CentraMed Eligibility™

CentraMed Eligibility provides physician groups and providers an automated daily review of self-pay admissions for Medicaid eligibility at a predictable low monthly subscription fee

Value Proposition:

CentraMed Eligibility gives providers a 12-month look back and daily review of Medicaid eligibility for self-pay accounts.  After completing the review and establishing a baseline, clients move to a daily review of admissions with a 24-hour return of eligible accounts.  Eligibility is determined before the bill drops. Clients typically find between 5% and 10% eligibility, yielding a 10x return on investment.

Detailed Solution Overview:

The daily review works as follows:

1.  CentraMed meets with Client IT to establish an automated daily feed.
2.  Client provides login credentials for the state Medicaid site(s) which the process will be performed on.
3.  Client data must include the following fields for the previous day self-pay admission:

  • Account SSN
  • Account DOB
  • Admit Date
  • Discharge Date
  • Procedure Date
  • Account First Name
  • Account Last Name

4.  The analyzed file is returned the following day with eligibility number.

Bottom Line:

Every hospital and physician group should be using an eligibility review solution.  CentraMed Eligibility offers a 100% accurate, daily review at a low, predictable monthly cost.  We typically find that 7% of self-pay accounts are actually Medicaid-eligible yielding a 10X return on investment.

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