Medicaid Eligibility

How you handle Medicaid Eligibility determination can affect your hospitals status as a not-for-profit entity, as well as your overall cash flow (cash collections).

NCO's Medicaid Eligibility Patient Advocacy Liaison Services (EPALS) helps you identify sources of payment through government assistance programs for inpatient and outpatient accounts.

With our years of experience and community sensitive culture, we implement programs for third-party eligibility, out-of-state Medicaid eligibility and billing, HMO member retention, and third-party liability. These services improve your revenue cycle management by accelerating cash flow and enhancing the patient service.

EPALS is powered by NCO’s innovative receivables management platform.
We automate previously manual processes.

At the heart of every EPALS solution is NCO’s automated system. Our proprietary, integrated receivables management platform with fully automated features designed specifically to process healthcare accounts. NCO’s platform automates parts of the Medicaid eligibility verification process, workflow management, letter and statement production, and reporting, seamlessly integrating these modules into one automated solution. The decision engine automatically triggers timely follow-up at every phase of the process.

Charity Care Screening
We identify and track charity care

NCO begins the process at Patient Access and screens patients for charity care and Medicaid eligibility to assist you with proper classification of bad debt.

Implementation
We implement according to a plan, designed to meet your specific needs

During phase one of our implementation process, our information technology staff works with yours to establish connectivity for data transfer. In phase two, we verify your requirements for work standards and patient interaction, and tour your facility to meet your key staff. NCO begins taking placements in phase three. Phase four begins 90 days after first placement. During this phase we obtain your feedback and discuss results to date.

Assignments
We staff to meet your needs

Depending on what type of accounts you refer and the volume, NCO assigns a combination of on- and off-site staff to your program. Established account-to representative ratios ensure accounts referred are processed by sufficient staff to achieve your objectives.

Patient Contact
We get the message across – every time

Whether inpatient or outpatient, NCO representatives first greet patients and inform them of their role in the Medicaid eligibility process. Our in-house representatives conduct bedside interviews to determine whether patients may qualify for Medicaid or for a third-party payer programs, including Charity Care, according to your hospitals policies. Off-site representative’s contact patients by letter and phone, or visit the patient’s home or place of employment if needed to assist in the application process. We coordinate DHS appointments, document acquisition, transportation to DHS and SSA appointments, record keeping, and follow-up—whatever assistance it takes to get your patients certified to the care they are entitled.

NCO Eligibility Patient Advocacy Liaison Services (EPALS) ® is designated as Peer Reviewed by HFMA.

NCO Healthcare Services is part of NCO Group, Inc. and focuses on meeting the revenue cycle management needs of more than 2,000 healthcare organizations. These customized solutions increase customer satisfaction, reduce self-pay patients bad debt and increase financial return on investment. Providing services from first point of patient access through health information management, Medicaid Eligibility and collections, NCO Healthcare Services consults with healthcare organizations to provide solutions customized to meet their needs.