Community Benefit & Patient Advocacy Services

Our Community Benefit & Patient Advocacy Service are dedicated to uncovering any and all possible enrollment opportunities for governmental insurance programs, such as Medicaid or Charity Care Programs, to ensure patients are covered for current and future services.

Our best practices mindset allows for our operations to use all channels to qualify and enroll self-pay patients and continue the necessary revenue stream that our partners rely on throughout the year.

Our Patient Advocacy and Self-Pay Receivable Management Service includes:

  • Screen self-pay patient for eligibility in governmental assistance programs
  • On-site financial counseling at bedside
  • Home field visits with portable scanning technology.
  • Assist patients in applying for Medicaid, SSI, & SSD
  • Obtain valid Medicaid, Medicaid Managed-Care, and Medicare number through automated process
  • Identify & qualify patients under the Medicaid expansion program
  • Assist patients towards qualified State of Health insurance carriers that best fit our client’s needs
  • Work within new regulations of the Accountable Care Act to maximize reimbursement.
  • Screen all patient accounts for 3rd Party insurance coverage and government assistance program
  • Routinely follow-up with Medicaid offices on submitted applications through disposition
  • Reconcile the number of Charity Care priced claims against the number of approved Charity Care applications to ensure all applications are submitted to the fiscal intermediary timely
  • Institute a Dual Eligibility Outreach Program to assist elderly patients in obtaining secondary coverage through Medicaid
  • Utilize predictive dialing and call recording technology
  • Apply Risk Factoring across each performance grade (Patient Scoring) to enhance outcomes

Expected Outcomes:

  • Convert Self-Pay into insurance revenue
  • Increase insurance repeat revenue
  • Improve accuracy of patient data and insurance information
  • Improved Cash from uninsured/underinsured patients
  • Decrease Bad-Debt placements and costs to collect
  • Lower days in Self-Pay Accounts Receivable
  • Improved reporting and key performance indicators
  • Improve patient communication and satisfaction

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We provide Hospitals & Health Systems with comprehensive revenue cycle management services