Client:
A 110–bed community hospital located between Baltimore and Philadelphia
Challenge:
In late 2001 this hospital contacted us when they realized they were not maximizing Medicaid revenue using the County Department of Social Services' caseworker. Under this longstanding contract, the County caseworker worked four days a week at the hospital and the hospital paid the County employee's salary. Year after year, the caseworker converted approximately $150,000 annually in self–pay accounts to Medicaid.
Solution:
Financial Health worked with the County Department director to move the caseworker back to their central office. We implemented a Medicaid Verification & Payment program and placed an employee in the hospital's business office to interview every self–pay inpatient upon admission. Patients are asked to complete the Medicaid application, a limited power of attorney and releases. Then and now, Financial Health files all the completed applications and gathers verifications as required by the County. Our on–site employee accompanies applicants to all County interviews, monitors each application through the approval process and enters referred accounts into our receivables management system. This process guarantees that our inventory of accounts is always reconciled with our client's system. We also keep the client fully informed of each account's status through weekly and monthly reports.
Results:
Since the County's caseworker was reassigned in November 2001, Financial Health has recovered $100,000 or more EACH MONTH—that's over a MILLION dollars each year—in additional revenue for our client.