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Patient Pathway

Are you tired of writing off Medicaid claims that have been “stuck in limbo?”

Medicaid Eligibility Issues
  • Retroactive Enrollment: Because of the time it takes to complete an application for Medicaid, Medicaid will retroactively enroll a patient. Enrollments can be activated up to 90 days after the visit. The cost of tracking these patients manually usually does not justify the expense.
  • MCO Enrollment Timing: There can be a period of 7 to 40 days where the recipient is not found at Medicaid or at the managed care organization due to lags in the enrollment processes. The claim will be rejected at both locations. Patient Pathway will find this condition and indicate which entity to bill.
  • Coordination of Benefits: COB conditions are often overlooked. The primary payor must reject the bill first before the bill can be submitted to Medicaid or the MCO.
  • Errors in Demographic Information: These errors can cause claims to not be matched and then rejected.
With Patient Pathway, finding patient eligibility can provide a great source of additional revenue for your practice.

Patient Pathway Flow Chart



 



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Have you noticed how difficult it is to get answers to your claims issues these days?

In business since 1992, MD Claims, Inc. has years of experience in helping you resolve your claims issues quickly and accurately.





Featured Product

Patient Pathway


Ohio Medicaid
Eligibility Search

Stop writing off bad debt!

Custom reports and electronic claims resubmission to Ohio Medicaid and Managed Medicaid Companies.

Your pathway to additional revenue for your practice.  

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