Case Management for Benefit Appeals

Tyler and VIP Team Up to Replace 22 Aging Applications

Visionary Integration Professionals (VIP) is leading a multimillion-dollar software and services transformation for a state agency managing some of the largest welfare and social services programs in the country. They’ve chosen Tyler’s Case Managent Development Platform as the technology platform to improve operations and outcomes.

Problem: Unconnected, Inefficient Legacy Systems

An agency managing some of the largest state-based welfare and social services programs in the country needed to update their internal systems. They are responsible for ensuring due process for individuals who wish to appeal administrative decisions on benefits regarding 22 different public social service programs. At the same time, they must comply with federal mandates imposing strict deadlines on how quickly requests must be adjudicated — despite handling an average of 100,000 appeals annually.

This large undertaking was being hampered by the variety of outdated, isolated systems supporting each of the individual benefit programs — including database architecture that dated back to the 1970s.

Solution: VIP Know-How and Justice Plus Technology

As experts in aligning strategy with execution, VIP knew they needed both a flexible case management platform and a technology partner who understoods the intricacies of delivering solutions to government. VIP selected Tyler’s Case Management Development Platform, powered by Entellitrak, to power the new appeals management system.

VIP recognized Tyler had experience supporting other agencies with their appeals processes and saw the value in the fully configurable platform. The Case Management Development Platform offers completely integrated, fully-featured modules for different aspects of case management including document management and analytics. This highly integrated approach empowers users to create, access, deliver, and use the information in the system in a more efficient way.

A commercial off the shelf (COTS) solution, the Case Management Development Platform will improve operations for the administrative law judges and support staff in the state capital, as well as in regional offices throughout the state. It will modernize case intake, scheduling, reporting, hearing, decision writing, and decision dissemination for the entire agency.

Results: Multiple Agencies, a Single Workflow

Based on the Case Management Development Platform, VIP provided the agency a single case management system that combines intake, automated scheduling, adjudication, and reporting functions for responsible agencies across the state, including:

  • Department of Social Services
  • 58 individual counties
  • The department administering Medicaid
  • The state’s ACA health insurance marketplace

With modern technology and integrated workflows, the new system reduces the average life cycle of an appeal case from receipt of the hearing request to release of the decision. It provides a user portal, allowing individuals to request hearings or check the status of their existing cases. Its efile capabilities streamline the submission of documents associated with cases — a significant component of the solution, which may handle more than 500,000 documents per year.

This joint project between VIP and Tyler is one of the most expansive of its kind in the nation. The transformation of the statewide system sets a new bar for how public sector organizations modernize their appeals operations.

Case Study Highlights

  • 100,000 appeals annually
  • 58 individual counties
  • 500,000 documents per year

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