RFI Response - Web viewState of California. Office of Systems Integration. RFI Electronic Visit Verification. State of California. Office of Systems Integration. State of California

RFI ELECTRONIC VISIT VERIFICATION (EVV)

Submitted by: Customer Dynamics a Microexcel

companyRichard A. Novia

480-88-5986

State of CaliforniaOffice of Systems Integration

RFI Electronic Visit Verification

Important Notice: This document and any attachments submitted with it are confidential and intended solely for the use of the individual or entity to which it is addressed. If you are not the intended recipient, you are hereby notified that any use, dissemination, forwarding, printing, copying or other use of this document, any attached documents, and the information these documents contain, is strictly prohibited. If you have received this by mistake, please advise the sender immediately and destroy / invalidate the document.

Page iiUse or disclosure of proposal data is subject to the restriction on the title page of this proposal



Table of Contents

RFI Response.................................................................................................................................1

Introduction....................................................................................................................................2

Statement of interest......................................................................................................................5

Dynamics 365:..............................................................................................................................5

Respondent’s business and its experience...................................................................................7

Risk Mitigation.............................................................................................................................7

Industry Leading Technology......................................................................................................7

Data Security, Reliability, and Compliance.................................................................................7

Verification methods or strategies...............................................................................................8

User Experience.............................................................................................................................9

Optimizing accountability among Medicaid service providers....................................................9

Quality assurance alerts that help detect anomalies and prevent gaps in service provision.........9

Electronic billing interface capabilities that deter fraudulent or abusive billing........................10

The application and utility (including perceived advantages & disadvantages) of “Open Source” EVV technology software systems...........................................................................10

Costs and Attachment A response..............................................................................................11

Page iiiUse or disclosure of proposal data is subject to the restriction on the title page of this proposal

RFI Response TO:

Albert De León

Acquisitions & Contracting Services

Division Office of Systems Integration

Phone: (916) 263-4285

E-mail Address: [email protected]

Responder:

Customer Dynamics, a Microexcel company7135 Highland DriveSuite 100Salt Lake City, UT 84121

Web Sites:

www.customerdynamics.com

www.microexcel.com

https://www.microsoft.com/en-us/dynamics/field-service

Personal Contacts:

Richard A. NoviaCustomer DynamicsSolution [email protected]

Signed: Date: 12/05/2017

Michael YagerMicroexcelVP Public [email protected]

Signed: Date 12/05/2017

Page 1Use or disclosure of proposal data is subject to the restriction on the title page of this proposal

mailto:[email protected]

mailto:[email protected]

https://www.microsoft.com/en-us/dynamics/field-service

http://www.microexcel.com/

http://www.customerdynamics.com/



Introduction

Government organizations today are faced with seemingly contradictory challenges. You must improve service delivery and citizen engagement while reducing costs; be open and transparent while meeting privacy and compliance requirements; and enhance collaboration and data sharing with old, inundated systems with siloed data that is difficult to access. Into this challenging environment, Microexcel & Microsoft has introduced technology solutions that help government agencies innovate and adapt to changing demands in a secure and reliable way.

Microsoft Dynamics 365 is a case management platform used by Health and Human Services organizations to increase efficiency, enhance visibility and improve the service delivery experience for recipients. Microsoft Dynamics 365 facilitates the delivery of rapid business value with an agile solution framework that can be easily tailored and configured to adapt to changing requirements over time. The Dynamics platform is built on a modern and intuitive design which interfaces directly with Microsoft Office/Office 365 and features a fully offline capable mobile application which brings the rich data environment of the case management system to the mobile worker.

The Electronic Visit Verification RFI issued by CMIPS is seeking technology and processes that will verify the utilization and delivery of services including home health services associated with California’s Medicaid. We propose to accomplish the objectives by utilizing the “Field Service” module of Microsoft Dynamics 365. Dynamics 365 Field Service capabilities deliver intelligent, world class field service, including scheduling, mobile and resource optimization while maximizing efficiency and minimizing costs. Field Service can also be integrated with IVR telephony systems for audio confirmation, Electronic Medical Records systems for patient information, and Financial Systems for invoicing and payment. Microsoft Dynamics software is used by a variety of Health and Human Service organizations at the federal, state, and local level to manage health and human services cases.

