Proper payment is important to both patients and hospitals. DECO’s Recovery Management Services can be an invaluable asset to both the lives of patients and for hospitals needing to collect payment for the patient’s treatment.

DECO has devised a system in which individuals who pay-out-of-pocket are tested for Medicaid eligibility. Those patients then become insured patients and the hospital gains a definite form of payment where there may not have been a payment at all. This greatly impacts the healthcare revenue cycle. Aside from the assistance that those who are eligible for Medicaid receive, there is also help for individuals with disabilities, as well as others who qualify for assistance. DECO provides transportation and other resources to persons whom may not be aware that they qualify for these programs.

DECO has devised a way to better your facility’s revenue cycle system by converting potential bad debt into cash, and also by making it more organized and streamlined with our dedication to ever-changing processes and our detailed attention to technology.

DECO’s Services and Programs

Health Insurance Marketplace Outreach and Application Services

Navigating the Health Insurance Marketplace can be difficult for those who are uninsured. Understanding the nuances of the Affordable Care Act can pose their own challenges. As a Navigator, DECO is trained and ready to handle the customer service, education, enrollment, follow up, and next actions for new enrollments using the Affordable Care Act marketplace.

DECO will educate uninsured patients on the benefits available through the Health Insurance Marketplace including qualified health plans (QHPs), premium tax credits, and cost-sharing reduction. DECO will screen patients for eligibility, assist eligible individuals with applying for benefits, and facilitate enrollment into QHPs.

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Medicaid

For those who do not have insurance, paying medical bills can be a stressful experience. For the institutions treating those individuals, getting paid can also be a roundabout and stressful experience. As an added complication, the time of information capture matters more now than ever.

When DECO becomes a part of a hospital’s team, the revenue cycle is streamlined and more patients are able to pay. Our 94% capture rate means that more patients are able to pay for the services they receive. The more money the hospital is able to collect, the more services it can provide.

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CHIPs

Children’s Health Insurance Program (CHIP) provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. This is one of the many coverage options DECO can help patients to apply for during our screening process.

SSI/SSDI

Filling out the paperwork associated with Social Security and Disability takes time and attention to detail, something that most organizations don’t have. Instead of using up valuable time for your staff, let our team handle the busy work. Our team has a higher than average conversion rate, meaning more patients are able to pay. And, as an SSI- certified company, we have an upper hand in the filing process.

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Maternal Newborn Medicaid

Nearly two-thirds of women covered by Medicaid are in their reproductive years (ages 19-44). As part of the Affordable Care Act, The Centers for Medicare & Medicaid Services seek to improve the quality of maternal care. As part of DECO’s screening process, we check coverage for mothers and newborns under this umbrella.

Emergency Medicaid

Those without health insurance live in fear of a medical emergency. Under certain emergency situations, millions of Americans can qualify for Emergency Medicaid benefits. Just as each state has varying requirements for standard Medicaid, each one also has certain requirements for Emergency Medicaid. Emergency Medicaid cannot be applied for ahead of time, so staff must know the requirements for their state and how to complete the process.

Section 1011

Section 1011 of the Medicare Modernization Act of 2003 (MMA) provides $250 million each year for Fiscal Years (FYs) 2005 – 2008 for payments to eligible providers for emergency services furnished to undocumented and other specified aliens.

Victims of Crime

Crime victim compensation is a government program to reimburse victims of violent crimes- such as assault, homicide, rape, and, in some states, burglary – as well as their families for many of their out-of-pocket expenses. Every state has a crime victim compensation program.

Third Party Liability

Examples of third parties which may be liable to pay for services:

  • Group health plans
  • Self-insured plans
  • Managed care organizations
  • Pharmacy benefit managers
  • Medicare
  • Court-ordered health coverage
  • Settlements from a liability insurer
  • Workers’ compensation
  • Long-term care insurance
  • Other state or Federal coverage programs (unless specifically excluded by law)
Charity Applications

In certain cases, patients may be able to find coverage in the form of Charity Care. This option can vary by family income, location, employment status and other factors. By bringing in DECO staff that are knowledgeable of all the options available, more patients can find coverage for their medical procedures.

Community Benefit with Presumptive Charity Scoring

Using technology that leverages credit-score-like data, demographic information and social media data, hospitals can determine whether patients are likely to qualify for charity care.

Long Term Care/Nursing Home

Skilled nursing care is typically provided for rehabilitation patients that do not require long-term care services. Nursing home care provides permanent custodial assistance, whereas a skilled nursing facility is more often temporary, to solve a specific medical need or to allow recovery outside a hospital.

Qualified Medicare Beneficiary (QMB)

People with Medicare who are in the QMB program are also enrolled in Medicaid and get help with their Medicare premiums and cost-sharing. Medicare providers and suppliers may not bill people in the QMB program for Medicare deductibles, coinsurance, or copays, but state Medicaid programs may pay for those costs. Our staff is able to screen for this option and it’s availability to patients.

The DECO Difference

Hospital Bottom Line

DECO significantly decreases facility bad debt by converting a projected $0 pay account into a paying account. DECO consistently converts more accounts in less time, thereby reducing accounts receivable days. Our clients have experienced as much as a 45% increase in collections, recovered 15% more reimbursements, and secured 12% more paying accounts.

Disability Advocacy

DECO’s team of specialized Disability Representatives has an 80% conversion rate in comparison with the national average of 52%. DECO’s representatives have decades of experience and have been certified by the Social Security Administration. As a result of our strategic central location, DECO has developed a network of contacts with SSA Central Operations and Field Offices.

Technology

DECO has developed a proprietary, in-house designed Eligibility Management software— DECOnet. DECO’s software has been specifically designed to promote tasking, tracking and reporting both eligibility and disability statuses. DECOnet works seamlessly with most hospital systems and has the ability to electronically import referred accounts and export notes into the facility system. DECOnet’s robust nature allows for customized reports and monthly electronic reconciliations.

Superior Staff

With an active, internally-promoted ‘Culture of Service’, DECO staff becomes client staff— integrating with your facility’s revenue cycle team. DECO’s comprehensive approach fully compliments your existing processes and allows your employees to perform their duties more efficiently and effectively.

Interested in how DECO can help your organization?

Book a consultation with our Sales team.

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