Acentra™ Health Implements Modular, Cloud-based Medicaid Claims System for Utah

MCLEAN, Va., June 22, 2023 (GLOBE NEWSWIRE) — Utah Medicaid providers have a modern, efficient system for submitting claims following implementation of the state’s Provider Reimbursement Information System (PRISM). The fully modular, cloud-based system was designed, built, and implemented by Acentra^™ Health (formed by the merger of CNSI and Kepro), a leading Medicaid Enterprise Systems (MES) provider, in partnership with the Utah Department of Health and Human Services. Utah announced PRISM’s go-live on April 3.

Built on Acentra Health’s proprietary evoBrix^® platform, PRISM replaces the Utah Department of Health and Human Services’ 35-year-old legacy Medicaid Management Information System (MMIS) with a user-friendly system that helps providers easily submit claims and track payment status online. With the full suite of nine MES modules, PRISM enables continued system flexibility with an efficient system that delivers cost savings for the state. The configurable system includes Acentra Health’s Audit Studio^® and ClaimsSure^® solutions, to support program integrity, and the company’s HealthBeat^™ dashboard providing real-time system performance information.

“The Utah system launch continues our commitment to providing the most innovative and configurable solutions to the state government healthcare industry,” said Todd Stottlemyer, CEO. “This new solution forms the foundation for enabling the Utah Department of Health and Human Services to better measure patient outcomes while also empowering Medicaid participants to have an active role in the care they receive.”

“PRISM embodies our commitment to ensuring Medicaid-enrolled Utahns have access to the vital healthcare services they deserve,” said Jennifer Strohecker Medicaid Director; Director, Division of Integrated Healthcare, Utah Department of Health and Human Services. “The system’s modern design and intuitive interface will help reduce the administrative burden for providers so they can focus on delivering best-in-class care.”

Acentra Health is a recognized trailblazer for developing technology solutions that support state government MES needs. The company was the first to develop a web-based MMIS and the first to bring a MMIS to the cloud. In collaboration with the Wyoming Department of Health, the company set the record for the fastest implementation of a full claims adjudication and fiscal agent services system. In 2022, the Wyoming system received full certification with zero findings from the Centers for Medicare and Medicaid Services (CMS), becoming the first fully modular MES certified under CMS’ new Streamlined Modular Certification.

About Acentra Health

Acentra Health, formed in 2023 by the merger of industry leaders CNSI and Kepro, combines public sector knowledge, clinical expertise, and technological ingenuity to modernize the healthcare experience for state and federal partners and their priority populations. From designing and developing advanced claims, encounter, and provider solutions that drive efficiency and cost savings to delivering clinically focused service models for care management and quality oversight, Acentra Health is accelerating better outcomes. Acentra Health is backed by Carlyle (NASDAQ: CG), a global investment firm.

For information on Acentra Health, including a company video and an organization timeline, visit acentra.com. A comprehensive new website will launch later this summer. For more information on CNSI and Kepro, visit cns-inc.com and kepro.com, respectively.

Media Contact:

Janice Moore

Director, Corporate Communications

703-214-3552