Partnership Powered by Results
$25M+
collected in 12 months
59 Days
from average placement to payment
89%
recovery rate on eligible inventory
RESULT
Significant Recovery:
- Collected almost $26M in out-of-state Medicaid claims with an 89% recovery rate on eligible inventory
Accelerated Cash Flow:
- Average of 59 days from account placement to payment—accelerating cash flow and reducing AR delay
Every Eligible Provider Enrolled:
- Enrolled and maintained 563 facilities and 2,000+ physicians across all state Medicaid and MCO programs
CHALLENGE
Enrollment at Scale:
- Managing Medicaid and MCO enrollment for 563 facilities and 2,000+ physicians across 40 states had outgrown the client’s in-house team
Credentialing Roadblocks:
- Slow physician paperwork and facility compliance gaps stalled enrollment and reimbursement
Eligibility Churn and Staffing Gaps:
- Shifting patient eligibility and staffing shortages led to more denials and slower resolution
SOLUTION
Expert Provider Credentialing:
- Enrolled every facility and physician in all state Medicaid and MCO programs, clearing the compliance backlog
Proactive Authorization Management:
- Partnered with case management to verify eligibility and notify the right state of inpatient stays on time, preventing denials before they start
Full-Cycle Claims Management:
- Managed the complete out-of-state Medicaid claims lifecycle, from initial billing through follow-up and appeals, to accelerate reimbursement
“Aspirion is excellent with our organization, and they have great customer service. The firm is mutually aligned with our organization to have great customer service, and they address problems very quickly if there are any. They communicate with us and provide timely reporting.”
About the Provider
A large health system with more than 500 facilities in 40 states, Washington, D.C., and Puerto Rico. Its locations include acute care hospitals, freestanding emergency departments, outpatient centers, a surgical hospital, and inpatient and outpatient behavioral health programs.