Eligibility Advocacy and Enrollment

We work hard on behalf of hospitals and their patients to ensure the integrity of insurance coverage, identifying appropriate government and managed care programs, and doing what is necessary to get patients enrolled. Our success in this area is a result of experience, passion and cutting-edge technology.

Our tailored solutions identify and secure programs available for patients that can yield higher reimbursement for hospitals for inpatient, outpatient and ED services. Armed with our robust technology, rich database and proven processes for discovery, our onsite Eligibility Specialists and our Disability Experts serve as advocates for patients to uncover eligibility for a variety of government and other financial assistance programs including SSI, Victim of Crime, or liability-related injuries. Friendly, thorough application assistance, management through resolution and availability of advocates when the patient goes home from the hospital all help patients understand their financial obligation and navigate complex billing process.

Over 267K accounts approved for coverage in 2014 with charges of $3B

We offer:

• Specialized state-by-state expertise in the intricacies of Medicaid and Disability qualification positions to help patients gain access and hospitals get appropriate reimbursement.
• More than 25 years’ success advocating for patients and self-pay to Medicaid conversion rates higher than industry standard of 30%.
• The unique perspective of more than 200 clinicians and seasoned examiners to assess the information necessary to secure Disability coverage.
• Our Solace™ bedside tool and face-to-face interaction with patients and their family increases conversions by taking the time to build the trust necessary to secure the information necessary for determining coverage, and assure we are considering all alternatives for the patient’s personal situation.

Over $346M in revenue collected for clients in 2014