Medicaid Eligibility &

The need to meet increasing Medicaid challenges

The increasing number of Medicaid patients directly impacts eligibility determination and billing. Healthcare facilities are challenged to receive appropriate reimbursement for their Medicaid billed services.

A full spectrum solution for the Medicaid application and eligibility process

Alltran Health’s Medicaid Eligibility and Verification solution can increase patient satisfaction, decrease volume on unpaid bill or charity care referrals, increase hospital cash flow, and reduce A/R management expenses.

Our program and partnership includes:

  • Hands-on, onsite eligibility assistance to patients on behalf of your facility
  • Assisting patients in completing the Medicaid application and obtaining needed supporting documents, often converting Self Pay to Medicaid
  • Ongoing support and education for patients as they complete the application submission and eligibility determination process
  • Submission of all Medicaid eligibility determination to the facility for appropriate claims submission
    Support for patients in cases of Appeals and Fair Hearings
  • Establishment of working relationships with Social Security Disability Insurance (SSDI) and Medicaid offices

Transforming the Medicaid process through customizable solutions

  • Complying with HIPAA, PHI, PCI, and all other federal, state, and local regulations
  • Increase follow up success to ensure timely eligibility determination
  • Increase net revenue from Medicaid billing
  • Reduce office management time and dramatically decrease expenses
  • Increase follow up success to ensure eligibility determination
  • Increase patient satisfaction

Alltran Health works with you to develop processes and protocols that meet your business objectives and ensures the delivery of a customized patient-friendly Extended Business Office solution.

Our Success Story

Profile: A 110 – bed community hospital located in Maryland

Challenge: The hospital was not maximizing Medicaid revenue using the County Department of Social Services’ caseworker. Each year, the caseworker converted approximately $150,000 annually in Self Pay accounts to Medicaid.

Solution: Alltran Health implemented a Medicaid Verification & Payment program and placed its specialist in the hospital’s business office to interview every Self Pay patient upon admission. Alltran Health filed all of the completed applications and gathered verifications as required by the county.

Results: Alltran Health implemented a Medicaid Verification & Payment program that successfully exceeded client goals:

  • Recovered $100,000 or more each month
  • Recovered over $1MM in additional revenue for the hospital

Healthcare news & events

HFMA Annual (ANI) Conference 2019

June 23-26,2019

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NAHAM Annual Conference 2019

April 23-26, 2019

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