Proven Medicaid ROI
The Maryland Department of Human Resources AVS spurred a denial of benefits in 6.3% of cases, resulting in roughly $18 million in ROI.

 

From October 2012 to December 2013, the Florida Department of Children and Families has saved more than $85 million as a result of implementing an AVS.

 

Title VII, section 7001(d) of P.L. 110-252 (Supplemental Appropriations Act of 2008) added section 1940 to the Social Security Act requiring all states to implement an electronic asset verification system. We are a national leader in managing the design and implementation of electronic asset verification solutions for state health and human services agencies. PCG customizes our asset verification solution to be either seamlessly integrated into state benefits eligibility systems or as a stand-alone, Web-based solution in order to discover the undisclosed assets of Aged, Blind and Disabled (ABD) populations while ensuring state compliance with Section 1940 of the Social Security Act.

 

PCG and our partner, Accuity Asset Verification Services (Accuity), offer Medicaid agencies the only proven Asset Verification Service (AVS) in the country, backed by an experienced team of Medicaid eligibility subject matter experts and the nation's most comprehensive network of financial institutions. With our AVS experience on behalf of health and human services agencies in Florida, Maryland, North Carolina, New York, and New Hampshire, as well as for the Social Security Administration, no other vendor can match the lessons learned and best practices we provide. Our AVS solution has been repeatedly tested and has yielded proven results in multiple live Medicaid environments.

PCG Services

Our AVS can be customized as either a Web-service feed into a state's eligibility system or as a secure Web-based solution. The fundamental purpose of the service is to facilitate the expedited exchange of financial account information between a Medicaid agency and the national, regional, and local financial institution community. Two primary mechanisms prompt requests for asset verification:

  • Batch Transfer: This method allows agencies to securely transfer files containing batches of verification requests to a PCG SFTP server. Response data can either be picked up (pulled) by the agency from the SFTP server or delivered (pushed) to an SFTP server hosted by the agency. This mechanism is used by the Florida Department of Children and Families, the New Hampshire Department of Health and Human Services, and the North Carolina Department of Health and Human Services.
  • SOAP Web Service: This method includes an interface defined for accepting asset verification requests, an interface for returning response data from Financial Institutions, and an interface for determining which financial institutions were included in searches for undisclosed assets. This mechanism is used by the Social Security Administration and the Maryland Department of Human Resources.

Regardless of the request and response transmission method chosen, two processes are used concurrently to identify assets and accounts other than those reported by applicants and recipients:

  1. 1. Early Warning Services, LLC (EWS): EWS's Account Locator quickly checks all accounts in an automated search against the National Account Locator Database of contributed data by participating financial institutions. Early Warning's National Shared Databases include account data, identity related information, ACH data and fraud/abuse data with a variety of products and analytics developed and provided based on these data. These databases, updated daily, include nearly 50 percent of all Direct Deposit Accounts and 78 percent of all ACH transactions (350 million new transactions added each month), most of which are identifiable by Social Security Number and Name. The ACH database includes a significant portion of all national payroll and benefit transactions paid via direct deposit. A substantial electronic check database is also maintained and more than 3.9 billion inquiries are processed annually for deposits, payments and identity verifications.
  2. 2. GUARD: Accuity's GUARD (Geographic Undisclosed Account Radial Detection) application identifies financial institutions based on logic such as the geographic proximity to further search for unreported financial accounts. Accuity developed this application in concert with the Social Security Administration and this application has proven successful in identifying and targeting local financial institutions that other vendors may not have access to.

The combination of Accuity's proprietary GUARD application and EWS's National Account Database allows us to quickly and comprehensively canvas thousands of financial institutions in search of assets that may not have been disclosed by the applicant or recipient. These powerful geographic search tools support multiple parallel search requests, canvassing the banking system to detect financial accounts not otherwise disclosed. All requests sent to financial institutions include a request for information on both open and closed accounts, going back for a period up to five years, as determined by the state.

 

Our account balance responses provided to the state, either via a batch transfer or through the SOAP Web Interface, include applicant and beneficiary account balances from the following types of commonly held financial instruments: annuities, time/CDs, checking accounts, custodial accounts, burial or funeral accounts, IRAs, money market accounts, savings accounts, Keoughs, rent securities, trusts, Christmas clubs, and more.

 

PCG and our partners also offer additional options to enhance your agency's member eligibility verification process, reduce costs, and maximize savings; each can be seamlessly integrated into the front end of your eligibility determination process.

  1. Real Property Discovery
  2. Residency Verification
  3. Disability Benefits Management
  4. Income Verification
  5. Cost Sharing Reduction Reconciliation Auditing

Making a Difference in Student Achievement Using the Common Core State Standards for English Language Arts
Download the Asset Verification System Consulting Datasheet

If you would like a printable copy of this information please download our datasheet.

 

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More Information

For more information on how we can help your state or organization design and implement these programs, please contact us at info@publicconsultinggroup.com or 1-800-210-6113.