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Patient-Focused Eligibility & Enrollment
When your patients come first, results follow.
At MedData, EVERY patient matters. Our eligibility services can backstop your internal programs or current partner to ensure your patients receive the financial care they deserve.
Our proprietary technology finds more payer sources than anyone else does and helps patients easily advance through the eligibility process. We persistently work ALL patients – not just the high-dollar accounts – throughout all phases of care so they don’t become ineligible.
We typically recover 15%-25% more self-pay revenue IN ADDITION TO what our clients are currently getting.
* HFMA staff and volunteers determined that MedData’s Eligibility Services have met specific criteria developed under the HFMA Peer Review Process. HFMA does not endorse or guarantee the use of this product.
We have been providing this service to our customers for over 20 years. Our teams of billing experts have access to tools that allow them to quickly identify and verify coverage, including our Payer Management Portal, which tracks all Medicaid payers nationwide and drives workflows and quality assurance based on those profiles.
We have internal tools and processes that identify what referral and certification requirements are required for all out-of-state Medicaid plans. Some of these tools that set us apart are:
- Claim Editor/Electronic Submission
- MedData’s proprietary billing tool, the Claim Editor, identifies payer-specific billing rules and guidelines for out-of-state Medicaid plans.
- Eligibility Verification Website
- Hospital registration staff has access to an Eligibility Verification tool that uses patient demographic information to check against state databases for patient eligibility for Medicaid, Medicare and other third-party payers and automatically uploads the account information into our account management system where it is immediately flagged to an eligibility screener for double-checking.
- Screening/Tracking Tools
- Our screening technology allows our staff to screen for all 350 different government programs across the country. It’s updated in real-time as federal and state policies change, so advocates are equipped with up-to-date information to accurately validate the patient’s coverage.
Patients at more than 650 hospital locations have gained access to assistance through our work.
MedData’s patient-focused healthcare eligibility services find appropriate assistance to help pay medical bills, and in fewer days than other providers. Every step of our process is designed to meet the needs of hospitals working to manage their revenue cycles while maintaining the service levels their patients expect.
Other single service line vendors don’t have the technology, expertise, or coordination to process claims in a timely and compliant manner, causing hospitals to miss additional revenue opportunities. But we help solve every challenge throughout the entire patient financial experience, simultaneously screening multiple programs across our unified services.
Over the past 20 years, we have built a better approach through an integrated model that works for hospitals and patients across the various eligibility programs such as:
Our Eligibility and Disability services are an integral part of MedData OneTouch℠ – an integrated service line approach that specifically improves upon siloed services and unites them into a single solution. This platform does something entirely unique in the marketplace by identifying all payer sources and the most appropriate coverage in the properly compliant order through a single touch-point for patients, whether they’re insured, under-insured, or uninsured.
MedData has a dedicated team who proactively represent our customers in legislatures at the state and national levels. They are dedicated to researching federal and state laws and training our employees on program or policy changes. This team is led by Doug Turek, our Senior VP of Regulatory Government Affairs.
MedData’s MPower Audit Capability audits the work of our advocates in real-time using proven rule sets that guide them through the steps necessary for each account, so revenue recovery is maximized and compliance is maintained. This practice maximizes revenue and complies with CMS Payer of Last Resort Regulations.
Actual quotes from our Clients’ patients.
“I have been in the industry over 30 years and MedData has the most efficient and comprehensive Medicaid Eligibility program I have ever dealt with.”
You do what you do very well. What makes you stand out is that you are more of a partner with us to help us be successful in our business.
The MedData staff is responsive to our patients needs and obviously to our needs as an organization, not only with our service & process. They are always right on top of issues. Very quick to respond and nip it.
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