How one senior care organization streamlined Medicaid eligibility reverification
For more than 50 years, National HealthCare Corporation (NHC) has provided a continuum of care that spans skilled nursing, assisted living, independent living, homecare, hospice, memory care, pharmacy, rehabilitation, and more. As we continued supporting communities across the care continuum, our revenue cycle team saw an opportunity to make Medicaid eligibility verification more efficient, accurate, and consistent.
The testimonial below is from the staff at NHC.
The challenge
Before automation, our teams spent significant time manually keying data into systems, reviewing eligibility responses, and validating monthly member responsibility amounts. The work was time-intensive, and the number of manual steps increased the potential for human error.
We needed a more consistent, efficient way to verify Medicaid eligibility while keeping our team’s attention on the accounts that needed it most.
The solution
We implemented MatrixCare Intelligent Automation Services for the Tennessee Medicaid Eligibility Reverification process. Medicaid eligibility can now be proactively reverified before claims are submitted. The process pulls and standardizes data from the state portal, then identifies changes in coverage, liability, plan details, and monthly member responsibility.
Verification data is also loaded into MatrixCare Resident Documents, giving our team documentation for future claims payment reviews and potential recoupments.
MatrixCare Intelligent Automation Services has given us a streamlined, standardized approach to Medicaid eligibility verification, helping us capture important changes consistently and promptly.
– Meadow Song, MBA, CPA, Assistant Vice President, Accounts Receivable, National HealthCare Corporation
The impact
One of the biggest changes has been the move from reviewing every record to using an intelligent change-report model. Our team now receives a focused report highlighting only the members whose eligibility or financial responsibility has changed.
That more targeted view allows staff to concentrate their time where it’s needed, supporting greater productivity while maintaining compliance and accuracy. It also gives our team more time for higher-value work, including issue resolution and proactive account follow-up.
The result is a more efficient workflow, improved data integrity, and a stronger foundation for managing revenue cycle activities. By reverifying eligibility before claims are submitted and documenting the results, the process can also help reduce claim denials, rework, and reimbursement delays.
Instead of reviewing every record, our team can focus on the members whose eligibility or financial responsibility has changed. That gives us more time for issue resolution and proactive account follow-up.
– Meadow Song, MBA, CPA, Assistant Vice President, Accounts Receivable, National HealthCare Corporation
Consider what’s possible for your organization
A more focused approach to Medicaid eligibility reverification can help teams spend less time reviewing every record and more time resolving issues and following up on accounts. With consistent data and documentation readily accessible, organizations can support billing accuracy, reduce rework, and manage revenue cycle activities more efficiently.
MatrixCare Intelligent Automation Services can help make that possible by standardizing eligibility data, identifying changes, and loading verification information into resident documents. Contact us to see how intelligent automation could support your revenue cycle operations.