MEDICAID ELIGIBILITY AND ADVOCACY SERVICES

Many patients struggle to get the assistance they need, while you are struggling with revenue loss. Our patient benefit advisors can help.

At Parallon, our Medicaid and advocacy specialists operate on a proactive platform designed from our extensive knowledge of third-party recovery programs and processes, and years of interacting with indigent populations, medical providers and government agencies. With advanced technology and a highly trained staff, we can increase Medicaid eligibility certifications and reduce processing time for Medicaid and SSI for you and your patients. With a team of 350, we have deep experience and knowledge of Medicaid regulations and state-specific programs.


Improving Results for Your Patients and Your Hospital

Increase reimbursements

In addition to better Medicaid outcomes, our specialized staff is trained to find all alternate sources of reimbursements, like state-specific programs, COBRA, and Social Security Disability.

Enhance patient satisfaction

Each patient has a dedicated team from start-to-finish who receive robust training and coaching so that your standards and community standing are upheld. Our team also has strong people skills that support our patient-first approach.

Reduce processing time and cost

Our highly targeted process, advanced technology and proper case development ensures consistency and efficiency so that you can identify the cases most likely to be certified and gather the right information.


CASE STUDY: Service In Action

The Issue

A large acute care hospital, a pediatric hospital and a small community hospital within a well-known national health system were all struggling with a loss of revenue due to an underperforming Medicaid eligibility vendor.

The Action

We deployed a team to establish relationships with local Medicaid agencies, created new processes, trained new patient advisors and coordinated departments.

The Result

A 53% increase in paid Medicaid accounts and more than one-third improvement in patient screening days.

Parallon Results

How it Works

1

Initial screening and analysis

Screenings are conducted on all potentially eligible individuals, with a strong focus on connecting with patients on-site to maximize results. We evaluate eligibility, based on state guidelines and a five-step sequential evaluation used by the Office of Hearings and Appeals. Advanced technology and analytics enable staff to focus time interacting with patients with the highest likelihood of certifications.

2

Case development and management

We gather all supporting documentation for each case, follow up with appropriate government offices and ensure that each application or appeal for government assistance is supported by medical evidence and professionally generated correspondence. We work closely with the hospital staff to ensure all relevant information is incorporated in case development.

3

Quality assurance

Each client has a dedicated team and our teams regularly undergo robust training and coaching. We provide you a monthly review of key performance indicators and other reports, and monthly benchmarking and feedback regarding all aspects of Medicaid eligibility services.

Help Patients and See More Revenue

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