Self-Pay Revenue Management

3 min read

Medicaid Enrollment- Use tech to help refine your process.

January 9, 2020 - 3:11 PM

Each year hospitals and health clinics lose billions of Medicaid dollars from:

  • Time consuming business processes
  • Lack of automation
  • Insufficient follow up

When we first observed this challenge, we immediately saw some ways technology could help in solving this problem.  Why tech? Because it costs a lot less than staff and it offers some enhancements you never dreamed possible.   

Process Enrollment Enhancement

Get digital tech. Bottom line, this is a huge resource time save here. Technology gives you the ability to  send a text message that can then start the medicaid enrollment process, a double win. Plus having a digital communication channel reduces patient time with your Medicaid enrollment counselor. Goodbye manual outbound call tracking and hello reduced man hours. I bet you won't miss that process. 

Solving Proof of Eligibility

Does your team have time to perform a daily Medicaid eligibility check on all unpaid accounts within your database? If no - then tech is a good option here too. Emerald's claim miner product looks for missed eligibility events. This product has found that 1 and 10 claims go unbilled to Medicaid. 

What about Presumptive Eligibility?

A lot of hospitals use this product. In some states, presumptive eligibility can help health centers get patients enrolled right away so they can bill for that day's visit. Generally, people that meet the federal poverty-level, kids or pregnant women can get a presumptive enrollment while their application is processed.  

People who receive SSI are also automatically eligible for Medicaid from the date of their eligibility determination for social security benefits.  

This product won't capture everything. All of those patients that require an appointment with Medicaid will need follow up. Remember, using digital tech for the follow up will save you time and money. 

What Happens After the Enrollment?

Presumptive eligibility won't solve all the enrollment challenges. All of those patients that require an appointment with Medicaid will require follow up. Remember, using digital tech for the follow up will save you time and money. 

Summing it Up  

Staffing and time issues will continue to be one of the biggest reasons that hospitals and health clinics miss out on Medicaid dollars but it doesn't have to be an issue.  Use our free calculator to find out if your health center is missing Medicaid dollars. 

Stop missing missed billing opportunities. Automate your Medicaid eligibility today. 

Emerald
Written by Emerald

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