Dynamics 365 enables HHS agencies to create and manage traditional cases that can be linked to customers, contacts, businesses (e.g. providers), and other entities. The case record encapsulates everything that is pertinent to a client/individual’s care – including assessments, eligibility determinations, service plans, and financials. The account record associated with the recipient provides a holistic view of a client, capturing all touch points with agency staff and facilitating information-sharing, both within the agency and with other counties and states as needed. This case management functionality creates the foundation for reducing fraud, waste, and abuse associated with client services through machine learning and advanced analytics.




Key capabilities of Dynamics 365 include:

Schedule and dispatchGives the ability to manage individuals, and teams with flexible scheduling options that enable precise appointment scheduling, tracking, and billing. The system includes (optional) route optimization and alerts that provide the service provider and agency immediate status updates.

Visit and case managementCase management both in the office and in the field, helps enhance visibility and control client information with the ability to view history and easily update the information in the field with pictures, audio capture, and electronic signatures which over time increases service consistency and decreases costs.

Service billingThe billing and invoicing feature allows, employees and external service providers to create and manage invoices based on milestones, partial payments and final payments as well as at cost (time and material).

Business intelligenceDelivers insight and analytics to provide real time and historical as well as predictive and proactive information. Meet objectives, achieve goals and continue to improve operations.




MobileUsing native applications gives real time and true offline data on-site to service providers, no matter what device they use, including those based on iOS, Android, and Windows. Having visibility into customer information at their fingertips and a tool that is highly configurable to your field processes increases productivity.

Dynamics 365 geocodes each service account record with latitude and longitude values so that when you generate work orders for that service location, the work order inherits the coordinates and the system can calculate estimated travel time when attempting to schedule the work order to a resource. In addition to manual visit verification such as managing telephone call visit information or collecting recipient signatures, Dynamics 365 can also determine arrival and departure times based on proximity to the site coordinates, including frequent date/time stamping of the mobile devices location. This ability to determine the length of time within a window of time can confirm provider information automatically and help uncover anomalies and outliers that could signal fraud or abuse.

The remainder of this document will demonstrate our commitment to meeting CMIPS Electronic Visit Verification requirements, bringing value to overall business, and partnering to drive long-term success. The solution is designed to provide a high-value, low-cost alternative while addressing your requirements for a flexible, comprehensive Electronic Visit Verification system that provides seamless integration, simple administration, and easy on-going support.

We look forward to the opportunity to meet with the CMIPS team to show you the Dynamics 365 and the other Microsoft stack of capabilities described in this RFI response can meet/exceed the requirements stated in the RFI.




Statement of interestFor more than 12 years Customer Dynamics and Microexcel has been delivering innovative solutions to solve challenges faced by government agencies. We are on the cutting edge of innovation delivering mobile enabled, location aware, intelligent products that leverage machine learning to overcome modern challenges. Thus, Customer Dynamics/Microexcel is very interested in applying the strengths in delivering intellectual property and experience to help CMIPS solve challenges related to visit verification and billing.

One of our flagship products is Dynamics 365. Dynamics 365 is a fast, flexible and affordable software platform designed to facilitate case management related workloads. Dynamics 365 features a familiar user experience that promotes easy learning and use. More than 40,000 organizations and 4 million people use Microsoft Dynamics 365 because:

It works the way you do: Dynamics 365 has a design consistent with an outlook experience and integrates nicely within Microsoft Office/Office 365. No need to learn a new user interface.

It works the way your business does: every organization has its own specific workloads, requirements, and complexities. This requires a system to be adaptable to your processes and not the other way around. With Dynamics 365 you customize the system; the system is not customizing you.

It works the way IT does: Deployment, maintainability and integration should be easy. Dynamics 365 is based on standards and does not require highly specialized or unique knowledge to configure.

