The missing link Hospitals need to…  Compensate for their Uncompensated Care!



The Self-Pay Challenge

Each year hospitals lose millions in uncompensated care by not recognizing or fully exploiting Retroactive Medicaid reimbursements.

While a patient may not have had Medicaid coverage on their date of service, many times that same encounter can go on to become eligible for Retroactive Medicaid reimbursement long after the date of service or discharge.

This presents a challenge for Institutional Health Providers since institutions can have tens of thousands of self-pay encounters within their Patient Accounting Systems, with more being added every month. Any of those encounters can potentially become eligible for Retroactive Medicaid, but unfortunately many will expire beyond their respective timely filing periods before they’re discovered.


The Self-Pay Challenge

Each year hospitals lose millions in uncompensated care by not recognizing or fully exploiting Retroactive Medicaid reimbursements.

While a patient may not have had Medicaid coverage on their date of service, many times that same encounter can go on to become eligible for Retroactive Medicaid reimbursement long after the date of service or discharge.

This presents a challenge for Institutional Health Providers since institutions can have tens of thousands of self-pay encounters within their Patient Accounting Systems, with more being added every month. Any of those encounters can potentially become eligible for Retroactive Medicaid, but unfortunately many will expire beyond their respective timely filing periods before they’re discovered.



What About The ACA?

A report by the National Association of Public Hospitals and Health Systems projects that by 2019, hospitals will see $53.3 billion more in uncompensated care costs than originally estimated when lawmakers approved the ACA.

Even with the millions of people who have gained coverage under the ACA and the great strides that have been made to facilitate the Medicaid enrollment process at the point of care, many patients begin their application process long after their initial visit. Regardless of where the application process begins, eligibility determination in most states can take 30-90 days, if not longer. When patients are slow to provide the necessary documentation, and additional time is required for those who appeal their denied applications, the final determination date can stretch well beyond six months.


What About The ACA?

A report by the National Association of Public Hospitals and Health Systems projects that by 2019, hospitals will see $53.3 billion more in uncompensated care costs than originally estimated when lawmakers approved the ACA.

Even with the millions of people who have gained coverage under the ACA and the great strides that have been made to facilitate the Medicaid enrollment process at the point of care, many patients begin their application process long after their initial visit. Regardless of where the application process begins, eligibility determination in most states can take 30-90 days, if not longer. When patients are slow to provide the necessary documentation, and additional time is required for those who appeal their denied applications, the final determination date can stretch well beyond six months.



You Might Be Thinking…


You Might Be Thinking…


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How Does It Work?

Learn how our 100% Contingency service is implemented by phone in less than 60 minutes with no integration required or complicated software to install.

Schedule a Conversation!

We promise..., 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.

Hospitals & Health Systems was last modified: January 23rd, 2024 by Fix Healthcare Technology, LLC