The Medicaid Eligibility Decision System: Interfaces with EDITS to automate the entire processing cycle for Nursing Home, MLTC, and community/hospital (non-MAGI) Medicaid recipients in New York City. Best in class client service ensures any case entered in the system that should be approved has the coverage put up correctly for billing. MORE...
Automated Medicaid status checking for entire census (nursing home) or member list (health plan) for monitoring ongoing coverage. Compare coverage changes between months, track cases that lose coverage, and identify recerts due. MORE...
Complete revenue cycle management. High success rate of getting difficult/rejected Medicaid cases approved. A/R system audits to ensure all dollars are collected, and at the correct rates. MORE...
Correction and re-billing of rejected Medicaid and Managed Care claims. Collections services for private and NAMI bills. MORE...
