Eligibility Enrollment Service
- Medicaid and related program eligibility screening, application and enrollment.
- Uninsured/self-pay account reimbursement solutions for healthcare providers.
Human Arc's Eligibility Enrollment Service
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(EES) employs very systematic, proven protocols and follow-ups to help patients successfully achieve eligibility for Medicaid and other government healthcare programs.
Why EES is Relevant
In the United States, 46.3 million people, or 15.4% of our total population, lacked healthcare insurance coverage in 2008, according to the U.S. Census Bureau's Annual Report released September 10, 2009 (and President Obama stated on that same day that "the situation's grown worse over the last twelve months"). These people often don't seek adequate healthcare or don't have availability to it. There is too much pressure on emergency rooms to function as doctors' offices for the uninsured. Hospital staffs too often view the uninsured only in terms of their charity care cost. Also, many healthcare providers do not have the expertise or staff time to tackle the job of Medicaid eligibility and enrollment.
To address these important issues, EES provides a comprehensive, proactive approach and the right resources to determine potential Medicaid insurance eligibility and then arrange that eligibility through interviews (even at bedside or patients' homes), application assistance and all required interface with Medicaid offices and other relevant governmental agencies. The result increases the insured population and significantly expands access to quality healthcare services.
Major EES Benefits
- Maximized revenue stream - with reimbursement typically secured on more than 75% of accounts accepted for processing, in some cases even up to 95%.
- Improved cycle - with AR cycles commonly shortened by 10 or 20%, sometimes more.
- Minimized cost profile - with bad debt postings often reduced by 5%, sometimes 15% or even more.
- Optimum public service and image - with outreach to more than 20% of patients we've interviewed with valuable shelter, rent assistance, food, utilities, medicine, clothing, infant and other needs at no cost to them or their providers.
The Next Generation of Eligibility Solutions
For those hospitals wishing to improve the effectiveness and efficiency of their eligibility and enrollment processes, Human Arc is expanding its suite of hospital products and services with technology-based solutions. These new eligibility screening and enrollment solutions will improve the healthcare experience for uninsured patients and increase reimbursement and account processing efficiencies for hospitals. They also will complement our custom process consulting as well as our industry leading Eligibility Enrollment Service.
The Human Arc Edge
Human Arc gives you an unmatched array of advantages:
- Experience - Human Arc has over two decades of experience with Medicaid eligibility and enrollment. Since 1984, we've submitted hundreds of thousands of Medicaid applications, and our eligibility-related services have produced a billion dollars in incremental cash flow for our clients. We conduct thousands of eligibility-related interviews every month.
- Focus - Healthcare eligibility and enrollment are and always have been our core business. We are - and will be - focused on our clients' reimbursement success and their clients' healthcare access. They are our reasons to be.
- Very flexible, consultative approach to your business - We use individually tailored processes to optimize fiscal success for inpatient, outpatient, low-dollar and other accounts.
- Comprehensiveness - Human Arc doesn't just interview or process applications for Medicaid programs or disproportionate share funding; we provide total support from insurance verification through billing and follow-up services for all approved accounts.
- Making business human - We actually interview a vast majority of self-pay patients prior to their discharges. And our fundamental belief in promoting patient dignity throughout these processes translates into a more satisfied customer base.
- Knowledge plus - Our complete reporting insures our clients they will know what we're doing, when and how well, account by account, so there's no guesswork about our partnered eligibility efforts.
- Security - Human Arc is 100% trained in HIPAA requirements. You can be totally assured that your patients' privacy and information confidentiality are fully protected
EES Case Studies
Nothing speaks like proof, so here's how EES has actually helped its clients.