Medicaid Eligibility

Trusted by healthcare organizations for decades of Medicaid Eligibility expertise.

At Panacea, our main focus is to make sure every eligibility opportunity is fully explored so patients can receive the most appropriate coverage. As patient advocates, we handle the challenging task of identifying and enrolling qualified beneficiaries, which also helps our clients’ bottom line. The Panacea approach to eligibility enhancement combines years of professional experience, clinical resources, and exclusive data analytics to meet the needs of your facility and community.

Explore our solutions below.

The Opportunity

Outsourcing

Medicaid Recoupment Analysis

Reviews accounts that your hospital has written off. Our data analytics and years of experience in eligibility enable us to identify patients that qualify for Medicaid and other governmental programs. Using our sophisticated qualifying techniques, we find patterns in your data that suggest eligibility and enrollment opportunities. Learn more →

Doctor consulting with overweight patient, discussing test result in doctor office. Concept of health risks of overwight and obesity.

Out-of-State Medicaid Eligibility

Panacea offers a suite of services to assist your organization in obtaining Medicaid coverage for out-of-state patients. We free your state from this resource-driven process so they can concentrate on other tasks where they can be more efficient and productive. Learn more →

Virtual Eligibility Counselor (VEC)

VEC offers a seamless solution to increase completed Medicaid applications, reduce enrollment barriers and supplement staffing. Learn more →

Outsourcing

Medicaid Eligibility Services for Providers – Outsourcing

Our patient advocacy approach to Medicaid Eligibility provides on-site point-of-service financial screening for self-pay patients to qualify and enroll them into federal and state Medicaid programs. We combine our vast experience and Medicaid program knowledge with data analytics to explore every opportunity to ensure that patients get their appropriate coverage and our clients receive appropriate payments for services. We screen, investigate and assist in the identification/qualification process for all patients.
Our efforts include:

Field representatives for home visits
Document interpretation and collection
Meetings with state and federal agencies as patient advocates
Meeting with on-site hospital staff for a transparent and accountable process

This service assists facilities in reducing self-pay patients by enrolling eligible patients into a Medicaid program, leading to added revenue from accounts that were potentially written off to bad debt or charity care. Our process looks at enrolling all of your self-pay population, leading to an improved patient experience with increased revenue potential.

With experience in both expansion and non-expansion state Medicaid processes, KA Consulting, a division of Panacea Healthcare Solutions is also certified application counselor (CAC) organization under the Affordable Care Act, which enables us to enroll patients in the Affordable Care Act insurance exchange.

Recoupment Analysis

Second Sweep Medicaid Eligibility Service

We help you identify revenue that would have been lost due to gaps in the eligibility process. This service also includes a complete assessment of these files to improve the eligibility process and minimize missed revenue opportunities.

Our professionals examine bad debt or charity care files (depending on the state) and find applicable programs to qualify patients. Using our qualifying techniques, we find patterns in hospital data that identify additional eligibility opportunities. Furthermore, we perform a complete assessment of these data files and identify any and all Medicaid eligibility process gaps that could be costing your facility revenue. Our Second Sweep Analysis gets patients entitled benefits and reduces providers’ bad debt/write offs, a win-win for all parties.

Out-of-state Medicaid

Out-of-state Medicaid Services

Our KA Consulting Division offers a suite of services to assist your organization in obtaining Medicaid coverage for out-of-state patients. We free your staff from this resource-driven process so they can concentrate on other tasks where they can be more efficient and productive.

Our solutions include:

Out-of-state patient eligibility screening and enrollment
Provider program enrollment support
Medicaid out-of-state billing

Is your organization looking to outsource the Medicaid eligibility screening and qualification process? With Panacea as a partner, you will be assured that every eligibility opportunity is pursued for patients to receive appropriate coverage. The incorporation of the Virtual Eligibility Counselor (VEC) in our enrollment process has resulted in industry leading conversion rates.

Virtual Eligibility Counselor

Reduce enrollment barriers, increase access and supplement staffing.

The Virtual Eligibility Counselor (VEC) provides the patient experience of an on-site Medicaid enrollment process with the benefits and convenience of providing the same process in a virtual setting.

By providing this process virtually, the patient and the hospital can benefit from the elimination of on-site enrollment barriers including language, time constraints and transportation.

In addition, our data shows that implementation of the VEC can increase Medicaid enrollments, by improving application completion, supplementing staff and increasing access to maximize enrollment.