Why Monitor Your Uncompensated Encounters
There are countless scenarios why retro-eligible encounters are frequently missed. Most have nothing to do with internal errors, lack of resources or the services providers have in place.
That’s because the patient’s eligibility status goes far beyond the simple binary of “eligible”, “not eligible”. There are many variables to a patient’s eligibility status that can change any time, even after eligibility is confirmed.
As an example, eligibility can be initially denied, only to be appealed months later. The patient can be slow to provide proper documentation delaying the final determination. These are just two simple examples that can push the patient’s final eligibility decision well out beyond their initial date of service. In some cases months, if not years.
Why You Should Monitor Your Uncompensated Encounters
There are countless scenarios that cause retro-eligible encounters to be frequently missed. Most have nothing to do with internal errors, lack of resources, or the vendors that providers have in place.
“Eligibility status goes far beyond the simple response of…
Eligible or Not Eligible!“
That’s because the patient’s eligibility status goes far beyond the simple response of “eligible”, “not eligible”. There are many variables to a patient’s eligibility status that can change at any time, even after eligibility is confirmed.
As an example, eligibility can be initially denied only to be appealed months later. The patient can be slow to provide proper documentation delaying the final determination. Examples like these can push the patient’s final eligibility decision well beyond their initial date of service. In some cases months, if not years.
Because Change Happens!
“It’s this fluidity that demands so much more than a simple Eligibility Check.”
Of course, changes also take place long after the patient’s eligibility is confirmed. Their eligibility can be lost, the scope of benefits can expand or decrease, secondary and tertiary payers can be added and removed.
It’s this fluidity that demands so much more than a simple “eligibility check”. It requires constant monitoring of the patient’s status to ensure these changes are captured and every dollar owed is reimbursed.
Stop “Checking” Medicaid Eligibility!
Start “Monitoring” Medicaid Eligibility!
Increase Your Medicaid Reimbursements… Guaranteed!
How It Works
RetroCAID® passively monitors all your uncompensated encounters for the full length of their respective timely filing periods. If the eligibility information of any encounter changes, your facility is immediately alerted and provided the details of the specific change. This includes all essential billing information required for reimbursement.
Captured changes can include:
- Medicaid Eligibility Status Changes
- Secondary Discovery
- Spend-down Monitoring
- Benefit Redetermination
- Benefit Changes (Increase, decrease, Lapsed benefits)
- Late addition Secondary and Third Party Payers (TPL)
- PCP Changes
- Etc.
Intelligent Claim Analysis
Eliminates False Positives!
To eliminate false positives, RetroCAID’s business intelligence analyzes each state response and compares it with the services provided to the patient.
Encounters found to be non-reimbursable are removed, freeing up your billing team to focus on only those encounters that will have a direct impact on revenue.
Custom rules specific to your billing environment can be created, releasing your billing team from the slog of tiresome and repetitive tasks. Even the most complex billing rules can easily be applied to reduce unnecessary busy work for your billing team.
Every uncompensated encounter is monitored daily
for 365 days or until it expires past timely filing.
- No Integration Required
- No Remote Access Needed
- No Software to Install
- Month-to-Month Agreement
- Implemented by Phone in
Less than 60 Minutes!
100%
Contingency Based!
RetroCAID® is a 100% contingency based service which includes daily tracking of unlimited encounters. There are no set-up fees, transaction fees, or fixed costs.
Your facility Pays Nothing unless retro-eligible encounters are captured and only after you are reimbursed by the payer!
Our month-to-month agreement can be canceled at any time with a simple email!
How Does It Work?
No integration required… completely implemented by phone in less than 60 minutes!
RetroCaid-Tracking™ monitors all of your Self-Pay and Sliding Fee encounters for the full length of their respective timely filing periods. If an encounter becomes eligible for Retroactive Medicaid reimbursement at any time within timely filing, your facility is immediately alerted and provided with all of the pertinent information required for reimbursement.
Designed to be a simple non-disruptive service, RetroCAID-Tracking™ requires no integration and can be completely implemented by phone in less than 60 minutes.
See Actual FQHC Results Here
100% Contingency Based!
RetroCAID® is a 100% contingency based service which includes daily tracking of unlimited encounters. There are no set-up fees, transaction fees or fixed costs.
Your facility Pays Nothing unless RetroCAID-Tracking™ finds retro-eligible encounters and only after you are reimbursed by the payer!
RetroCAID Tracking™ is provided on a month-to-month basis and can be canceled at any time with a simple email.
Verifiable Results From
Healthcare Facilities Just Like Yours
Within Their First Three Months!*
*The actual amounts collected in retroactive Medicaid by new clients within their first 3 months of utilizing RetroCAID.
Schedule a Conversation!
No long winded sales pitches or PowerPoint presentations. Just a straight forward conversation about your facility and what we provide for facilities just like yours around the country.
Your information is never shared and used only in response to your message.
