GAIN CONFIDENCE

INTEGRATED ELIGIBILITY

Bill Richardson, PMP

Working with our experts helps you to maximize the efficiency of eligibility determination and enrollment processes.

Tim Masse

Navigate complex integrated eligibility and enrollment processes with confidence, using our proven healthcare consulting expertise


The Affordable Care Act (ACA) allows states to leverage systems horizontally to determine eligibility for multiple health and human services programs, including Medicaid. BerryDunn has a team specialized in knowing and communicating the intricacies of Integrated Eligibility and Enrollment (including Medicaid and other health and human services programs) and Health Insurance Marketplaces.

Improve your business processes with specialized healthcare consulting approaches

We offer support to state agencies with planning for, procuring, and implementing integrated eligibility and enrollment systems, including services related to the business processes and policies that drive the needs and requirements for those systems. Working with our experts to understand the regulations pertaining to federal funding for these systems helps you to maximize the efficiency of eligibility determination and enrollment processes.

Among the services that our Eligibility and Enrollment practice offers to Medicaid and other health and human services agencies are:

  • Project management support
  • Independent Verification and Validation (IV&V)
  • Security audits
  • Financial audits
  • Programmatic audits
  • Advance Planning Document (APD) development
  • Business process analysis
  • Systems planning and procurement
  • Eligibility policy analysis and impact assessments
  • Formal / Wave and Payment Error Rate Measurement (PERM) testing

Get the latest thought leadership from our team on our blog, Firm Footing.