Compensating for
Uncompensated Claims
A patient’s Medicaid benefit profile is subject to change at any time. For instance, eligibility may initially be denied, then subsequently approved upon appeal after several months. Delays in final determination can also occur if patients are slow to submit the required documentation.
Even after eligibility has been established, the patient’s benefit profile may continue to evolve. Eligibility might be lost, the scope of benefits could either expand or decrease, and secondary or tertiary payers may be added or removed.
It’s this fluidity that demands so much more than a simple “eligibility check”. It requires constant monitoring of the patient’s benefit profile to ensure these changes are captured and every dollar owed is reimbursed.
Compensating for
Uncompensated Claims
A patient’s Medicaid benefit profile is subject to change at any time. For instance, eligibility may initially be denied, then subsequently approved upon appeal after several months. Delays in final determination can also occur if patients are slow to submit the required documentation.
Even after eligibility has been established, the patient’s benefit profile may continue to evolve. Eligibility might be lost, the scope of benefits could either expand or decrease, and secondary or tertiary payers may be added or removed.
It’s this fluidity that demands so much more than a simple “eligibility check”. It requires constant monitoring of the patient’s benefit profile to ensure these changes are captured and every dollar owed is reimbursed.
Everyday… an uncompensated encounter within your system becomes eligible for Medicaid reimbursement!
Everyday… Retro-eligible encounters expire because they weren’t discovered and billed in time!
Stop “Checking” Medicaid Eligibility!
Start Monitoring Benefit Profiles!
Retroactive Medicaid Tracking
The Self-Pay Problem
A patient’s benefit profile can change at any time. While a patient may not have had Medicaid coverage on the date of their original encounter, many times that same patient can go on to become a Medicaid recipient long after their initial visit.
This potentially makes their original encounter with your facility, eligible for Retroactive Medicaid reimbursement. Unfortunately, the task of tracking thousands of uncompensated encounters on a daily basis to determine Medicaid eligibility or to capture benefit profile changes are not only cost-prohibitive, its virtually impossible. As a result, many perfectly good retro-billable opportunities will go unnoticed and expire beyond their respective timely filing periods.
Everyday… a Self-Pay encounter within your system becomes eligible for retroactive Medicaid reimbursement!
Everyday… reimbursable Retro-Medicaid encounters expire because they weren’t discovered and billed in time!
Since 2013
The RetroCAID Solution
RetroCAID® passively monitors the benefit profile of every patient that has uncompensated encounters within your system. Every patient/encounter is monitored daily for 365 days or until it expires past timely filing.
If the benefit profile of any encounter changes, making it a reimbursable service, your facility is immediately alerted and provided with the details of the specific change. This includes all the essential billing information required for reimbursement.
Moving from “checking” retro-eligibility to “monitoring” the patient’s Benefit Profile has resulted in hundreds of thousands of dollars in increased Medicaid reimbursements for facilities just like yours throughout the country!
Read MoreThe Uncompensated Care Solution
Acting as a safety net, RetroCAID® passively monitors the benefit profile of every patient that has uncompensated encounters within your system. Every patient/encounter is monitored daily for 365 days or until it expires past timely filing.
If the benefit profile of any encounter changes, making it a reimbursable service, your facility is immediately alerted and provided with the details of the specific change. This includes all the essential billing information required for reimbursement.
The Uncompensated Care Solution
Acting as a safety net, RetroCAID® provides daily tracking of every Self-Pay and Sliding Fee encounter within your system. Each encounter is monitored for the full length of its respective timely filing period. If the eligibility information or benefit profile of any encounter changes, your facility is immediately alerted and provided with the details of the specific change. This includes all the essential billing information required for reimbursement.
Never Miss Another
Retroactive Medicaid
Opportunity Again!
*Optional supplemental billing support is available for retroactive claim processing and submission, creating a full end-to-end solution.
No Integration or Remote Access Required • Month-to-Month Agreement • No Software to Install
Fully Implemented by Phone in Less Than 60 Minutes!
*Optional supplemental billing support is available for retroactive claim processing and submission, creating a full end-to-end solution.
100% Contingency Based Service!
Pay nothing unless RetroCAID captures retro-eligible encounters and...
more importantly... only after your facility is reimbursed by the payer!
• Federally Qualified Health Centers – FQHC
• FQHC Look-Alikes
• Rural Health Centers – RHC
• Community Health Centers
• Healthcare for the Homeless Facilities
• Hospitals and Health Systems
• Behavioral Health Centers – CCBHC
• Substance Abuse Treatment Centers
• Laboratories and Toxicology Facilities
• Community Dental Care Facilities
Now Serving Over
4,500 Health Facilities
in 49 States, DC and VI!
4,500 Health Facilities
in 49 States, DC and VI!
Help Yourself!
Download our PDFs to learn more about RetroCAID® and see recent results from healthcare facilities just like yours.
