AHS has extensive experience in developing and administering a variety of programs for low-income populations and has been actively involved in the Medicaid Managed Care and Fee-For-Service arenas. As more and more states moved their Medicaid populations into some form of managed care, AHS has been able to assist Medicaid HMOs and MCPs with a variety of services designed to meet their contractual requirements to assure the provision of EPSDT and related services. We offer a proven track record along with the ability to quickly and effectively implement large-scale programs benefiting families, providers and, ultimately, the health plan.

Health plans have expressed tremendous satisfaction with AHS services and the resulting outcomes, such as increased EPSDT participation rates, timely submission of state and federal reports (including warehousing and reporting CMS 416 data), quality monitoring, efficient handling of EPSDT administration and a high rate of staff retention (95%) which ensures continuity with members and providers.

In partnership with health plans, AHS promotes the utilization of toll-free EPSDT helplines (providing services such as education, eligibility determination, referrals, etc.) for plan members and providers. In addition, AHS delivers a consistent, easily recognizable EPSDT message, all while conserving human and financial resources through economies of scale.

It is our intent at AHS to help health plans achieve an optimal EPSDT effort by centralizing the following essential, but labor intensive, tasks:

• Supporting participation of families in EPSDT by
  • Outreaching,
  • Informing,
  • Scheduling appointments,
  • Arranging transportation and other facilitating services, and
  • Tracking follow-up care and treatment; and
• Managing a quality EPSDT program by
  • Supporting providers,
  • Monitoring performance,
  • Adjudicating claims,
  • Performing continuous quality improvement, and
  • Providing outcomes reporting.

For additional information please contact us and we will be happy to discuss the particular needs of your health plan and/or state.