NCO's Eligibility Patient Advocacy Liaison Services (EPALS) are available as an outsourced service to provide federal, state and jurisdictional assistance programs for the uninsured and underinsured population of healthcare providers through onsite and offsite screening, ED staffing, extended office hours, and field visits.
We act as an advocate for our clients by seeking benefits verification for those patients uncertain if they qualify for benefits. Our EPALS staff specializes in assisting underinsured or uninsured patients navigate the complex process of obtaining eligibility verification for federal, state, and county programs. We apply our knowledge and expertise to your accounts, and apply our creativity and flexibility to your changing needs. We enhance your revenue by providing onsite and offsite patient screening, ED staffing, extended hours, and home visits.
Broad Reach. NCO provides EPALS eligibility verification and benefits verification services to more than 250 clients in over 40 states. This means we can quickly reach transient patients.
We Can Do It All. Our eligibility specialists guide and assist your patients throughout each step of the eligibility verification and benefits verification process to ensure correct reimbursement. They conduct bedside interviews to determine eligibility or get in touch with patients by letter or telephone. Our trained and caring staff will provide transportation to appointments if needed and use NCO's vast skip-tracing resources to locate hard-to-find patients. Skilled interpreters are available for patients who are hearing impaired or do not speak English.
We have proven processes in place to overturn denials of coverage. Experienced representatives do all of the research, request appeals, assist patients with documentation, and help them get to their hearings. EPALS even covers the costs associated with the additional forms and documentation needed for the hearings.
Out-of-State Medicaid Services
We know the process. NCO's expertise ensures that claims are handled by experienced professionals who are knowledgeable on rules, procedures, and policies governing reimbursement eligibility in each state. Our responsive reporting ensures that clients are informed about the eligibility verification process and status of claims.
As healthcare costs in America continue to rise, healthcare providers are experiencing ever-increasing pressure to manage an auditable full-service charity care program and maintain transparency within the self-pay bucket to achieve greater results, all while sustaining performance levels and inventory controls of the growing uninsured and underinsured populations. NCO Advantage is designed to help your organization address each of these issues – and so much more.
Bridging the Gap
NCO Advantage fills in the gap where current solutions fall short. This online application provides a real-time interface between your hospital’s accounts receivable system, admissions, and NCO EPALS. NCO Advantage addresses the differences between multiple systems by bringing information sharing to a new level and allowing a more rapid and more thorough response to the accounts receivable cycle.
Your staff has instant access to detailed information at any stage of a patient’s medical assistance process with your hospital, from pre-registration and initial intake through eligibility verification – including charity qualification. NCO Advantage also gives you the ability to review the progress NCO EPALS has made on your inventory, and to fully assess our team’s performance with a broad variety of on-demand reports, up-to-date inventory statistics, real-time performance metrics, and benchmarking baselines. This holistic,transparent approach to information sharing is unprecedented in the industry.
Critical Data Elements
NCO Advantage provides account-specific information on the most critical data elements at a glance, including:
• Screening results
• Eligibility status
• Billing details
• Charity qualification
• Account documentation of all work events
• Out-of-State Medicaid Assistance information
• Inventory management by status and results
• Production and quality assurance reporting
Furthermore, patient accounts are colorcoded to serve as quick identifiers of special circumstances, such as high balance, minor patient, and other unique categories.
Your Single Hub
NCO Advantage is an easy to use, intuitive tool that organizes your accounts receivable logic into a single hub. From here, you can mine patient data at a granular level – or see the big picture of your self-pay inventory, depending on your particular needs. Our web-based architecture allows for tablet PCs and online access for MA and SSI applications.