Out-of-State (OOS) Medicaid
Centauri has more than two decades of experience in Out-of-State (OOS) Medicaid billing and account management. We offer unparalleled expertise in Medicaid and Medicaid Managed Care Plans. Through our targeted focus on OOS collections, we manage nearly $2 billion in claims annually for our clients.
Understanding the complexities of each state's Medicaid program is a full time job. It can be difficult and time consuming for a hospital to keep on top of all of the changes. Our billing specialists learn the nuances of each state’s Medicaid rules so our clients don't have to.
We look at all avenues for maximum recovery, and collect as many Out-of-State Medicaid claims as efficiently as possible. Our goal is to remove the strain from your team’s resources.
Out-of-State Medicaid Eligibility Verification
Patient eligibility can be verified via our website 24/7. We obtain the correct amount of information from the online submissions and provide you with the most accurate results.
As part of our eligibility verification process, clients are advised if authorization is required. Supplied contact information can be used to obtain a timely authorization. This minimizes the need for post-treatment authorization appeals.
Claims, Billing & Appeals
Clients can submit out-of-state Medicaid claims to us in a variety of formats and media. These include electronic (ANSI, print image, proprietary) and paper. If granted access, we can even pull accounts from their system.
All claims that arrive with complete documentation and an active provider number with the specific Medicaid program are billed within one business day. We submit as many claims as possible electronically to Medicaid or MCO.
We take all steps necessary to minimize the need to file an appeal. However, if an appeal is necessary, we will file it and follow up on our client's behalf.
Reporting
An extensive suite of reports is included with Centauri's Out-of-Medicaid solution. The reports provide accurate and up-to-date information about accounts both individually and collectively. Other reports enable clients to monitor our performance. Access to these reports is available 24/7 on our secure client site.