SCHAUMBURG, Ill. Feb. 25, 2011
"One of our clients described the current situation as a ‘perfect storm’ in social services," adds Duda. "Forty-six states have made spending cuts in social services, and forty-four states have enacted furloughs or layoffs. Meanwhile, enrollment in social services programs increased in every state in 2009."
Increased oversight places additional burden on understaffed social services organizations. "Analysts and managers spend up to forty percent of their workday on activities related to federal and state reporting obligations."
"Fraud, waste, and abuse has also increased during the economic downturn," explains Duda. "Organizations understand that that they cannot continue to dismiss these losses as inevitable costs of doing business. Our solution helps automate key functions within the reporting and fraud discovery processes so that social services personnel can spend more time serving the citizen."
CountyLine™ is a software solution that includes an industry-leading identity reconciliation engine and a high-powered reporting and analytics platform.
The solution gathers social services data from across the enterprise – including child support, Medicaid, elder care, mental health, workforce services, and other welfare programs – and builds a consolidated "dossier" of information on each client. The consolidated information is then made available to the reporting and analytics platform.
According to Duda, holistic analysis is extremely difficult for most social services organizations. "Information is typically isolated and ‘siloed’ within each social services function. Holistic reports often involve months of manual reconciliation and fact checking – and that diverts key resources away from core social services functions."
The CountyLine™ solution addresses the problems of fraud, waste, and abuse by automating many of the tedious and time-consuming reconciliation tasks that burden analysts and investigators.
"It would take an analyst a number of hours, and a bit of luck, to uncover a situation where a health care provider has submitted multiple Medicaid claims for the same treatment," explains Duda. "CountyLine™ performs that analysis automatically, as new data enters the system, and generates alerts when potential circumstances of fraud and abuse present themselves."
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