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Overcome the Challenges of Out-of-State Medicaid

Overcome the Challenges of Out-of-State Medicaid

July 17, 2020
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Especially for facilities near state borders, out-of-state Medicaid claims can cause huge headaches. Many hospitals just consider it write-off business. But this outlook leaves millions of unclaimed dollars on the table—and we can help you get that revenue back.

When patients cross state borders to receive care at your facility, out-of-state Medicaid claims increase and often remain unpaid. These patients may become repeat visitors if your organization is located near state lines. Unfortunately, each subsequent visit presents more hoops for your staff to jump through—from individualized Medicaid program rules to regulation updates. Viable revenue hangs in the balance.

Billing requirements change frequently, varying from state to state, which complicates the task of tracking regulations. Your team must stay on top of 50 sets of requirements, limiting your efficiency. Overlooked processes will delay reimbursement and ultimately lead to lost revenue. Our team is committed to staying up to date on the latest processes to ensure your healthcare facility gets reimbursed quickly.

Each state also has its own credentialing requirements for facilities and providers. To ensure successful reimbursement, facilities and physicians must maintain their credentials in adherence to each state’s individual timelines, which requires long-term attention and investment. Unfortunately, few organizations have the time or resources to devote to such a detailed, ongoing process.

At Aspirion, we leverage electronic claim submission, produce custom reporting, ensure comprehensive physician and facility credentialing, and adhere to strict data security standards to give this often-overlooked segment of provider Revenue Cycle Management the care and attention it requires. Want to learn more about of Out-of-State Medicaid services, learn more here.

Aspirion

Aspirion

For over two decades, Aspirion has been a trusted ally to hospitals and health systems nationwide, focusing on maximizing revenue from denials, underpayments, and complex claims. Our team of expert legal, clinical, and technical professionals leverages cutting-edge proprietary technology powered by artificial intelligence to ensure our provider partners recover their earned revenue. With a client base spanning the entire United States, Aspirion proudly serves half of the nation's 10 largest health systems.

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Find out how Aspirion’s Revenue Cycle Management services will optimize reimbursement for your most challenging claims.