Dynamics 365: Is a low code/no code, configuration based application development platform Inherits security, and extensibility from the core Microsoft technology stack (Active

Directory, .NET, SQL, etc.) Is natively interoperable with Office 365 (Outlook, SharePoint, Office) Is scalable from lightweight to very complex use cases Has a native form designer, business rules engine, as well as report generation and

workflow management tools Includes robust reporting and data visualization (Power BI can be embedded to

further enhance visualization) Includes web portals and is fully mobile enabled

Dynamics 365 is commonly used in state and local government agencies, including the following scenarios:

Case management Field agent management (technician and human services) Electronic forms and routing Contracts and grants management Licensing and permitting Facilities and fleet management Service request management




We propose to leverage the inherent capabilities of Dynamics 365 Field Service to orchestrate the management of Medicaid service providers. Dynamics 365 includes out of the box core capabilities associated with field agent management, including scheduling, routing, and optimization of provider / recipient services. Agents in the field are empowered through the Dynamics 365 mobile application to provide the highest degree of informed service to the recipients. At the same time, the geo-aware mobile application prevents fraud, waste, and abuse by allowing administrators to confirm accurate site location, visit duration, and anomalies associated with proximity of the provider to the intended recipient.

Dynamics 365 facilitates automated validation processes that trigger workflows for notifications and warnings. In addition, standard confirmation receipts, such as a recipient’s signature confirming services received are enabled through the native tools. Microsoft additionally offers a robust set of business analytics tools that apply machine learning to identify anomalies in site visits that help to uncover fraudulent activity. Potential fraudulent activity is tracked in cases to resolution.




Respondent’s business and its experience Microsoft is the manufacturer of Dynamics 365. The implementation and customization of the software is provided by Customer Dynamics/Microexcel whom staffs have an extensive network of Certified integrators. As a Worldwide Gold Partner of Microsoft, we provide intellectual property and expertise to accomplish the objectives of the many government agencies that utilize Dynamics 365 and other Microsoft products necessary to meet requirements.

Risk MitigationGiven the size, growth, brand, diversification and profitability provide a much greater assurance of corporate longevity than many of the much smaller, emerging growth competitors.

Industry Leading TechnologyWe only utilize world class manufacturer’ like Microsoft given the depth and commitment to product R&D and on-going support.

Microsoft invests billions of dollars annually on research and development making our products among the most innovative, robust, and secure across all categories. Microsoft Dynamics is consistently ranked in the highest categories by both Gartner and Forrester. https://www.microsoft.com/en-us/dynamics/analyst-coverage-awards.aspx

Our approach to delivering EVV functionality will leverage discreet capabilities within field service management including machine learning to detect anomalies and identify efficiencies. This article describes some of the efficiencies being achieved in healthcare using Microsoft products:

https://enterprise.microsoft.com/en-us/industries/health/the-transformation-of-healthcare-through-machine-learning-and-cloud-based-predictive-analytics/

Data Security, Reliability, and ComplianceThe patient data collected by CMIPS representatives and transferred to mobile devices will inevitably contain Personally Identifying Information (PII) protected under HIPAA/HITECH and other State and Federal mandates. The ability to secure that data is paramount in selecting a technology provider. Microsoft provides a unique offering to secure and protect data on behalf of CMIPS. This web site provides further information on Microsoft’s ability to provide a trusted, reliable, and secure environment for CMIPS:

https://www.microsoft.com/en-us/trustcenter/default.aspx


https://www.microsoft.com/en-us/trustcenter/default.aspx



https://www.microsoft.com/en-us/dynamics/analyst-coverage-awards.aspx



Verification methods or strategies Dynamics 365 will enable the traditional methods of EVV using the patient’s home telephone discovered through Automatic Number Identification (ANI) technology to match the patient’s telephone number stored in the Dynamics 365 system. The service provider enters a unique identifier and password to authenticate and create an electronic signature.

Dynamics 365 can also authenticate against location data for the known address of the patient using the longitude and latitude geocoding provided by the service provider’s mobile device. This additional level of verification automates a “double check” against traditional methods, or provides a unique verification method.

Dynamics 365 can also enable patient signatures, photos, and audio recordings (all of which are date time stamped and can be geolocated) if CMIPS chooses to pursue additional opportunities to provide EVV related confirmation events.




User Experience

Dynamics 365 is built upon an industry leading user interface that facilitates rapid adoption and utilization across a broad spectrum of end users. The application includes a dynamic process flow control at the top of forms which adds context to otherwise static records. Instead of just viewing any (provider, recipient, address, case, etc.) record in isolation, the process flow visualization shows the record history (how it got to its current state) and the record destination (what steps are next to achieve the desired outcome). Users can also switch among multiple business process views based on record type, role or purpose.

