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Medicaid Eligibility Verification

Verifying Medicaid eligibility can be tedious, costly and error prone. It doesn’t have to be. For mission-driven healthcare organizations, every minute and dollar saved in the back office is a minute and dollar that can instead go towards providing excellent patient care.

Regularly checking Medicaid eligibility, especially for healthcare organizations with a large population of recurring patients, is one of many administrative tasks that keep providers away from their mission-oriented work – caring for patients. The good news: this tedious process no longer requires a human brain to perform. Our bots can be trained to log into any website and any EHR or CRM to identify patients that require an eligibility check, subsequently perform that eligibility check within the State’s Medicaid portals, and then make the corresponding updates in the system of record.

Looking at labor costs alone, hiring a claims analyst to perform this task could cost as much $2.50 per record*. For a bot performing the exact same task, it could cost you less than a dollar per record, and it will be processed in a fraction of the time. And that labor cost isn’t including the high cost of turnover in this industry and the associated productivity dip as new hires are onboarded and trained. A bot only needs to be trained once, and can handle a near infinite workload without ever needing to take a weekend or even a break. Humans are also, well, human. Mistakes in processing claims can be a huge hit to your organization at a time when efficiency is everything. Bot a bot will do exactly what it is trained to do with perfect accuracy - it doesn’t even know how to deviate.

The labor market is tightening across all industries, and the healthcare industry is of course not immune. With the pandemic, national nursing shortage, and more, budgets are tightening to ensure that the top priority – patient care – doesn’t fall victim to the economic dips. On top of that, the federal Public Health Emergency is on it’s way out in 2023, including continuous coverage. To ensure patients continue to receive the care they need, there will be a huge bolus of work to check and recheck their Medicaid eligibility. Now is the time to invest in tools that will help your team improve the efficiency of back office operations, freeing up your team to focus on patient-facing engagement.

Automating your eligibility verification processes with Thoughtful is quick and easy; no technical experience required. You walk us through your unique requirements, and we’ll build a fully custom bot that will start delivering real value within 6-8 weeks. With just a small lift from your team, you’ll start seeing massive cost savings, up to a 10-fold improvement in OpEx, virtually perfect output, and a happier human workforce. Let us do the heavy lifting so you can continue to focus on delivering exceptional patient care.

Function:

Accounts Receivable

Revenue Cycle Management

Steps

  1. Login to application software.
  2. For each segment (FL, GA, PA, SC, KY), filter and pull search data.
  3. Navigate to state Medicaid website.
  4. Conduct eligibility verification check.
  5. Update application.
  6. Update bot report.

Popular Applications

Our services are not limited to these applications. This bot is available for any cloud based application.

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