State's Dept of Health Care Services Uses Intellisys to Audit Software and Rewrite its Medicaid System

A state’s Department of Health Care Services’ (DHCS) critical Medicaid patient claims processing system was run by an old, undocumented and unmaintainable legacy system. The federal government mandates that the state’s systems remain current with changing legislative requirements, so it was imperative to audit the software and  that the program be modernized for proper future maintenance. The first requirement was to extract and validate the embedded rules against the policy manual in order to transform the rules into modern code before moving to a modern platform. The state initially awarded the project to a large domestic outsourcing company. But after the project’s second year, the state was finding inaccuracies that continued to delay the project.