Out-of-State Medicaid Claims Management Services
Overcome complexity to drive reimbursement and shorten the AR cycle
Reduce the Impact of Out-of-State Medicaid Complexity
Out-of-state Medicaid (OSM) claims are complex, tedious, and labor-intensive, requiring RCM teams to stay on top of ever-changing state regulations as well as provider credentialing.
Aspirion’s end-to-end approach successfully tackles the complexities of OSM revenue recovery. Our typical appeal approval rate is 95%, representative of our extensive knowledge of all out-of-state payers, managed care organizations (MCOs), and care plans.
Knowlegeable and Responsive
Our OSM team is well-versed in all state Medicaid program regulations and requirements. Through automation and efficient processes, we’re responsive and flexible to each client’s need.
Aspirion’s 100 percent US-based team includes:
Out-of-State Medicaid Claims Resolution
Verification of patient Medicaid eligibility
Physician and facility enrollment and maintenance for state Medicaid or MCO programs
Adherence to state Medicaid and MCO timely filing via electronic claims submission and management
End-to-end management of coverage or payment decision appeals
Our Elevated Experience
We’re experts in the nuances of Medicaid programs across all 50 states. From complex state-specific regulations to tedious provider credentialing and billing practices, our specialized team manages it all.
Our proprietary technology streamlines electronic claims submissions to accelerate revenue recovery through flexible and scalable workflows with 24/7 access to our performance.
All costs to collect are inclusive of our OSM contingency fees. It’s just that simple—we only get paid when you get paid.
We adhere to strict data security standards across all Medicaid state programs and MCOs. Our HITRUST Risk-based, 2-year Certification validates our commitment.
For 9 years, Aspirion has helped us collect on our out-of-state Medicaid claims. We had one very difficult claim from California that took over two years to resolve.
The Aspirion team worked relentlessly on our behalf until we were paid what was due- a high dollar payment, at that. Aspirion continues to be a true partner in all of our billing and enrollment needs for out-of-state Medicaid.”
Don’t let missing information prevent reimbursement. Find out how you can give your staff the support they need.
Learn how to overcome OSM complexity to maximize reimbursement and shorten the AR cycle.
Learn how mounting prior authorization denials are worsening hospital-payer relations.