Emdeon and TennCare Youth
Emdeon, in collaboration with TennCare's eHealth Initiative and Shared Health, has worked to develop a system to alert providers on the healthcare screening status for Tennessee children and young adults covered under Medicaid.
The new process gives providers enhanced eligibility information at the point of care indicating whether the required Early Periodic Screening Diagnosis and Treatment (EPSDT) screen has been completed according to protocol for patients 22 years old and younger. The protocol is designed to help prevent disease and reduce hospital stays and emergency room visits.
Emdeon developed a transaction workflow within its real-time switching infrastructure that can prompt a clinical message when an Eligibility and Benefits Inquiry (270) transaction is launched. When the provider enters the patient's date of birth, the system simultaneously sends an Eligibility inquiry to the payer and a clinical message search to a data analytics partner. Emdeon receives both the payer response on eligibility and the clinical result and creates an enhanced outbound Eligibility and Benefits Response (271) transaction with the appropriate messaging that goes to the provider.
Results
- Since the program went live on November 20, 2008, TennCare is averaging nearly 1,400 EPSDT screening look-ups per day. That translates into 28,000 opportunities every month for children and young adults to get needed preventive care that might otherwise get overlooked – inside the provider's existing workflow and technology.
***Submitted by Susanne Powell, Director, Corporate Communications, Emdeon, spowell@emdeon.com
Published: January 26, 2009
