Sold by: Deloitte Consulting GPS
Deployed on AWS
Enhance Medicaid encounter data processing with HealthTranslate™, a SaaS solution for State Medicaid programs. Efficiently ingest and validate X12 (837) and NCPDP data, automate response messaging, and access intuitive reporting through a user-friendly portal. Enhance quality measurement, monitor Managed Care Organizations (MCOs) contract compliance, and meet regulatory requirements, all within a secure and scalable platform.
Overview
HealthTranslate™ is a SaaS-based encounter processing engine designed for state and local agencies, enabling the ingestion of X12-compliant medical (837) and pharmacy (NCPDP) encounter data, and automated generation of appropriate response/ acknowledgement messages (TA1, 999, and 277CA) for the trading partners. The solution includes a user-friendly front-end portal and robust reporting features.
- Enables measurement of the quality of care provided by the MCOs.
- Provides standardized validations for industry transactions
- Monitors MCO contract compliance for data quality
- Adheres to CMS reporting requirements
- Allows Department of Health and Human Services to perform what-if analysis
The solution is hosted on the AWS cloud and leverages core AWS services, including Amazon S3 for data storage, Amazon CloudWatch for system monitoring, Amazon RDS for database management, and Amazon Bedrock for advanced AI capabilities. To support client-specific environment compatibility needs, additional AWS services such as Amazon EKS (for container orchestration), AWS Lambda (for serverless computing), and AWS OpenSearch (for search functionality) can be integrated as required.
Notional Pricing | 12-month Contract We have various pricing models based on scope. Please reach out to Hoag Don, dhoag@deloitte.com or Riddle Cheri, criddle@deloitte.com for Custom Pricing.
- Tier 1 X-Small | $901,684.04
- Tier 2 Small | $1,050,505.96
- Tier 3 Medium | $1,235,889.22
- Tier 4 Large | $2,911,949.04
- Tier 5 X-Large | $5,050,118.07
Highlights
- Integrates a configurable business rules engine with over 150 pre-configured industry-standard rules across multiple formats (837-Institutional, Professional, Dental; NCPDP- 45, 47, 51, D.O; PACDR).
- Includes an interactive portal for onboarding, management, and providing insights for trading partner and state-specific requirements.
- Provides analytics and detailed reporting capability on patient encounter data to authorized parties.
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