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AuthentiCareEVV The Innovative Solution forHome and Community-Based Care 2018 First Data Corporation. All rights reserved. The First Data name,logo and related trademarks and service marks are owned by First DataCorporation and are registered or used in the U.S. and many foreigncountries. All trademarks, service marks and trade names referenced inthis material are the property of their respective owners.
Agenda First Data Overview AuthentiCare Solution Overview First Data EVV Experience Implementation Methodology Training Fraud, Waste, and Abuse – Prevention and Detection Why First Data? Q&A2
10% of US GDP flows throughFirst Data everydayLARGESCALEGLOBALLEADERSHIPGLOBALFOOTPRINT6 million business locations#1 Merchant acquirer118 countries with First Data clients4,000 financial institutions#1 Issuer processor36 countries with First Data operations1 million STAR#1 Independent Debit network23,000 owner-associates worldwide28% of global ecommerce processed in 2014branches globally distributing36,000 bankFirst Data’s solutions locations74 billion 2014 global transactionsOVER 2,300 TRANSACTIONS PROCESSED PER SECOND3
AuthentiCare Solution OverviewAuthentiCare Mobile ApplicationClaim Import / Data Aggregator21stCentury Cures Act ComplianceAuthentiCareOverview
AuthentiCareEVV Functionality Interactive voice response (IVR) Smartphone App for Visit Verification Captures worker’s location and service time Current interface to DXC and other MMIS systems Voice biometrics Automated claims and billing (837 & 835) Integrated scheduler with real-time alerts for missed visits Adaptable to a variety of services Data scoping with configurable access and views Web services & batch processing options Interactive provider dashboards Flexible reporting to assist in payroll processing5
AuthentiCare servicesanytime, anywhereIVR Check In / OutIVR Check In/OutQR Code Capture forLimited Service zonesMobile App w/GPS Tracking6Store & ForwardWorker InteractionsMobile Appw/GPS trackingStore and forwardWorker interactionsLimited Service Zones
Systems Integration / Data AggregationData Import ProcessesThree input sources: Web portal file drop SFTP managed file transfer JSON/REST web servicesStandard application programInterface objects (API’s): Providers Workers Consumers Self-direct employers Case managers Authorizations Claims Encounters EDI 835User-defined file mapping *NEW*: Claims Encounters7ApplicationSystem Tier: PresentationWeb File Dropand ResultsPick-upWeb PortalUserDatabaseImport ResultsData FileFile Type SelectionCustom FileTemplateLayout Designer(Claims, Encounters)StandardFile ImportProcessSFTP Job SelectionFirst DataSFTP FileGatewayData FileImport ResultsSFTPUserJSON/RESTWeb Portal(TLS 1.2)Web ServiceUserObject Batch PutWeb ServiceMethodsAuthentiCareData
AuthentiCareElectronic Visit Verification – Meets all 21stCentury Cures Act Section 12006 Requirements› Electronically verified visits with respect to: ››››8››››››Type of service performed Individual receiving the serviceDate of service Location of the service deliveryIndividual providing the serviceTime the service begins and endsMinimally burdensome Takes into account existing best practices and EVV systems already in useConducted in accordance with HIPAAStakeholder training is provided
AuthentiCare and 21st Century Cures Act Compliance“KDADS utilization of AuthentiCare has put Kansasahead of the curve in complying with the upcoming 21stCentury Cures Act.”Amy Penrod, CommissionerKansas Department for Aging and Disability Services9
Successful AuthentiCare ImplementationsAuthentiCare has continued success with our State and Agency ReferencesNew MexicoIVR Check In/Out10QR Code Capture for Limited ServicezonesMobile Appw/GPS trackingStore and forwardWorker interactions
Project Management MethodologyInitiation Prepare First DataImplementation Team Conduct KickoffMeetingo Introduce Project andTeamo Review Project Scopeand Missiono Review ManagementApproach, Plan, andScheduleo Review CommunicationsPlan and ReportingRelationshipso Review DeliverableAcceptance ProcessPlanning Joint ApplicationConfiguration SessionsOnsite Baseline ProjectSchedule Approval of ProjectManagement Plan Establish task specificentrance and exitcriteria Finalize RTM Finalize SystemIntegration Plan andBusiness Rules Initiate PlatformConfigurationConfiguration ConfigureAuthentiCare Solution Unit Testing Update RTM Update EVV SystemDesign Documents Update Reporting UserGuide Update User Manual Update Test Plan &Acceptance CriteriaDeployment QA Testing Client AcceptanceTesting Provide Test ResultsReport Provide OperationalReadiness ReviewResults Create ContractAdministration Plan UpdateImplementation Plan Update RTM Update User Manual Update Training &Outreach Plan andMaterialsTraining11OperationClosing Deploy EVV Solutioninto Production & DREnvironment Create ProjectCloseout and LessonsLearned Report Create Transition Plan Closeout Project Transition Meeting withOperation Managementand Support Provide OperationsReview Report Provide Monthly StatusReports Provide ContractManagement andSupport
Training – Initial and Ongoing From CMS Presentations States that have implemented EVV underscorethat training is a critical element of successin deploying and operating EVV. Vendors, provider agencies, and states all reportthat the most successful training is donecollaboratively, involving all stakeholders. Training Planning / Outreach Building a plan together to be successful Identify participants Training registration Training locations12 Training Methodology – Initial Onsite Providers train their staff Training Environment Training Methodology – Ongoing Webinar Refresher Trainings Access to customized User Manual Online Self-Paced Learning Tool Training Environment Provider Assistance Forums Client Support One-On-One Training
AuthentiCare: Fraud Prevention and ProactiveDetectionProactive FraudDetectionFraud Prevention Early identification ofSuspected Bad ActorsPre-defined reports withconfigurable search optionsAutomated reportgenerationSupport for analysis resultsinto your Fraud CaseManagement system13 Suspect claims preventedfrom automated submissionFraud PreventionDeterrents Voice Biometrics GPS location of servicedeliveryControls and AuditingCost Avoidance isthe Highest CostSavings! Prevent improperpaymentsEarly detectionAvoid doing pay &chase
Expertise of key personnel in EVV and Medicaid Extensive HHS and Medicaid consulting expertise Successful Statewide deployment in variousimplementation design models Size/Scale of First Data – large public company Complete and proven mobile solution Experience integrating into DXC and other MMISsystems14
Thank youGrant McKayAccount Executive513-878-8325Grant.McKay@firstdata.com15
Successful AuthentiCare Implementations . AuthentiCare has continued success with our State and Agency References. 10. IVR Check In/Out Mobile App w/GPS tracking. Store and forward Worker interactio
