We work with state agencies to enhance their ability to improve their federal claiming processes, find new revenue opportunities, and coordinate with other payers to capture revenue whenever possible. With a deep knowledge of federal Medicaid regulations, we are able to maximize opportunities, while ensuring compliance with all applicable state and federal rules. 

Examples of our work include the following:

• Collaborating with the Medicaid federal reporting unit in the Commonwealth of Massachusetts to automate its reporting function through the creation of a web-based system that produces superior information and results.
• Providing Massachusetts and Texas with comprehensive medical billing and accounts receivable, as well as other services, to maximize the collection of federal, third-party, and private reimbursement for health care and related services provided by public hospitals, mental health clinics, psychiatric hospitals, skilled nursing facilities, and community-based programs.
• Maximizing and claiming allowable reimbursement for direct medical services to Medicaid-eligible students — as well as associated administrative activities — that qualify for federal reimbursement.
• Providing necessary compliance calculations required by the federal government, such as upper payment limit calculations, and disproportionate share limit calculations.
• Ensuring that the state Medicaid program is the payer of last resort by effectively pursuing payment from other entities for services provided to Medicaid recipients.