How We Deliver More
We go the extra mile with smart automation and expert support to make Out-of-State Medicaid claims easier, faster, and more successful—so you get more reimbursements with less hassle. How much revenue is your hospital leaving on the table?
Discovery
Verification of patient Medicaid eligibility
Credentialing
Physician and facility enrollment and maintenance for state Medicaid or MCO programs
Submission
Adherence to state Medicaid and MCO timely filing via electronic claims submission and management
Appeals
End-to-end management of coverage or payment decision appeals
Out-of-State Medicaid Excellence
In-House Specialized Resources
Your Out-of-State Medicaid claims are in good hands with our skilled legal, clinical, and billing experts. We know every state’s rules and requirements inside out, handling everything from complex regulations to credentialing and billing—all while maximizing your recoveries and keeping you compliant. We succeed together—we only get paid when you get paid.
Advanced Proprietary Technology
Compass, our proprietary technology platform, automates claims submission across all state Medicaid programs, improving your clean claim rates and reducing denials. By automatically applying the correct fee schedules and program rules, we maximize your reimbursement while streamlining the entire Out-of-State Medicaid claims process.
Clear Performance Insights
Our detailed reporting puts your data to work, from individual claim tracking to big-picture revenue trends. Get visibility into denial patterns, processing times, and payment rates across different states. We’ll spot opportunities to optimize performance and predict future revenue trends. Our performance insights help you make data-driven decisions and process improvements.
Secure Data Protection
We protect your data with the highest security standards in healthcare. Our Compass platform’s HITRUST Risk-based, 2-year (r2) Certification demonstrates our rigorous commitment to advanced cybersecurity. This robust security includes advanced encryption, continuous monitoring, and strict access controls that exceed industry standards— protecting your data against today’s cybersecurity threats.
Knowledgeable and Experienced
Our team knows every state Medicaid program inside and out, building strong relationships with agencies and health plans. Your facility and physicians are enrolled smoothly in required state programs and HMO plans—we handle all paperwork and just need your signature. By keeping provider data current, we minimize claim denials.
Compass, our proprietary platform, automates the process, connecting directly to clearinghouses and your systems while staying current with fee schedules and policy changes to minimize delays and maximize revenue.
Our US-based team includes:
attorneys/legal professionals
clinicians
claims specialists
For 9 years, Aspirion has helped us collect on our out-of-state Medicaid claims. We had one very difficult claim from California.
The Aspirion team worked relentlessly on our behalf until we were paid what was due- a high dollar payment, at that. Aspirion continues to be a true partner in all of our billing and enrollment needs for out-of-state Medicaid.”
Contact Us
Find out how Aspirion’s Out-of-State Medicaid and proactive Provider Credentialing services can help maximize reimbursement and shorten the AR cycle.