The Dynamics 365 for Outlook client is a top cited user benefit. In addition to the web client, the Dynamics 365 application operates within an Outlook client, permitting users to perform their case management related tasks and activities without having to open another window or screen, or navigate among multiple applications. The Dynamics 365 for Outlook client mimics the Outlook user interface which decreases training requirements, increases ease of use and delivers a consistent user experience. Additional ease of use features includes: a contextual ribbon bar, role-tailored design and simple user personalization of workspaces and views.

Office users can seamlessly integrate with the Dynamics 365 data to create mail merge documents from Word, use document or email templates for distributions or use Excel pivot tables or other data massaging for data modeling and analytics.

Dynamics 365 includes embedded adoption aides including “Learning Path” - a new guided user experience that’s tailored by role. For example, if you’re a case worker, you’ll see the appropriate content for your role. Learning Path leads you step-by-step through specific tasks while you work in Dynamics 365 and provides videos, eBooks, and Help topics in context just when you need them.

Optimizing accountability among Medicaid service providersAccurate manual and automated data collection, and evidence-based reporting are at the heart of fostering and optimizing accountability. Dynamics 365 collects, processes, and reports data in a way that promotes transparency and creates an environment where technology provides the baseline for recording site visit data, minimizing, minimizing the potential for service provider errors.

Quality assurance alerts that help detect anomalies and prevent gaps in service provisionThe nature of Medicaid service provision is that a very large amount of data is created. Microsoft is expert in not only the collection of data, but in its storage and in analyzing those large stores of data. This article on Anomaly Detection – Using Machine Learning to Detect Abnormalities in Time Series Data provides insight into how Microsoft will enable the detection of anomalies in EVV data. Once an anomaly is detected, the inherent capabilities of Microsoft Dynamics 365 will be leveraged to visualize the data for human verification and automatically create cases for follow up and mitigation.


https://blogs.technet.microsoft.com/machinelearning/2014/11/05/anomaly-detection-using-machine-learning-to-detect-abnormalities-in-time-series-data/

https://blogs.technet.microsoft.com/machinelearning/2014/11/05/anomaly-detection-using-machine-learning-to-detect-abnormalities-in-time-series-data/



Gaps in service provision are managed through the rules and workflow engine in Dynamics 365, which enables contingency scheduling, routing, case prioritization, and assignment based on real time anomaly triggers occurring within the system. Over time, the ability to identify and mitigate disruption due to anomalies or other gaps in service will be improved through detection and the resulting adjustments made within the system.

Electronic billing interface capabilities that deter fraudulent or abusive billing

Dynamics 365 can automate many billing functions associated with service providers to minimize the opportunity for fraudulent or abusive billing. Dynamics 365 can be further integrated with financial systems software to automate paying the service provider.

The application and utility (including perceived advantages & disadvantages) of “Open Source” EVV technology software systems.

There are many perceived advantages to “open source” software, least of which is no upfront licensing costs. However, open source software has proven in many cases to be unreliable for critical business operations. Because there is no clear-cut discipline, and competing interests are often at stake, open source can be fraught with reliability issues. Open source can also evolve along the path most preferred by developers as opposed to meeting the changing requirements of the business. Open source is also not formally supported, relying mostly on the community of users to resolve issues, so in most cases CMIPS would be left to provide patches and fixes in the event of an outage. Open source tends to be more prone to malicious attacks and security relative to PII can be questionable. Another issue of note is that open source applications can become incompatible with the present day mobile devices. And there is no guarantee that open source software will improve over time or even be adapted to meet the requirements of the next generation of operating systems. Finally, warranties and liability indemnity for open source products rarely meet the demanding standards required by government agencies.




