Redefining Healthcare Technology: hCentive

We are a low-cost alternative to traditional, expensive technology and service projects. We have flexible pricing options to control costs and meet your budget.

Since 2009, hCentive, Inc. has been providing healthcare technology and support services to states nationwide. hCentive provides a range of commercial-off-the-shelf (COTS), software-as-a-service (SaaS) cloud-based technology solutions. It also provides associated technology services to meet the needs of its government clients and technology partners. hCentive has the solutions and services its clients need backed by experienced teams dedicated to modernization and successful technology delivery.

As a privately-held, government-focused healthcare solutions firm, hCentive views every client as its long-term partner. The company remains dedicated and adaptable to its clients to meet their needs as they evolve and change. At hCentive, it is not its mission to merely obtain copious quantities of contracts – The firm focuses on building trusted and lasting partnerships. As partners, hCentive’s goals with every client are mutual and always driven by its passion to Redefine Healthcare Technology and Services.

hCentive’s product portfolio and project experience continue to grow. It has developed and supported technology and associated service projects for states directly and through the Centers for Medicare and Medicaid Services (CMS).

Product Portfolio

The WebInsure Suite of products meets States’ needs for healthcare technology, from eligibility and enrollment to data exchange and correspondence. hCentive’s products are Software as a Service (SaaS), Commercial off-the-shelf (COTS) technologies hosted through the Amazon Web Services (AWS) GovCloud.

WebInsure Integrated Eligibility & Enrollment:

hCentivehas been addressing State eligibility and enrollment challenges since 2009. To date, the company has processed more than eight million eligibility determinations, including individuals for Medicaid and CHIP coverage.

Product Features:

• Medicaid MAGI and non-MAGI eligibility determination
• Support for State-specific Medicaid programs and services
• Member Portal for 24/7 online, user-friendly application and enrollment
• Administrative Portal for real-time application intake, processing, and enrollment management (overrides, re-determinations, renewals, and more)

WebInsure Data Exchange Manager:

States today must integrate and exchange data across a multitude of disparate systems. Managing these data exchanges all while ensuring data is appropriately sent, received, validated, and responded to can be an arduous task. The WebInsure Data Exchange Manager technology has perfected and eliminated the complexity of data exchange.

Product Features:

• Sits ‘in between’ State and third-party stakeholder systems
• Multiple purposes such as consumer validations, single area reporting, and data exchange monitoring
• Supports HIPAA-compliant EDI transactions made between systems
• Administrative Portal provides a 360° view of all data transactions

WebInsure Master Data Management:

As States work with a multitude of providers to ensure the delivery of services to members, proper management of patient data often becomes a significant problem. The firm’s WebInsure Master Data Management technology is an effective, adaptive, and smart solution with a backend algorithm to manage patient data and 'learn' as information is received. As a machine learning tool, this enables ‘fuzzy matching’ to be conducted, without limitations, to ensure duplicate entries are identified and data is appropriately merged – unlike other solutions that rely on an ‘exact match’.

Product Features:

• Aggregate and maintain accurate, updated provider, patient, and health data across systems
• Search across databases through a single, central repository
• Identify and prevent duplicate entries
• Link and match patient records, relationships, and entities
• Provider Portal supports inquiries of patient information and a number of self-service functions

WebInsure Data Reconciliation:

Managing data across multiple systems is a complex task. It can be difficult to know if data was sent, reformatted, and correctly and accurately received in another system. This makes data reconciliation become a critical process to validate all data was appropriately sent and received. Data reconciliation ensures data errors are promptly discovered, addressed, and resolved so that only accurate, up to date information remains across systems. hCentive’s WebInsure Data Reconciliation technology is designed to ensure both accuracy and precision in all data reconciliation.

Product Features:

• Reconciliation of data received across disparate systems, even when there is no unique identifier present
• Backend integration with State and third-party systems
• Administrative Portal to validate and reconcile data and displays results
• Auto identifies, analyzes, and resolves data discrepancies

WebInsure Exchange Market:

States who have elected to operate their own State-based Exchanges (SBEs) often encounter a range of complex problems, from integration with Qualified Health Plans (QHPs) to modifying shopping and application functions, to supporting long-term operations and maintenance needs. hCentive’s WebInsure Exchange Market technology is designed to be a seamless replacement to any current, inefficient, and costly exchange technology you may have in place today.

Product Features:

• Fulfills the needs of SBEs through both an Individual and Small Business Health Options Program (SHOP) marketplace
• Marketplaces can be purchased individually or together to provide a single, comprehensive SBE solution
• Includes Consumer (Individual and/or Employer/Employee), Assistor, Plan, and Administrative Portals
• ACA, HIPAA, and Americans with Disabilities Act (ADA) 508 compliant

CEO Corner

Sanjay Singh, Co-founder, and CEO: Sanjay advances initiatives that ensure hCentive is a leading provider of government-focused healthcare technology and services. He is committed to building an exceptional company that embodies hCentive’s core values of customer success, execution excellence, and openness. hCentive was recently listed among the Top 25 Insurance Technology Solution Providers of 2017 and has nearly two million user accounts through its technology platforms.

Prior to hCentive, Sanjay was Co-founder and President of GlobalLogic, where he oversaw all aspects of the company’s operations and was responsible for defining and evolving the company’s service offerings and ensuring customer success. He sold GlobalLogic in 2013 when the company had grown to more than 3,000 employees across the globe.

Sanjay earned his Bachelor of Engineering from the Government College of Engineering in Raipur, India and his Master of Technology from the India Institute of Technology in Kharagpur, India.

“Our technology and service support aligns with the latest Federal and State guidelines and our own in-house best practices, with full monitoring and enforcement at all levels.”