Eligibility Enrollment
High-touch provider for complex populations reduces ineligible Medicaid dollars by 97%
High-touch provider for complex populations reduces ineligible Medicaid dollars by 97%. Case Study High-touch provider for complex populations reduces ineligible Medicaid dollars by 97%. BrightSpring, a complex care provider who assists clients residing in intermediate care facilities and/or receiving home-based services, saw a climbing number of ineligible Medicaid clients. This forced the client to write…
Non-profit system uses Epic optimization to improve enrollment process for patient eligibility
Non-profit system uses Epic optimization to improve enrollment process for patient eligibility. Case Study Non-profit system uses Epic optimization to improve enrollment process for patient eligibility. Jefferson Health, 607-bed, three hospital system experienced patient interview delays, slowed account conversion and increased risk of error when attempting to secure coverage for under and uninsured patients. Eligibility…
Medicaid eligibility conversion and collections improved by optimizing enrollment processes
Medicaid eligibility conversion and collections improved by optimizing enrollment processes. Case Study Medicaid eligibility conversion and collections improved by optimizing enrollment processes. For this academic health system of 1,104 beds and $1.8B NPR, Medicaid eligibility processes were highly manual and workflow had not been assessed since their Epic transition. This resulted in fewer conversions, less…
Patient access crisis drives innovation
Patient access crisis drives innovation. Case Study Patient access crisis drives innovation. Covid-19 incited a meteoric rise in emergency room visits. This surge in patients necessitated additional staff, increased registration efforts, and expanded follow-up services at the same time the pandemic created staff shortages and state mandated restrictions in onsite patient interactions. Fueling the obstacles,…
Public Health Emergency (PHE) Renewed. Medicaid Extended Again.
Public Health Emergency (PHE) Renewed. Medicaid Extended Again. April 13, 2022 Recently Reuters reported that the COVID-19 PHE (Public Health Emergency) end date has been pushed back after a renewal. The extension allows “millions of Americans to keep getting free tests, vaccines and treatments for at least three more months,” according to the news…
Social determinants of health and value-based reimbursement
Social determinants of health and value-based reimbursement Two of the biggest trends in modern health policy are shaping the evolution of today’s Medicaid programs. For starters, the shift towards value-based payment (VBP) is helping providers address health-related factors beyond a patient’s immediate need for care. Along with an increasing emphasis on social determinants of health, this shift is…
Minimizing Financial Risk in a Consumer-Driven Environment
Minimizing Financial Risk in a Consumer-Driven Environment When examining today’s consumer-driven approach to healthcare, there are multiple factors to consider in order to minimize financial risk and ensure appropriate reimbursement. Understanding your patients is the first step. Patients have gained increased control in the business of healthcare over the years, especially given the expansion of virtualization…
Ensuring Sustainable Revenue Cycle Health At Skilled Nursing Facilities
Ensuring Sustainable Revenue Cycle Health At Skilled Nursing Facilities With a focus on cutting costs, today’s payers are looking closely at site of care when it comes to treatment options. Hospitals are among the most expensive sites of care, prompting a general shift towards skilled nursing facilities (SNF) as an alternative. According to Becker’s Hospital Review,…
Are Medicaid eligibility requirements negatively impacting your bottom line?
Are Medicaid eligibility requirements negatively impacting your bottom line? With limited income and resources, a significant portion of today’s population depends on Medicaid for assistance with mounting healthcare costs. At the same time, Medicaid’s complexity leaves many qualified patients confused as to how to achieve and maintain coverage. For starters, Medicaid eligibility requirements…
Drive Revenue with a Patient-First Approach
Drive Revenue with a Patient-First Approach Savvy hospitals and health systems are trending towards the tenets of consumerism as they look to cultivate a more patient-centric approach. In the interest of the patient, healthcare organizations are steadily adopting more “retail-like” behaviors, including 24-hour scheduling and other services that operate around the clock using revenue cycle…