Medicaid Community Engagement Verification with Amazon Connect

State Medicaid Agencies face an urgent deadline to implement community engagement verification systems by January 1, 2027, as mandated by H.R. 1. This comprehensive solution combines AMPGS® Reimagine CX (featuring Amazon Connect) with AMPGS® Intelligent Document Processing to automate multi-modality beneficiary outreach, timecard collection, and work hour verification - achieving up to 80% administrative labor savings while ensuring continuous coverage for eligible beneficiaries.

Key Benefits

• Meet Federal Compliance Deadline: Deploy proven solution architecture to satisfy H.R. 1 requirements before January 2027 mandate
• Reduce Administrative Burden: Automate document processing and verification workflows to free eligibility specialists for complex cases
• Maximize Continuous Coverage: Proactive beneficiary engagement prevents inadvertent disenrollment due to missed reporting deadlines
• Scale for Peak Volumes: Handle monthly verification cycles for thousands of beneficiaries without infrastructure constraints
• Flexible Community Engagement: Portal options for citizens, case workers, and volunteer organizations
• Decrease SNAP Errors: Improve State SNAP error rates with our cost competitive solution including optional MMIS/Eligibility integration.

Why AMPGS® Reimagine CX + AMPGS® Intelligent Document Processing

This integrated solution combines TEKsystems' AMPGS® Reimagine CX (Amazon Connect) with AMPGS® Intelligent Document Processing using Amazon Bedrock and Amazon Textract to help State Medicaid Agencies automate community engagement verification:

AMPGS® Reimagine CX Capabilities:

• Automated Outreach at Scale: Outbound campaign manager proactively contacts beneficiaries with personalized messaging and deadline reminders
• Omnichannel Evidence Collection: Seamless integration of voice, SMS, and email enables beneficiaries to submit documentation through preferred channels
• Case Worker Support: Live agent capabilities provide eligibility specialists with real-time beneficiary information
• MMIS Integration: Direct connectivity to Medicaid Management Information Systems for real-time status updates

AMPGS® Intelligent Document Processing Capabilities:

• AI-Powered Document Extraction: Amazon Bedrock and Textract extract work hours from pay stubs, timesheets, and employer verification letters
• Automated Validation: AI extracts data and integrates with state eligibility systems to validate against 80-hour monthly requirements
• Confidence Scoring: Machine learning confidence scores flag documents requiring eligibility specialist review
• Volunteer Hour Processing: Specialized processing for volunteer activity and community service verification

Government-Ready Infrastructure:

• Scalable architecture adaptable to any state's specific requirements and business rules
• CMS reporting and audit trail capabilities for federal compliance
• Integration with state eligibility determination systems and legacy MMIS platforms
• Support for Medicaid Enterprise Systems Community (MESC) collaboration

Industry-Specific Applications

State Medicaid Agencies require specialized solutions that understand complex eligibility requirements, federal reporting mandates, and the unique challenges of beneficiary engagement. This solution addresses government-specific H.R. 1 needs including MMIS/Eligibility integration, CMS compliance reporting, and the ability to handle diverse documentation types while maintaining strict privacy and security standards required for protected health information.

How it Works

1. Proactive Beneficiary Outreach: Automated Amazon Connect outbound campaigns contact beneficiaries approaching monthly reporting deadlines

2. Secure Timecard Collection: Interactive Voice Response provide secure upload links via SMS/email

3. Intelligent Document Processing: AMPGS® IDP extracts work hours from diverse uploaded documentation in any format or language

4. Automated Compliance Determination: System evaluates hours against requirements and updates eligibility status

5. MMIS/Eligibility Integration: Real-time updates to Medicaid systems with compliance reporting for federal requirements

Why TEKsystems Global Services

TEKsystems Global Services brings deep public sector expertise with proven success implementing solutions for State Medicaid Agencies nationwide. Our team understands the complexities of Medicaid eligibility determination, federal compliance requirements, and the critical importance of maintaining continuous coverage for vulnerable populations. With AWS Government Competency and extensive experience in healthcare IT transformation, we deliver solutions that meet both technical requirements and policy objectives.

Contact us today to learn how AMPGS® Reimagine CX with AMPGS® IDP can help your state meet H.R. 1 requirements while improving beneficiary outcomes.