Out-of-State Medicaid
Streamline Out-of-State Medicaid billing with our expert services. We navigate the complexities of diverse state regulations, boasting extensive experience in all 50 states. Trust us for end-to-end support—from enrollment to billing and meticulous follow-up, ensuring your hospital's seamless compliance.
TRUST THE EXPERTS IN MANAGING COMPLEX CLAIMS
No Account Neglected. Committed Service from Start to Payment Completion.
50%
Expect a minimum increase of 50% in out-of-state Medicaid payments!
✅ Comprehensive management from application completion to submission
✅ Ensure state-specific compliance
✅ Onshore Medicaid billing specialists
✅ Proactive maintenance & monitoring
✅ Contingent fee pricing aligned with success
✅ Real-time online account management dashboard
✅ Early determination for increased conversions, remittance & reimbursement
✅ Close accounts often within 180 days, supported by transparent aging report
REAL-TIME TRANSPARENCY DASHBOARDS & REPORTS
Manage Your Self-Pay Population
Our real-time online dashboards and reports provide account drill-down capability, real-time updates, facility comparisons, easy Excel report download, front-end communication with our staff, and performance visibility.
✓ Enables collaboration with hospital staff and our Eligibility Advocates
✓ Proactively manage performance versus monthly or quarterly reviews
✓ Available across all service lines
COMMON OUT-OF-STATE MEDICAID CHALLENGES
1
Enrollment of Facility AND Providers
Gather sensitive information from board members and physicians: SSN, Addresses, Signatures
OPR providers must complete enrollment
Timely completion is crucial to avoid missing reimbursement opportunities
Enrollment process varies by state, posing a challenge for healthcare organizations seeking OSM Medicaid reimbursement
How We Can Help
We complete, submit, and maintain your facility AND provider enrollment applications at no additional cost to you.
Save yourself the money & time.
2
Billing & Follow-Up
The Medicaid billing process varies by state:
- Different claim forms
- Diverse billing requirements
- Varied lists of covered services
- Different reimbursement rates
Using the wrong billing template for another state can lead to denied claims
Follow-up on delayed or denied claims is
time consuming
How We Can Help
Our Team Specializes in Medicaid Resolution:
- Manage billing procedures for all 50 states
- Processing, follow-up, & appeals for claims
- We prevent errors & issues
- Higher remittance & faster reimbursement
3
Maintaining Qualifications & Revalidation
For each Medicaid program you wish to bill, your facility must maintain its qualifications according to the program’s requirements and your providers must complete periodic revalidation with the program(s).
Failure to do so will result in deactivation with the Medicaid program and denied claims. If a provider is un-enrolled, re-enrollment will entail more time and work and there may be a gap in eligibility for reimbursement
How We Can Help
We provide maintenance and monitoring of all your Medicaid credentials to prevent expirations and deactivation and to make sure you are proactively maintaining compliance with each program.
