OUR SERVICES

Do you feel your facility could increase reimbursement within its uninsured and underinsured patient populations?

With healthcare professionals’ workloads increasing on a daily basis, dedicating time to educate the patient on their healthcare financing options can be a daunting task. From assisting patients with Medicaid applications to reviewing the options made possible by the Affordable Health Care Act (ACA), communication and follow-up oftentimes slip through the cracks.

At Carter Health Management and Consulting, we work with your uninsured and underinsured patient’s hand-in-hand to improve not only reimbursement but your patient’s overall experience. At the onset of each engagement, your team at Carter Health Management and Consulting, creates a Medicaid Eligibility program tailored to your facility’s unique needs. Each program is designed to minimize unnecessary disruption to your day-to-day processes and maximize reimbursement with our systematic approach.

Our team of on-site representatives and field representatives work with your patients to collect all necessary information in the most convenient manner possible beginning at the patient’s bedside. CHMC screens each patient to determine eligibility and provides application guidance for the following programs:

MEDICAID ELIGIBILITY

SOCIAL SECURITY INCOME (SSI) & SOCIAL SECURITY DISABILITY INCOME (SSDI)

AFFORDABLE HEALTH CARE ACT (ACA)

CHARITY CARE COVERAGE

Quality Controls

CHMC’s services audit patient accounts on a daily basis to increase Medicaid acceptance rates and alternative reimbursement within your patient population.

PIMS Software

Behind every great company is a software tool streamlining business processes to improve the efficiency, accuracy, and return of its services. At CHMC, our proprietary software application, PIMS, ensures our services improve your facility’s overall Medicaid acceptance rates through the systematic processing of your patient accounts.

Backyard Knowledge

Our team live and work within Western Pennsylvania. As a result, we understand your patient population. We seek not only to interact with your patients and their families, but to provide education and ongoing support through the entire process.

SERVICES

MEDICAID ELIGIBILITY

Are your patients’ Medicaid acceptance rates low? How often do uninsured and underinsured patients leave without speaking to financial assistance representatives?

The first stage in recovering reimbursement for uninsured and underinsured patients is to identify whether or not the patient is eligible for Medicaid. Carter Health Management & Consulting is available to assist your patients through the process of applying for Pennsylvania Medicaid benefits. From guiding patients through the Medicaid application CHMC ensures all documentation is complete prior to submission. As a recognized Community Health Partner with the Pennsylvania Department of Public Welfare, our team files all Medicaid applications through COMPASS on the patient’s behalf. Utilizing PIMS, we then monitor the status of each application filed with COMPASS on a daily basis. In the event, additional information is needed or applications are denied, CHMC is available to provide representation at the County Assistance Office and in the Fair Hearing Process to support appeals.

COMMUNITY HEALTH PARTNER
COMPASS KNOWLEDGE
PATIENT REPRESENTATION

SSI / SSDI

Social Security Income (SSI) / Social Security Disability Income (SSDI) Benefits

Upon conducting the initial interview with the patient, Carter Health Management and Consulting screens to determine the patient’s eligibility for SSI or SSDI. If patients qualify, CHMC connects the patient with a Legal Disability Specialist for processing.

ACA Coverage


Federal Market Place

So your patient doesn’t qualify for Medicaid, what now? CHMC’s team will work with your patients to provide education on the various insurance options available through the federal marketplace.

Charity Care

When a patient fails to qualify for Medicaid CHMC will review the documentation collected during the patient’s first interview to determine whether or not they qualify for Charity Care. If the patient qualifies, a Charity Care application is filed on the patient’s behalf for review by your organization.

OUR PROCESS

The first stage of each engagement with CHMC begins with the development of a formal strategy. Each healthcare provider’s patient population is unique. CHMC works alongside your staff to understand your patient population and create a unique strategy addressing key factors such as location and demographics.

CHMC works to seamlessly integrate into your business office’s day-to-day processes enabling staff to focus on core day to day responsibilities, while simultaneously improving successful application rates for Medicaid eligibility, Affordable Care Act, and Charity Care.

LEARN MORE

It has been my privilege to have worked with Dorothy Carter for twenty plus years in the Healthcare field. She always offered the highest level of commitment and service to her clients. She takes pride in how she serves her clients and makes sure she has the best employees representing her company. There was never a time when she did not meet my expectations and always filled her contract obligations. She is a very honest and ethical professional, and goes above and beyond to provide a high level of service to her clients. Her tenacity to achieve the best possible results for her clients is unmatched in the field!

520 Bed Hospital, Johnstown, PA

Are you seeking assistance improving your facility’s Medicaid Reimbursement?

Contact Carter Health Management & Consulting to schedule a consultation.

CONTACT US