Eligibility Enrollment

Case Study: High-touch provider for complex populations reduces ineligible Medicaid dollars by 97%

November 11, 2022

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…

Case Study: Non-profit system uses Epic optimization to improve enrollment process for patient eligibility

November 11, 2022

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…

Case Study: Medicaid eligibility conversion and collections improved by optimizing enrollment processes

November 11, 2022

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…

Case Study: Patient access crisis drives innovation

November 11, 2022

Patient access crisis drives innovation. Case Study Patient access crisis drives innovation. Covid-19 incited a meteoric rise in emergency room visits. This surge inpatients necessitated additional staff, increased registration efforts, andexpanded follow-up services at the same time the pandemic created staffshortages and state mandated restrictions in onsite patient interactions. Fueling the obstacles, the provider saw…

Make the Most of Price Transparency Data: Charge and Reimbursement Benchmarking

November 11, 2022

Make the Most of Price Transparency Data:Charge and Reimbursement Benchmarking Thought Leadership Make the Most of Price Transparency Data: Charge and Reimbursement Benchmarking With the introduction of Hospital and Health Plan Price Transparency regulations and increasing prevalence of high deductible health plans, hospital chargemasters have become price comparison tools. In some instances, access to this…

Steps to Improve Patient Satisfaction and Increase Revenue

November 11, 2022

Steps to Improve Patient Satisfaction and Increase Revenue Thought Leadership Steps to Improve Patient Satisfaction and Increase Revenue The enormous influx of eligible Medicaid and community benefit participants poses both an opportunity and challenge for healthcare providers. The shortage of trained staff and the changing healthcare landscape demands that providers think “outside the box” to…

COVID-19 Public Health Emergency (PHE) Renewed. Medicaid Coverage Extended Once Again.

April 15, 2022

April 13, 2022: Recently Reuters reported that the COVID-19 PHE has been renewed. The extension allows “millions of Americans to keep getting free tests, vaccines and treatments for at least three more months,” according to the news agency. Reuters also reported that the Department of Health and Human Services (HHS) had said in a statement…

Social determinants of health and value-based reimbursement

November 16, 2021

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 laying the groundwork to…

Minimizing Financial Risk in a Consumer-Driven Environment

November 11, 2021

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 as a fixture within the current…

Ensuring Sustainable Revenue Cycle Health At Skilled Nursing Facilities

October 27, 2021

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, the average cost of most hospital stays is…