OUT-OF-STATE MEDICAID

Fifty States.

Fifty Sets of Procedures.

We Can Help.

The Affordable Care Act expanded Medicaid programs across the United States, but each state has own its procedures for eligibility, enrollment, billing and reimbursement. Liberty assists hospitals by managing the Out-of-State (OOS) Medicaid process from beginning to end, analyzing all accounts within 24 hours of referral.

Our detailed approach addresses every phase of the OOS Medicaid process:

  • Identifying patient’s type of OOS Medicaid coverage
  • Assessing the need for (and securing) physician authorizations
  • Enrolling physicians and facility as required by state
  • Reactivating, revalidating and re-enrolling hospitals and physicians
  • Verifying that supporting hospital documentation is up to date
  • Verifying patient eligibility
  • Determining reimbursement amount
  • Billing and following up on claims
  • Managing disputes and appeals
  • Transferring balances to self-pay as appropriate
  • Providing electronic and hard copy notes and reports
  • Meet with hospital management each month to review progress, provide operational improvement ideas and ensure that outcomes exceed hospital expectations

REAL RESULTS:

Liberty has an 85% collection rate on OOS Medicaid claims.

 

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