Why Medical Practices Should Assist Patients with Insurance Enrollment

The March 31 deadline to enroll in health insurance plans via the health insurance exchanges without a qualifying event is now in the past, but that doesn’t mean enrollment efforts should cease. Physician practices, especially those in underserved markets, should consider the millions of Medicaid-eligible patients who are still uninsured and can be enrolled throughout the year.

This is especially important for physician practices in states that have expanded the government-funded healthcare program. Many patients who may once have been covered by other programs (e.g. employers) may now be covered through the ACA-expansion. Physicians should be ready for an increase in patients seeking Medicaid services, as well as patients looking to switch to Medicaid.

In fact, practices can take a page from Federally Qualified Health Centers (FQHCs), which have received millions of dollars in grant money to enroll Medicaid-eligible patients. One of the most successful is California-based ChapCare, which has already screened and enrolled thousands of people from its surrounding San Gabriel Valley community. ChapCare is using innovative technology to screen and monitor enrollment, in addition to using it to connect with other clinics and physician offices and ensure coordinated efforts.

Inspired by ChapCare and other successful FQHCs, here are four technology strategies that physician practices can use when working with large populations of Medicaid-eligible patients:

1. Choose the right system for the job. There are thousands of different software options all claiming to make it easier to work with uninsured patients and improve revenue cycle management. The key is to keep your eligibility process simple by choosing an easy-to-use screening and enrollment tool that comes in multiple languages and produces personalized lists of coverage options for every patient. ChapCare, along with San Diego-based Sharp HealthCare, both look to PointCarePA, a web-based screening solution, to help their patients.

2. Maximize reimbursement with more than just Medicaid. Populations served by Medicaid will often be eligible for additional coverage and assistance opportunities, such as Women-Infants-Children and the federally-funded National Breast and Cervical Cancer Early Detection Program, but may not know it. Make certain that your process engages tools that screen for all coverage options and not just Medicaid, SSDI, and Medicare.

3. Consider a web-based, mobile-friendly tool to screen and enroll patients. The uninsured are hearing about the need to enroll in coverage from all angles, so why not become part of that effort? Working with other healthcare providers to reach the uninsured before they come into your facilities by offering health fairs and community outreach program is a simple, yet effective approach to securing coverage for patients and reducing uncompensated care costs. Investing in a web-based, mobile-friendly tool to screen and enroll patients will be especially helpful at such events. 

4. Make sure it can be integrated. Make sure the chosen technology can interface and interact with revenue cycle systems. This will allow staff to monitor appropriate payments, including bills that are unpaid or delayed.

Continuing to reach out to the nation’s uninsured throughout 2014 will help Medicaid-eligible patients secure their medical home and, just as important, it will help practices secure and manage an important source of reimbursement revenue.

Choosing to accept more Medicaid patients rather than refusing them, and adjusting your process to include screening and enrolling can bring a newly significant source of revenue to the table.

Everett Lebherz Vice President of PointCare, a developer of cloud-based health coverage screening software, has made dozens of presentations to clinic managers and hospitals on this topic, and has written numerous articles on enrollment of the uninsured in America. E-mail him here.