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Recent Posts

Analyzing Expanded vs. Non-Expanded Uninsured Qualification Data

Some states have chosen to expand. Others have not. The questions we often find ourselves asking are what does this mean for health systems, like FQHCs and hospitals, that are required to provide services in both expanded and non-expanded states? And where are these health systems more likely to be reimbursed for services?

The Importance of Proactive Coverage Management

Retroactive eligibility, a feature of Medicaid that has been around for decades, has just been eliminated in Iowa, as well as Arkansas, Indiana, and New Hampshire with New Mexico considering now too.

A Guide to 2018 Open Enrollment

With the 2018 open enrollment season around the corner, make sure your health system is ready to maximize this opportunity for your patients and organization. Check out the best practices below to make this year a successful season:

  • Be Informed:  With adjustments to funding at the federal, state, and local levels, public benefits and their eligibility requirements are changing every day. Are you able to keep up with the changes to ensure your patients are presented with every coverage option available to them? Connect with your local PCA or follow NAHU for the latest updates to public coverage options.
  • Communicate: Access to healthcare is still an issue across the country and, in most cases, it’s because there is a lack of awareness of what’s available. Communicate with your patients at the front desk, at point of care, or even at community outreach events to let them know they have options for healthcare coverage.
  • Be Data Driven: Keep staff engaged by setting up achievable patient enrollment goals during open enrollment and use data to understand how those goals are being met. Provide updates on total number of patients qualified or enrolled and celebrate reaching those goals for better employee engagement.
  • Follow Up is Key: With numerous steps, documents, and verification information needed for a single benefits application, making sure to efficiently manage your patient's coverage and be their advocate in the process through approval is key. Set aside time on your calendar to reach out to patients via email or phone to ensure they stay on top of their applications.
  • Keep Patients Engaged: Once the patient has been approved into coverage, follow-up and find out if they need any help with scheduling a preventive care visit or have any questions about how their benefits work! This will also help make sure your patient is successfully assigned to your health system as a primary care provider.

PointCare has ways to assist with each of these checklist items - from managing enrollments to helping your team follow-up. Discover how our Total Coverage Management services can result in quicker reimbursements, more PCP selections and covered visits, as well as stronger patient relationships this open enrollment season and into 2018.

Coverage Management vs. Care Management [Infographic]

Did you know your health system is operating two businesses? Care Management and Coverage Management. While there are many systems in place that assist in care management (ex. EHRs/EMRs) many health systems have yet to figure out the coverage management side of the business. See what your health system is missing without Coverage Management in the infographic below: