows end users to link assets such as proof documents, artifacts to produce evidence for auditors and generate multiple system compliance reports.
- Customization: The tool enhances existing or new certification standards with custom fields and has the ability to create an integrated solution with ReqTraceWeb for easy look up and connection of system requirements and components.
Extending Medicaid Connectivity for Managing EHR Incentive Payments
CNSI’s proven meaningful-use-certified Electronic Health Record (EHR) technology solution, eMIPP, is now taking the Medicaid program into the new age of connected healthcare infrastructure. eMIPP is a modular solution for managing the EHR Medicaid Incentive Payment Program (MIPP), Medicaid Health Record (MHR), and Health Information Exchange (HIE) connectivity. It offers a comprehensive and configurable solution to measure and demonstrate the EHR superior outcomes as outlined by CMS guidelines. This solution builds on the Medicaid Information Technology Architecture (MITA) principles and uses a services-based framework, thus enabling the solution modules to leverage and re-use existing state systems and quickly comply with Centers for Medicare & Medicaid Services (CMS) defined timeline.
CNSI’s eMIPP solution is built on a true services framework and can integrate with any existing MMIS system, HIE or other state system. The overall solution leverages a set of reusable services (provider registry, eligibility service etc.) to support state Medicaid agencies in administering the incentive payment program and meet federal audit and control standards.
The solution also provides an independent data set that combines clinical and administrative data sets;, leverages the open source CONNECT framework and integrates with external services like CMS’ National Level Repository (NLR) and the Office of the National Coordinator (ONC) to support and track the evolving requirements around meaningful use.
Learn more about eMIPP here.
Robust, Automated Framework to Extract, Analyze and Report Data
eCAMS HealthBeat™ provides a robust, automated framework to extract, analyze and report data from diverse business processes into a centralized enterprise service view of MMIS systems, either by a web portal or through the tablet/mobile App. eCAMS HealthBeat™ enables near real-time access to workload and system performance information and provides transparency to IT operations management and the enterprise-wide business.
- Accountability: eCams HealthBeatTM tracks and prepares users with critical business metrics provided in an enterprise view based on federal standards through a graphic dashboard. MITA business maturity improvements become possible through key MITA business-area monitoring measurement
- Readiness: The Alert Engine provides the user to subscribe to monitoring functions for a specific or conditional change in the Stats through e-mail, based on the user subscription. The product also supports service level agreement compliance tracking with automated alerts and trending features.
- Versatility: eCams HealthBeatTM is available in Web application format and also in Mobile application format supporting iOS iPAD and Android tablets.
Learn more about HealthBeat™ here.
Comprehensive tracking for managed care compliance
CNSI’s MC-Track is an intuitive managed care compliance tracking system that provides an in-depth understanding of contract terms and compliance requirements, providing customized stakeholder views to help project compliance scores of health plans across different paradigms – from measuring the quality of service to the timeliness of reporting requirements.
MC-Track is a web-based solution that enables both states and the health plans to upload and maintain the contract document, create a comprehensive view of contract compliance metrics, track compliance measures and meet all contract obligations.
In a health care system where cost and quality considerations are of paramount importance, MC-Track ensures better health outcomes through strict adherence to compliance and quality measures, allowing health plans to proactively pursue contractual financial incentives and capture at-risk revenue by ensuring compliance and avoiding contractual penalties.
Provides Enterprise Class Health Care Case Management
Generic case management systems applied to health care have a long history of user dissatisfaction. CNSI's Electronic Case Management solution (eCM™) provides a powerful, secure, and configurable platform to address case workflow for benefits administration, behavioral health, eligibility management, appeals and grievances management, program integrity, care management, and clinical and compliance audit management. Stakeholders are provided a 360-degree view that allows more effective monitoring and control when making critical business decisions.
eCM’s powerful capabilities:
- Provide access to a dashboard with real time data visibility providing transparency into business operations
- Ensure access to vital case information from anywhere at anytime
- Take advantage of built-in capabilities to allow for effective document management, content management, and correspondence
- Enable users to make effective decisions through an auto search mechanism
- Store and maintain beneficiary, provider and claims data, which may not be readily available in many other COTS products.
Manage Data Exchange and Service Interactions
eCAMS HealthCare Engine (HCE), is a services-based integration infrastructure that includes a health care rules engine (RuleIT®) which provides out-of-the-box Centers for Medicare and Medicaid Services -mandated rule sets (commonalities across states) for claims adjudication and payment processing and a business dictionary to configure state-specific policies and rules.
- Manage: eCAMS HCE uses an industry standard Enterprise Service Bus (ESB), to manage data exchange and service interactions between different systems and applications.
- Streamline: In addition, HCE provides a robust interface service repository that features a standard management framework with complete auditing, traceability, and exception handling. This functionality allows masking the integration complexity of different components and provides a more seamless business process experience with visibility across the process life cycle for all its stakeholders
- Integrate: HCE™ is foundation for all the future eCAMS development and installations in the various Medicaid implementations. Encounter Data Processing System established for the centers for Medicare and Medicaid Services, which is built on HCE, successfully processed one billion encounters while operating over the last three years.
