Health and Human Services

SSG helps our clients obtain Title IV-E, Medicaid, CHIP, TANF, SNAP, SSI, Medicare and other Federal recoveries while managing existing recoveries by preparing for audits, performing compliance analyses, and updating rates.

SSG offerings in the area of Health and Human Services include program consulting, Federal claiming and regulatory compliance, cost allocation, financial management, rate setting, and financial and regulatory healthcare consulting in Medicaid, Title IV-E, CHIP, TANF, SSI, Medicare, and a wide range of block grant funding areas. Our consulting experience includes revenue management services in mental health, child welfare, developmental disability, substance abuse, public health, financial assistance, child care, juvenile justice, long term care services and drug and alcohol services.

Changes in state plans, waiver requests, and other required regulatory documents often attract considerable attention and interest from state and Federal officials. We approach the governing federal officials in a cooperative partnership, and do not place our client in a position of any undue risk of future disallowances. Our team’s comprehensive programmatic and revenue recovery understanding, and our knowledge of what it takes to operate and manage state programs result in innovative, adaptable, and effective revenue recovery designs.

Our Staff: Our team of consultants has delivered revenue management services to more than 25 states over the above program areas, resulting in obtaining and protecting hundreds of millions of federal recoveries.

Our Systems: We offer our state-of-the art, web-based HIPAA/FERPA-compliant Administrative Claiming System (e-SivicMACS), which collects observation data from program participants using Random Moment Time Study module, and offers end-to-end functionality from collecting roster data to generating the Administrative Claim for numerous Federal programs (Medicaid, SNAP, TANF, IV-E, IV-D, CHIP, etc.). It is designed to support policy changes with minimal modifications to the system code by using our state-of-the art architecture and design of the core system.

We also offer our state-of-the art, web-based HIPAA-compliant Medicaid Rehabilitative Option (MRO), and Targeted Case Management (TCM) claiming system which has been successfully serving hundreds of social services state agencies in multiple states across the nation. Our system encompasses web-based service capture, claiming, third party billing, document capture, and payment reconciliation functionality. The strength of the system is the flexibility and configurability of the system screens and business rules to easily meet the requirements of our clients.

We also offer our state-of-the art web-based cost allocation e-SivicCAP system designed for large and complex state and county human service agencies. The system allows clients to configure the system, thus avoiding the need for computer development staff to implement CAP changes.

Our Price: We offer the most competitive and best value prices in the industry, while obtaining maximum revenues and protection for our clients.

Cost Allocation Services – e-SivicCAP

The SSG team has considerable cost allocation experience providing services to more than 25 states, developing and modifying PACAPs, negotiating Plan acceptance with federal agencies, developing indirect cost plans, reviewing and implementing time studies, and providing systems that perform allocation of costs and produce claim information consistent with Federal claiming formats.

Our Staff: Our cost allocation team includes a 30 year career consultant who has managed over 25 cost allocation plan projects, with a focus on maximizing, protecting and preserving federal reimbursements. Many of these projects involved automated systems which supported the CAP program. The rest of the team are senior cost allocation and revenue management consultants, and as a team, have provided cost allocation services to more than 30 states.

Our System: We offer our state-of-the art, web-based cost allocation system, e-SivicCAP, designed for large and complex human service agencies, with hosting provided by SSG. The system provides all components of state and county Cost Allocation Plans (CAPs), including allocation statistic data entry and import functionality, security access with full or limited read/write access, structured version control, leave time allocation process, multiple levels of approval, and flexible and powerful reporting. The system is designed to allow clients to configure the system to meet business needs and the approved CAP, thus avoiding the need for computer development staff to implement CAP changes.

Our Price: We offer the most competitive and best value prices in the industry, while obtaining maximum revenues and protection for our clients.

Revenue Enhancement

The SSG team includes revenue enhancement experts with more than 25 years of revenue maximization experience in more than 30 states. Our team has unparalleled systems capacity with web-based systems using the most advanced technology, including federal claiming systems and our cost allocation system, e-SivicCAP.

SSG brings renewed energy, fresh ideas, and a conservative approach to our clients. Our staff has extensive experience in the assessment and documentation of social services Federal claiming processes to increase Medicaid, Title IV-E, CHIP, TANF, SSI, and Medicare Federal revenues and put in place the processes to ensure the increased revenue is protected.

SSG ensures that the possibility of disallowances is minimized by working cooperatively with Federal officials, in conjunction with client staff, and by designing an effective quality assurance program with detailed quality control measures to ensure compliance. Given our quality control approaches and conservative design, we implement programs with minimal or no negative audit findings. It is of no benefit to the client to have a very aggressive project design if the Federal oversight agency will not approve the claiming methodology or disallows claims in the future.

Revenue Management Compliance

Assuring compliance with all applicable Federal requirements is of the utmost importance to the success of Federal programs. Over the past decade, CMS, ACF, and the Federal Office of Inspector General (OIG) have been much more active in their oversight roles, with particular emphasis being placed on Title IV-E and Medicaid Administration, Medicaid Rehabilitative Option (MRO), and Targeted Case Management (TCM) claiming. SSG conducts compliance reviews and analysis, and assists states to prepare for and manage the Federal audit process.

We rely on the experience of our staff who realizes Federal requirements change over time, sometimes explicitly with very clear expectations, and other times, implicitly with interpretations that must be made by the State using other states’ audits and consultation with Federal officials.