What Healthcare Providers Should Know About Medicaid Eligibility?

Millions of Americans are eligible for Medicaid because of The Affordable Care Act. States are required to cover people that meet the Medicaid eligibility definition. Some states are refusing to expand their programs to poor Americans between the ages of 19 to 64. On the other hand, healthcare providers are welcoming the new law. This new law increases revenues for providers because millions of uninsured Americans are getting access to healthcare services.

Moreover, individuals will qualify based on a federal poverty level percentage rate. On this scale, a single person making less than $14,856 a year may possibly receive benefits. A family of four that earns less than $30,656 may also receive benefits. This is important because healthcare systems will have to update their Revenue Cycle Management (RCM) systems to properly serve and charge new Medicaid patients.

Hospitals and medical clinics will have to do a better job when obtaining information from all patients. RCM systems can assist medical professionals when trying to determine if a patient is eligible for Medicaid. Using the RCM system to help implement the ACA, will help lower the amount of denied claims.

Finally, the cases can stay in the court systems for many years and the providers are not paid for several years. To survive, medical facilities must find ways to enroll the 72 million Americans that use Medicaid with fewer mistakes. Therefore, it makes sense for providers to consider using an RCM system.