Costs and Attachment A response

Dynamics 365 licensing and pricing information publicly available through its web site: https://www.microsoft.com/en-us/dynamics/pricing-list.aspx We are happy to provide price quotes for licenses based on a more complete understanding of the requirements for CMIPS (number and types of users, etc.) Services associated with implementation will be provided along with a detailed Statement of Work once the process is more clearly defined and quantified.


https://www.microsoft.com/en-us/dynamics/pricing-list.aspx



Response to Attachment A:1. Covered in Statement of Interest2. Methods and Strategies

a. The system has the capability of accepting data from Mobile devices, Laptops, Desktops, and other internet capable devices.

b. In as much as the core product is built on the Microsoft stack there are very few items that cannot be overcome. Why? It has the capability to be customized throughout the stack to meet needs.

c. As outlined on page 7 in this documentd. The system will be configured to include all necessary data point for collection in

various methodologies as preferred by CMIPS.e. All data point fields and be identified as “Required” and listed with the drop down

or menu driven access for consistency and completeness.f. Automatic features and workflows are designed to reduce User dependencies

which prompt action by another member of team and or individual.g. This system is built on Microsoft Products which meet and or exceed the ADA

requirements. If there are any special needs, we can modify as best practices and as the technology allows. (More defined use case would be required.)

h. Features of the system that address the needs of special populations that cannot be near electronic devices. (More defined use case would be required.)

i. Could call into a call center agent for remote information input and verification.

ii. In Contact System recognizes the call and handles baseline verification.i. Off line sync mode availablej. Integrations:

i. PowerBI for more in-depth analytics.ii. Integration with telephone systems like InContact for call-center

functions.iii. Click Dimensions for marketing and on boarding activities.

k. Organizational insight provides information on usage, storage, capacity and operations of Dynamics 365.

l. Microsoft guarantees uptime of 99. 9% up time. Details can be found here:https://port.crm.dynamics.com/portal/static/1033/sla.htm

m. As stated given this is the Microsoft Stack most of needs are covered with configuration. However, if needed custom code can and will be introduced should such be warranted after close review of use case, existing capabilities and the cost effectiveness.

n. The PowerBI tool will be employed and can be viewed in detail at this URL:i. https://powerbi.microsoft.com/en-us/power-bi-premium/

o. <1 minute on sign on and <2 minutes on sign out. 3. In as much as the process will be monitored via workflows all parties requiring

knowledge of a completed task will be notified and where applicable escalation tasks can be incorporated to ensure the timeliness of completion and accuracy.

4. In as much as the system can keep track of transactions, time keeping and case management in a centralized system any affiliated system can receive data. The system is


https://powerbi.microsoft.com/en-us/power-bi-premium/

https://port.crm.dynamics.com/portal/static/1033/sla.htm



not a payroll system to create pay period disbursement but can export data to a Payroll type service.

5. We will supply references upon next stage.6. Traditional tools such as Knowledge base within the product is standard and can be

updated as features are added and removed. Along with that key “Self-Learning Tool” we will be conducting training webcast which will be recorded and catalogued. In addition, there are many self-learning tools on line for the base system/user to learn basic and comprehensive navigation. In certain application we have also employed a tool called “Walk Me”. This would be a very good tool given the number of users and various levels of training and needs. www.walkme.com

7. Extremely strong Project management, structured meeting with team goals and objectives, User participation at various stages to ensure UX and UI are meeting objectives.

8. Existing clients have had a successful deployment and user experience.9. Year 1 - Monthly review and a quarterly Release if required would prefer doing a 6-

month release. Year 2 - Quarterly review and Bi Annual Release. Year 3 - 6 Month review and annual release. Ad hoc as needed. All billed as T&M so to lower cost for you as client as opposed to a fixed fee.

10. The new EVV system would contain functionality that would replace existing ETS. ETS data could be sync with IHSS (Batch or real time) increments based upon business requirements.

11. Each person that is providing service is listed within the system. When visit verification is required that individual is interacting with the system. Association to a provider is not required.

12. Software as a service with the ability to customize to meet specific needs either through configuration or custom code.

13. There is a fixed cost per user module as this product is a SAAS model.14. Simply put the architecture is so scalable and lends itself to customization those elements

can and probably, be include as a Phase 2 to roll out in 2019 as part of the release candidate.

15. Notifications of all kinds Email, Task, Letters, Phone calls, can be tracked within a case or a contact or both Out of the Box. Further capabilities are within the Click Dimension product.

16. As described within #9 above.


http://www.walkme.com/

Documents

RFI Response - Web viewState of California. Office of Systems Integration. RFI Electronic Visit Verification. State of California. Office of Systems Integration. State of California