Out-of-State Medicaid
Capture Your Out-of-State Medicaid Claims Revenue
Dealing with Medicaid claims across state lines is a real headache. Every state has its own maze of rules and requirements, and keeping providers properly credentialed is a constant juggling act. Your revenue cycle teams have their work cut out managing all these moving parts.
Let us help you. Our advanced tech platform with intelligent automation works alongside our US-based team of experts to handle everything across all 50 states—from billing, appeals, and proactive provider credentialing—ensuring maximum reimbursement and compliance. The results? A 95% success rate for qualified placements.
Partnership Powered by Results
Revenue Protection
95%
Success rate for qualified placements
Speed to Revenue
50%
Reduction in days to pay
Excellence Delivered
50%
Increase in reimbursement
How We Deliver More
We go the extra mile with smart automation and expert support to make out-of-state Medicaid claims easier, faster, and more successful—so you get more reimbursements with less hassle. How much revenue is your hospital leaving on the table?
Advanced Proprietary Technology
Compass, our technology platform, streamlines Medicaid claims across all states. Fee schedules and program rules are managed to drive clean claim rates, reduce denials, and maximize reimbursement for out-of-state Medicaid claims.
Dedicated Account Management
Your dedicated client success director guides you through every step of the out-of-state Medicaid claims process—from seamless implementation to ongoing training, strategic optimization, and detailed performance tracking.
Expert Provider Credentialing
Our expert team handles all facility and physician enrollment for State Medicaid and MCO programs. Our comprehensive approach reduces claim denials and eliminates enrollment complexity, letting you focus on patient care.
Medicaid & HMO Claims Education
We provide specialized training in Medicaid and HMO claims, ensuring adherence to billing guidelines across all programs. We’ll handle the process to minimize errors, improve compliance, and maximize claim approval rates.
Claims Investigation & Authorization
With full responsibility for refining the investigation, notification, and authorization processes, our team ensures claims are accurately and promptly submitted. Our first-pass acceptance rate ultimately accelerates payments.
Insurance Verification Specialists
Your team’s workload is lightened by our expertise in managing the ever-changing complex state requirements across all 50 states. We ensure full compliance while optimizing Medicaid and MCO revenue recovery.
Discovery
Verification of patient Medicaid eligibility
Credentialing
Physician and facility enrollment and maintenance for state Medicaid or MCO programs
Submission
Adherence to state Medicaid and MCO timely filing via electronic claims submission and management
Appeals
End-to-end management of coverage or payment decision appeals
Knowledgeable and Experienced
Our team knows every state Medicaid program inside and out, building strong relationships with agencies and health plans. Your facility and physicians are enrolled smoothly in required state programs and HMO plans—we handle all paperwork and just need your signature. By keeping provider data current, we minimize claim denials.
Compass, our proprietary platform, automates the process, connecting directly to clearinghouses and your systems while staying current with fee schedules and policy changes to minimize delays and maximize revenue.
Frequently Asked Questions
What recovery rates can your Out-of-State Medicaid services achieve for healthcare organizations?
We consistently achieve a 95% success rate for qualified placements, a 50% reduction in days to pay, and a 50% increase in reimbursement. Our advanced technology platform and US-based expert team handle everything across all 50 states to ensure maximum revenue recovery.
How does your Out-of-State Medicaid solution integrate with our hospital's existing systems?
Our proprietary Compass platform seamlessly integrates with your systems, connecting directly to clearinghouses while maintaining current fee schedules and policy changes. This streamlines Medicaid claims across all states, drives clean claim rates, reduces denials, and maximizes reimbursement for Out-of-State Medicaid claims.
What if we’re already outsourcing to another company?
Most firms that offer OOS Medicaid do so as part of a broad suite of services. We have a team dedicated to OOS Medicaid. Clients that have made the switch to Aspirion will readily attest to the dramatic improvement.
What fee structure do you offer for your Out-of-State Medicaid services?
We operate on a contingency-based model, charging a small fee only upon successful collection of an Out-of-State Medicaid claim. We’re committed to maximizing your recovery while minimizing your cost to collect.
How does Aspirion leverage technology to manage Out-of-State Medicaid claims more effectively than traditional approaches?
Our team utilizes our Compass platform to manage everything from eligibility verification and authorization notification to provider enrollment and appeals processing. The platform stays current with fee schedules and policy changes across all 50 states, streamlining the entire process to achieve higher reimbursements with less administrative burden.
What makes Aspirion's approach to Out-of-State Medicaid different from other healthcare RCM vendors?
Our comprehensive approach includes expert provider credentialing, insurance verification specialists, and dedicated account management—handling facility and physician enrollment for all State Medicaid and MCO programs while building strong relationships with agencies and health plans to ensure optimal results.
“Aspirion has been super generous in their fee structure because they know the financial restraints that healthcare organizations are up against. They have also been so generous in their time to implement. They are doing R&D to make things more automated and easier for patients and hospitals. They are adding technology to make the speed of acquiring complex claims revenue much faster.”
Contact Us
Find out how Aspirion’s out-of-state Medicaid and proactive provider credentialing services can help maximize reimbursement and shorten the AR cycle.