Out-of-State Medicaid Claims Management Services

Overcome billing and credentialing obstacles to drive and secure reimbursement

Reduce the Impact of Out-of-State Medicaid Complexity

Out-of-state (OOS) Medicaid claims are complex, tedious, and labor-intensive, requiring RCM teams to stay on top of state-specific rules and guidelines as well as provider credentialing.

Aspirion’s end-to-end approach successfully tackles the complexities of OOS Medicaid revenue recovery. Our typical client recovery rate is 95%, representative of our extensive knowledge of all out-of-state payers, managed care organizations (MCOs), and care plans.

Aspirion's Services

Knowlegeable and Responsive

Our OOS 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.

Our US-based team includes:

attorneys/legal professionals


claims specialists

Our Approach

Out-of-State Medicaid Claims Resolution

How much revenue is your hospital leaving on the table?


Verification of patient Medicaid eligibility


Identification and notification of authorization requirements


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 US-based team manages it allno claims are managed offshore.


Our proprietary technology streamlines electronic claims submissions to accelerate revenue recovery through flexible and scalable workflows with 24/7 access to our performance. 

Cost Savings

Costs to collect can be inclusive of our OOS Medicaid contingency fees. It’s just that simple—we only get paid when you get paid.

Data Security

We adhere to strict data security standards across all Medicaid state programs and MCOs. Our HITRUST Risk-based, 2-year Certification and HIPAA compliance 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.

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.”

Kathy Lonidier, Director Hospital Revenue Cycle

Ochsner Health System

Contact Us

Find out how Aspirion’s Out-of-State Medicaid and Provider credentialing services can help maximize reimbursement and shorten the AR cycle.

Supplemental Resources

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Don’t let missing information prevent reimbursement. Find out how you can give your staff the support they need.

Service Summary icon

Learn how to overcome OOS Medicaid complexity to maximize reimbursement and shorten the AR cycle.

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Learn how mounting prior authorization denials are worsening hospital-payer relations.