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We helped the Illinois Department of Human Services re-verify eligibility for the State’s 1.4 million existing Medicaid members. Since eligibility redeterminations had not been done in a number of years, it required matching data from external databases for evidence of eligibility. By implementing our Enhanced Eligibility Verification (EEV) solution, MAXIMUS was able to aggregate electronically both government and commercial data source into a single view, significantly improving the accuracy and efficiency of Illinois’ eligibility determinations.

Our EEV solution performs electronic data matching to associate all files with the correct member, compares the results to state eligibility rules, then provides eligibility recommendations to the state caseworkers based on the verified data matches. The recommendation and source data are presented in a consolidated screen view, which saves considerable time and improves the quality of the verification over the traditional methods that were previously used.

According to the State, the EEV project has a potential return on investment of more than $200 million in annual savings to Illinois.