Eligibility Services

Our staff combine a proprietary screening tool with the human touch to maximize patient engagement.

Medicaid Coverage/Social Security Disability and Income

We have highly trained staff with extensive experience in Medicaid eligibility. Our staff perform eligibility services in our corporate offices, in the hospital setting and in the field. They work closely with hospital personnel, federal and county agencies, and with patients and their families on a regular basis. MRSI uses a proprietary screening tool to assess Medicaid coverage opportunities for uninsured patients. This tool allows us to quickly identify the appropriate federal, state or local program for the patient. We also provide a low dollar eligibility screening program that can offer tremendous future benefit to you and your patients who utilize your facilities on a frequent basis. See the white paper "Increased Revenue from Outpatient Self Pay Accounts" on our website for more information. If a patient is deemed possibly eligible for Medicaid, MRSI's specialists perform these activities:

  • Assist the patient with the complete application process including helping patients obtain all required documents and verification information.
  • Attend scheduled appointments with the counties or another agency on behalf of the patient when necessary.
  • Pursue eligibility up to and including appeals and hearings.

Second Looks

If you are using an eligibility vendor, you may want to send closed back accounts to us for a second look. It's a good way to evaluate the effectiveness of your current vendor arrangement without immediately incurring any additional cost. MRSI is highly successful in this area and is asked regularly to perform this service.

CASE STUDY

MRSI has been providing Medicaid Eligibility Screening services for a large healthcare institution for several years. This program became an integral part of the self pay account assessment. Conversion to third party coverage between 2009 and 2013 has been 47%, 51%, 48%, 46% and 44% respectively. In FY2009 our client went through a software conversion. As you can see, the rates decreased over time, due to process improvement activities initiated in large part due to MRSI's ability to share observations, identify problem areas and report our findings. This program also provides the client with "future benefit dollars" for returning patients who now have Medicaid coverage.

Three major outcomes of this program:

  1. Identification of outpatients who qualify for Medicaid
  2. Identification of outpatients with third party coverage missed at time of registration
  3. Identification of problems with information gathering by point of service location