Articles Tagged With: Medicaid
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62% of self-pays obtain coverage
Self-pay patients are converted to some type of coverage 62% of the time at West Valley Medical Center in Caldwell, ID, reports patient access director Jennifer Bette. The department uses these approaches:
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Nearly Half of the Uninsured are Eligible for Medicaid or Obamacare
Nearly half of the 32.3 million nonelderly people in the US who didn’t have health insurance at the beginning of this year are eligible for Medicaid or subsidized coverage through the ACA.
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Presumptive eligibility is big revenue producer
Patient access staff at Unity Point Health System — Rock Island (IL) occasionally see patients who reside in Iowa. There is a marked difference in how self-pays are handled in the two states. The reason is that Iowa offers a larger eligibility criteria for presumptive eligibility, which “has been a big revenue producer and a godsend for a lot of patients.”
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It’s not just about money: Build trusting relationships
Initially, many self-pay patients have a negative perception of financial counselors.
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Medicaid mental health spending uneven even within single state
Would you expect a New York Medicaid client to be able to access mental health service equally well, regardless of where he or she lived within the state? -
Is it legal for Medicaid to limit non-urgent ER visits?
As a general rule, courts have upheld limitations on Medicaid reimbursements for services, as long as the services are "sufficient in amount, duration, and scope to reasonably achieve their purpose," according to Laura Hermer, JD, LLM, an assistant professor of health policy and bioethics at the University of Texas Medical Branch in Galveston. -
Resources are issue with CMS' Medicaid claims audit program
A new Medicaid recovery audit contractor (RAC) program will help strengthen the integrity of the Medicaid program, according to Xiaoyi Huang, JD, assistant vice president for policy at the National Association of Public Hospitals and Health Systems in Washington, DC. "That being said, we need to be cognizant of program integrity efforts that places undue burden on providers," she cautions. -
Volume of referrals, appeals are concern with RACs
A state plan amendment submitted by North Carolina Medicaid to the Centers for Medicare & Medicaid Services (CMS) to participate with the Medicaid recovery audit contractor (RAC) program has already been approved, and a request for proposal will be released shortly, reports Brad Deen, a spokesperson for North Carolina Division of Medical Assistance (NCDMA). -
Oregon expects cost savings from primary care investment
The Affordable Care Act (ACA) requires that state Medicaid agencies reimburse primary care providers at 100% of the Medicare fee schedule for two years, notes Donald Ross, manager of the policy and planning section at the Oregon Health Authority's Division of Medical Assistance Programs. -
Staffing shortages present obstacle to new access regs
Under a proposed rule published in May 2011 from the Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies would have to review access to a subset of Medicaid-covered services every year, and review access to every Medicaid-covered service at least once every five years.