Department of Health Care Services

Estrada Consulting, Inc. (ECI) managed the team and developed User registration that was federated managed by external providers and included integration with Azure authentication, as well as User Dashboards for ease of access to key information and templates to use for cost reporting.  ECI built a Custom Business Rules Engine to manage rules for reporting forms designed within the system.

Results and Value

ECI provided the project team roles of Scrum Master, Product Owner, Business Architect/Analyst, Application Architect, Test Analyst, and a development team of four (4).  Project documentation included System Requirements Specification, User Stories, Backlog, Release Plan in Team Foundation Server, System Design Document, DHCS User Manual/Provider User Manual, Release Notes (by Sprint, and by Release), Test Plan, Test Scripts (by Sprint, and by Release), and External Stakeholder Communication Materials.

This Cost and Reporting system also included:

• Forms generated from data to ensure user definition of forms is supported. Forms allow for provider upload of supporting documentation.
• Online certification eSignature compliant with State of California standards.
• Full audit trail for all changes to data in the solution entered by Providers or DHCS stakeholders.
• Acceptance or rejection of submitted cost reports.
• Assignments of teams and auditors to process submitted cost reports.
• Tentative Retroactive Adjustment for interim settlement of reconciliation requests including unlimited revisions.
• Automated data integration with enterprise data for providers using web services.
• Final Settlement processing with documentation uploads with options for entering cost report adjustments based on audit results.
• Unlimited revisions, amendments, and re-computations for settlements that have been appealed.
• Automated generation of financial processing files used in financial transactions.
• Role-Based Access Control.
• Notifications management to ensure all communicated information is retained for analysis and reference by involved parties.
• Due date management for cost reports with processing of extension requests.
• Automated notifications for withhold of payments for overdue annual reports.
• Data extracts and reports throughout the functionality pages.