In the healthcare industry, the role of a clinic or hospital encompasses beyond just giving medical treatment. An added service that can be offered to patients is to help them apply for Medicaid. With proper guidance from doctors, nurses and other hospital staff, patients can determine their eligibility for Medicaid and have a better chance of receiving the benefits they deserve. Medicaid and Revenues Research has found that hospitals with a mix of patients with Medicaid and other private healthcare plans are more successful in getting collections. This is an improvement compared to hospitals or clinics who serve only self-paying patients or privately-insured clients. Data suggests that with the right healthcare revenue cycle management strategies and with proper monitoring, hospitals can expect profits, even if they have many patients under the Medicaid program.
Qualifying for Medicaid In general, Medicaid is a benefit provided by the government to low-income families for them to be able to lead healthy lives. Patients under this program need not pay for certain treatments or consultations from hospitals or clinics. Instead, the state covers these expenses for them. How does one know if a patient is qualified for Medicaid? Depending on Federal Laws, certain states differ in the requirements for Medicaid, and these criteria need to be carefully assessed by state-regulated administrations. Pregnant women, whether they are married or not, are eligible to receive Medicaid to pay for prenatal care, delivery and postpartum assistance, if needed. Newborn babies of moms under Medicaid are also covered by benefits until a certain age, which may be 18 or 21 depending on some states. Children who will be newly-applied for Medicaid may also be eligible to get healthcare coverage if their family falls within the specified income bracket. For aged individuals, such as those above 65 years old, Medicaid may also be granted for them to receive hospice care. The same also applies for persons who are disabled, and they may avail of the benefits, provided that their disability or impairment is certified by medical professionals. If you need more information on the eligibility of your patients when it comes to Medicaid, you can always consult with the experts. These specialists can talk you and your patients through the application process, inform you of any deficiencies that need to be completed and help improve the chances of getting approval for benefits. Sources: Hospital revenue cycle management and payer mix: do Medicare and Medicaid undermine hospitals’ ability to generate and collect patient care revenue?, researchgate.net revenue cycle management (RCM), searchhealthit.techtarget.com