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Facts about Non-Compliant Medicaid Applicants

Lucy's Medicaid Minute

By Lucia Buffaloe, MBA - Director

Aug 2021

CBIZ’s internal data shows that the largest percentage of non-compliant Medicaid applicants (those who don’t complete the application process) are between the ages of 25 and 44. This group also represents approximately 50% of total Medicaid applicants. From interviewing applicants in these age groups, we determined that the primary reasons for failing to complete a Medicaid application were due to the patient’s internal environmental factors, such as work and family obligations, as well as issues related to getting to the hospital.

As I discussed in my last blog, Increasing Medicaid enrollments for non-compliant patients, in order to increase overall Medicaid enrollment for this population, your hospital needs to provide more flexibility for patients to complete applications. Our experience through the pandemic has taught us that virtual and online environments can help facilitate enrollment gains for these difficult-to-reach patients. We’ve learned that with additional convenience from an online or virtual environment, patients will be more inclined to complete the application process.

Another way to reduce the number of non-compliant applicants is rigorous follow up throughout the Medicaid application process. Many patients require weeks and months of follow up to complete their applications. For many hospitals, and their associated vendors, they are very active in the Medicaid eligibility follow up process during the first 30 days after a patient’s date of service. After that point, many organizations shift their attention and resources to more recent potential applicants. Unfortunately, this decision results in many patients falling through the cracks.

CBIZ’s follow up process remains robust even months after the date of service. Over 15% of our completed Medicaid enrollments are from patients after 60 days from their date of service. Our rigorous follow up process has led to a significant increase in completed Medicaid applications and associated revenue for our clients.

If you would like to learn more about how CBIZ can assist your hospital in reducing your non-compliant Medicaid applicant population, please reach out to me at Lbuffaloe@cbiz.com or 609-918-0990.  

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