Transforming provider site visits
CNSI’s Site Visit Pro is a portable application that can be taken directly to provider sites to perform unannounced site visits. The application is mobile enabled for tablets, eliminating the need for paper forms. Additionally, it supports organizations in performing site visits using real-time provider information directly from the Medicaid Provider Enrollment system, eliminating redundant data entry.
The solution streamlines site visits by eliminating periods of no activity on the site visits through alerts to the appropriate state staff, decreases the time it takes to approve or reject a provider’s application for enrollment and eliminates redundant data entry and manual updates to the Medicaid Provider Enrollment system.
Map, Trace & Manage Requirements for Maximum Productivity
ReqTraceWeb is a comprehensive requirements management tool that enables stakeholders to access and manage the requirements online, and enables widely-distributed teams to ensure the requirements are managed at a single location throughout the software development lifecycle (SDLC).
- Map: This tool enables users to have appropriate access to view or edit requirements and maintains an audit trail of changes throughout SDLC.
- Trace: ReqTraceWeb provides the capability to trace requirements from initial analysis to solution acceptance, and allows customization to the needs of the project.
- Manage: ReqTraceWeb’s integrated solution approach enables prioritization of requirements to releases and manages them down to solution acceptance while meeting auditing and regulatory compliance expectations.
Learn more about CNSI's ReqTraceWeb here
Streamlining Affordable Care Act provider enrollment screenings
CNSI’s Provider Credentialing Service (PCS) solution fulfills the Affordable Care Act’s mandated screening procedures for providers that want to participate in Medicare and state Medicaid programs. The PCS solution is comprised of pre and post-enrollment screening processes that integrate the system with a real-time credentialing service.
This one-stop solution provides improved automation and reduced manual intervention. Pre-enrollment screening results are available in real-time for the provider enrollment specialist to review and make appropriate decisions regarding approval or denial.
Through these advances, the solution creates cost savings due to process automation of screening procedures, integrates workflow solutions to provide improved automation and reduced manual intervention and helps state staffs conduct additional research and decision making.
Rules Management System
CNSI’s Business Rules Management System (BRMS) allows users to define Business Rules quickly and easily – requiring no programming skills. RuleIT helps enterprises implement business decisions by managing and configuring the Business Rules that drive their business processes.
- High Performance: Unlike other rules engines, RuleIT uses a “sequential process” algorithm, in which the evaluation is controlled by the rule, its conditions and the associated branching.
- Flexible: Rules engine architecture provides the flexibility of allowing a Business Analyst to determine the sequence of rule evaluation for a single rule or a series of complex process flow rules.
- Cost Efficient: Given the overall average Software Development Life Cycle effort ratio of 40 percent development to 60 percent maintenance, RuleIT dramatically reduces an application's maintenance and extensibility costs.
- Proven: Architected and tuned for performance, RuleIT can handle most of the complex processing environments. RuleIT is proven and tested, and is currently in production with high volume and high-throughput applications, including Provider Enrollment and Medicaid Claims processing systems.
Learn more about CNSI's Rule IT™ here.
Fraud, Waste & Abuse Detection
ClaimsSure is a real-time, prepayment, improper billing detection system which will prevent Medicaid, Medicare and commercial health care providers from making excess payments and highlight potentially fraudulent cases.
- Real-Time Execution: An incoming claim is associated with a probability of improper billing and sent back to the adjudication system in real time.
- Improper Billing as a Service: Improper billing is identified at a claim level so that the reviewers can efficiently investigate and take appropriate action.
- Multiple Improper Billing Patterns: Claims go through seven scenarios of improper billing which assume multiple patterns of improper billing.
- Plug and Play Device: ClaimsSure can be plugged at the end of the adjudication cue and used directly.
- Proven Methodology: ClaimsSure has an established success story of identifying a substantial amount of improper billing and stopping it before any payment is made.
Learn more about CNSI's ClaimsSure here
Consumer Engagement in One Touch
CNSI’s Consumer Engagement product suite acts as a bridge between payers and health care beneficiaries, comprised of myHealthPortal, a member-centric online web portal, and myHealthButton, a native mobile application counterpart - both of which will allow health care beneficiaries to securely access their health information.
- Custom: Both myHealthPortal and myHealthButton platforms provide personalized information, including demographics, healthcare providers, benefits and eligibility and health insurance.
- Accessible: They also provide the beneficiaries with online and real-time ability to make authorized changes, to see claims filed for services rendered by providers and to view or request a replacement mihealth card.
- Patient Ownership: The member is enabled to view benefits such as eligibility, coverages and other insurance details and request changes. The member is also empowered to view authorized providers, find a doctor, qualify diagnoses from state systems and set and track goals based on health behaviors and measures.
Learn more about CNSI's myHealthButton® here