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How VEC Helped a Mother in Need

Learn how VEC was able to prevent an application denial for a long term care patient

December 2022

By Francisco, Francisco, Assistant Manager and Alisha Mendez, Manager

CBIZ’s Virtual Eligibility Counselor (VEC) has been a substantial difference-maker for all stages of the Medicaid enrollment process. In this case, a minor who resided in New York with her mother, was transferred to one of our New Jersey clients’ facilities for rehab. The attending physician determined that the child would need long-term care; however, the child’s insurance policy did not cover the required services. While her child was on a ventilator and gastrostomy-tube dependent, the mother faced a large amount of duress to comply with the extensive requirements for a New York long-term care Medicaid application.

A busy work schedule and a traffic-filled commute from New York to New Jersey did not allow the mother to visit her child until 6 p.m. at the earliest each day. VEC was instrumental in providing flexibility for the mother due to her limited availability. VEC’s capabilities allowed the mother to meet virtually with a live CBIZ representative during after-hours, facilitating the initial screening and completion of her child’s Medicaid application. Upon review of the application, the assigned Medicaid caseworker sent a notice requesting additional documents from the mother, which she did not receive in the mail. Experienced in time-sensitive cases, CBIZ proactively followed up with the caseworker and identified that the case was subject to denial if the additional paperwork was not received by the New York Medicaid office within 24 hours.

In the past, this scenario might have taken a financial toll on the mother, as she would have been required to take unexpected time off from her demanding employer to address this urgent matter. But by using VEC’s secure portal, the mother was able to upload the missing documents, which allowed her to not miss any time off from work. CBIZ then promptly forwarded the documents to the state case worker. Thanks to VEC, the amount of time required for this procedure was reduced significantly, resulting in Medicaid approval for the child’s case.

If not for VEC, this child’s application would have been denied for failure to provide documentation within the required timeframe. A denial would have resulted in the need to resubmit a new application, adding more time and expenses to the process that the mother could not afford. In this case, VEC was a benefit for the child and her mother during a challenging time.

In addition to assisting our patients, VEC has been a benefit to providers and staff members as well. Throughout the course of the new year, we will discuss the benefits VEC provides to different personnel and areas within the patient-centric revenue cycle.

If you would like to learn more about how VEC can be a valuable resource to your provider, patients, and staff please reach out to [email protected]

Copyright © 2022, CBIZ, Inc. All rights reserved. Contents of this publication may not be reproduced without the expressed written consent of CBIZ.