By Alisha Mendez, Manager-Medicaid Eligibility Services, Matthew George, Manager-Medicaid/Charity Care Eligibility Services, Francisco Francisco, Supervisor-Medicaid Eligibility Services
CBIZ is known for going the extra mile to assist potential Medicaid-eligible patients in obtaining their entitled coverage. These efforts result in additional revenue for our client hospitals. With the pandemic reducing many patient touchpoints, CBIZ has addressed the question of how to maintain our same level of success in a reduced patient contact environment. Our solution is the Virtual Eligibility Counselor (VEC). This innovative solution allows us to securely, efficiently, and effectively convert complex uninsured cases into Medicaid eligibility for patients and additional revenue for our clients. Below are two success stories where VEC has proven to be a difference-maker in this new environment.
Patient A: Upon admission, an elderly patient was registered with insurance coverage at one of our client facilities. Days later, it was determined that the insurance policy listed on the account did not belong to the patient. The account was then referred to CBIZ, but the patient had already been transferred to another facility. After calling the patient, it was determined that he had a language barrier, so we needed to communicate with the primary contact on file, which was a family friend. Our client facility was still not permitting face-to-face interaction with visitors so we scheduled a virtual appointment via VEC and completed an eligibility screening. Upon completion of the appointment, CBIZ was able to determine that the patient was eligible for Emergency Medicaid.
As part of the process, signatures for the Emergency Medicaid application needed to be secured. Using our secure FTP portal, we were able to send the application and requirement list to the family friend electronically. From there, the family friend was able to print the application, have the patient sign the necessary forms, and upload all of the completed documents through our secure portal. Once CBIZ received the application and supporting documentation, we proceeded to submit the application electronically to the local agency for Medicaid.
The result of the virtual process was that the patient was approved for Emergency Medicaid, which helped cover his hospital bill at our client facility, as well as the bill at the facility where he was transferred. VEC allowed us to complete a Medicaid application from beginning to end, leading to Medicaid approval within four weeks. Our method to completing the enrollment process made it possible to take all of the necessary steps electronically, helped expedite the application completion time by two to four weeks, and made it convenient for the family friend to complete the application through his cellphone.
Patient B: An out-of-state patient on vacation with his family ended up being admitted to a client hospital. The patient, responsible for taking care of his elderly parents in Florida, needed to fly home immediately following discharge. In addition to his family responsibilities, the patient now had to worry about an unpaid hospital bill in another state.
After the patient returned to Florida, CBIZ was able to schedule an appointment through VEC and guided the patient through the entire financial assistance application process electronically. The patient completed all of his documentation online and qualified for Medicaid. The patient was grateful that even though he was far away, the eligibility process still flowed seamlessly.
Our success stories illustrate how CBIZ’s VEC serves as an asset from beginning to end of the Medicaid enrollment process. Our scheduling software is easy to use and has been well-received by patients, even those who are hard to reach or are not tech savvy. Our success has been possible because of how convenient we’ve made the Medicaid enrollment process. Patients that may not be able to visit our offices due to lack of transportation, job responsibilities, or time availability now have a viable, convenient solution to enrolling in Medicaid. As a result, VEC has helped expand the number of successful Medicaid applications at our client hospitals.
If you have any questions about our eligibility services or how VEC may be able to assist your organization, contact our office at 800-957-6900 or email at firstname.lastname@example.org.
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