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Medicaid Program Integrity

Account for
|.

Every organization accountable. Every service tracked. Every record connected. One longitudinal view.

Get the Full Picture
The Rising Process

Scrutiny is increasing.
Visibility should too.

Medicaid services now span more programs, providers, and community organizations than ever. Each adds more complexity, while oversight remains the same.

  • Agencies must prevent fraud, waste, and abuse and demonstrate accountability for every public dollar spent.
  • Funded services span multiple programs, providers, and community organizations across jurisdictions.
  • Claims audits confirm a bill was submitted. They don't confirm a service reached the member.
Unite Us dashboard showing claim submission and claim details, including organization qualified, service delivered, and outcome documented
What We Offer

Connect Accountability Layers at
Every Stage of the Member Journey

Two providers reviewing a credential checklist for Eastside Alliance, showing requirements met, credentials current, and no active exclusions
Account For Who Delivered It

Network Participation
& Exclusion

Every organization agrees to the same participation terms and meets the same exclusion criteria to join and stay in the network. One standard for all.

A driver helping a member out of a vehicle, with a closed-loop transportation assistance card showing referral accepted, service authorized, and ride completed
Account For What Was Delivered

Closed-Loop Referrals
& Service Delivery

Closed-loop referrals follow each service from acceptance through delivery to outcome in one system. The record builds as the work happens.

Learn more about Closed-Loop Referrals
A smiling man with headphones holding a phone, with an across-programs card showing one member record spanning food assistance, housing support, and maternity health
Account For Where Services Reach

Enterprise Master
Person Index

The index ties services from every program and provider to one longitudinal record. The history follows the member, not the program.

A provider and patient in conversation, with a population-signal card showing a need identified before any related claim, including food insecurity flagged, referral sent within 24 hours, and service delivered
Account For When Needs Emerge

Predictive Analytics
& Population Insights

Population-level analytics help agencies see unmet social needs and service gaps earlier in the process. An earlier signal, not hindsight.

Learn more about our Insights
Webinar

Hear how program integrity is changing, from someone who's sat in the chair.

Keith Gardner spent two decades in government, including as chief of staff to the governor of New Mexico. Now SVP of Regulatory and Government Affairs at Unite Us, he talks with Medicaid leaders about what accountability requires as policy shifts.

Watch Now View our Knowledge Hub
Keith Gardner waving, with webinar and video player interface graphics around him
550K

Programs held to network participation standards

2.1M

Services delivered tracked from referral to recorded outcome

124.7M

Connections to care across one accountable network

Frequently Asked Questions

  • Unite Us is the infrastructure that connects programs, providers, and community organizations into one longitudinal record. Claims audits and payment integrity tools look at transactions. Unite Us gives agencies visibility into the service behind them.

  • Closed-loop referrals track each referral from acceptance to service delivery to outcome. Every step is recorded in one system. Agencies see what happened, not just what was sent.

  • Organizations agree to network participation terms and an end user license agreement that require compliance with applicable laws. Unite Us exclusion criteria prohibit organizations that are under federal or state investigation, debarred, or on the OIG exclusion list from joining or staying in the network. Complaints about fraud, waste, or abuse are reviewed, and organizations that fall short can be removed.

  • An Enterprise Master Person Index (EMPI) ties services from every organization and program to a single individual record. Agencies see a member’s full service history in context, not just what one program paid for.

  • Population-level analytics help agencies identify unmet social needs and service gaps sooner. Connecting members to the right services at the right time may reduce avoidable utilization and reliance on higher-cost programs. Program integrity starts upstream.

Ready to see the full picture?

Start Accounting for
Every Step Today.

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