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Our Work

Aligning Technology with Healthcare Solutions

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Markets

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:

  • Michigan Seal Illinois Seal Utah Seal Washington Seal Hawaii Seal Arizona Seal Wyoming Seal New Hampshire

    CNSI is an industry leader in developing, implementing and operating cutting-edge technological solutions that modernize state Medicaid Management Information Systems (MMIS). We were the first in the nation to implement a web-centric MMIS and an integrated social services provider enrollment system. CNSI continues to address the many challenges that exist in the state Medicaid landscape, including the highly-impactful opioid epidemic and the ever-evolving question of modularity.

    State of Michigan State of Washington State of Illinois State of New Hampshire NASPO ValuePoint Provider Services

  • Federal health care agencies must deliver on their vision of health care quality, access to coverage, healthy outcomes, force readiness and population health while also lowering the cost of payment, delivery, and IT infrastructure. CNSI stands at the ready with our proven solutions and products that enable automation of health care administration processes. Our low-risk, rapid deployment solutions range from business transformation to claims and encounter adjudication systems to mobile applications. Our solutions are engineered for performance at every level of the systems architecture. CNSI’s deep health IT domain expertise is validated by our recent contact wins with the following federal and state health agencies.

    Centers for Medicare and Medicaid Department of Veterans Affairs Department of Labor

Solutions & Products

Not every company can say it changed an industry, but we can. At CNSI, we continue to revolutionize the way we manage health care through technological innovations, which include cloud-based systems that provide for more efficient processing of medical claims, cutting-edge technology that can eradicate improper billing and waste and mobile applications that provide easy access to health benefits.

Here is our suite of enterprise Health IT Solutions & Products that increase programmatic efficiency and drive business value, leading to better care, better health and lower costs.

Solutions

  • evoBrix X™

    evoBrix X™

    evoBrix X™

    With states under tremendous pressure to modernize and develop more effective Medicaid IT systems that align with Centers for Medicare and Medicaid (CMS) modularity mandate, agencies are looking to streamline infrastructure while reducing implementation cost, time, and risk. Enter CNSI’s Next Generation Modular Delivery Platform, evoBrix XTM.

    evoBrix XTM supports each State’s Medicaid Enterprise needs by enabling:

    • Tenant-specific Configuration and Customization
    • Reusable Business Functions
    • Flexible Procurement and Implementation
    • Utilization of a CMS-certified and federally compliant solution

    Learn more about evoBrix XTM

    by clicking here.

  • eCAMS™

    eCAMS™

    eCAMS™

    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.

  • Provider Credentialing Service™

    Provider Credentialing Service™

    Provider Credentialing Service™

    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.

Products

  • Audit Studio™

    Audit Studio™

    Audit Studio™

    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.

    Features:

    • 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.

     

  • HealthBeat™

    HealthBeat™

    HealthBeat™

    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.

     

    Features:

    • 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.

  • MC-Track®

    MC-Track®

    MC-Track®

    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.

    Learn more about CNSI’s MC-Track® platform here.

  • RuleIT®

    RuleIT®

    RuleIT®

    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.

     

    Features:

    • 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.

  • ClaimsSure®

    ClaimsSure®

    ClaimsSure®

    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.

     

    Features:

    • 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.

  • myHealthButton®

    myHealthButton®

    myHealthButton®

    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.

     

    Features:

    • 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.