MB-3311 - USA (Ohio) - Medicaid Eligibility and Financial Counseling Services - Deadline August 15,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3311

Government Authority located in Ohio; USA based organization looking for expert vendor for medicaid eligibility and financial counseling services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide medicaid eligibility and financial counseling services
- The pre-service financial counsellor and enrolment specialist assists in completing all necessary
functions related to the screening and insurance enrolment process, medical center’s uninsured and underinsured patients who are scheduled to incur services at medical center,
- The pre-service financial counsellor and enrolment specialist, under the guidance of the director of patient access, is responsible for reviewing and maintaining a worklist that contains all uninsured or underinsured patients scheduled for an upcoming visit,
- Be responsible for making outreach attempts to all patients within this worklist with the objective of screening the patient or guardian for potential funding sources for their service, included but not limited to Medicaid, Medicare, COBRA, accident-related coverage, and financial assistance,
- The pre-service financial counsellor and enrolment specialist will be responsible for guiding and assisting the patient in completing the necessary steps to enrol in all eligible funding sources and will initiate all necessary requirements with the respective payer to ensure the patient’s services will be paid. as part of ongoing responsibilities, the pre-service financial counsellor and enrolment specialist will document all efforts as required by the medical center, attend all required meetings and provide regular updates regarding patient enrolment statuses to leadership teams,
- Reviews, prioritizes, and manages uninsured worklist,
- Contacts patients and guarantors prior to the date of service by phone, letter, and in-person conversation to discuss the financial options available,
- Leads the process to determine eligibility and enrol the patient in the identified coverage opportunity on behalf of the patient; this includes but is not limited to Family Medicaid, Disability, COBRA, Crime Victim’s, Alien Emergency, COBRA, and Financial Assistance enrolment,
- Educates and monitors the patient’s and guarantor’s compliance with the gathering and submission of supporting documentation required for coverage,
- Completes necessarily follow up with payers to ensure submitted applications are in process and under active review,
- Schedules in-person appointments and accepts walk-in patients when necessary to discuss financial options or assist in the enrolment process,
- Verifies and enters patient’s coverage information upon receiving approval of eligibility,
- Requests patient payments prior to service when necessary or required,
- Engages interpreters to speak with patients as necessary,
- Provides updates as required to hospital leadership team and escalates encounters that are at risk of being delayed or cancelled as the result of patient non-compliance.
(2) All the questions must be submitted no later than July 25, 2019.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Thursday, 15 August, 2019

Question Answer Deadline : Thursday, 25 July, 2019

Category : Medical Billing and Coding

Country : USA

State : Ohio

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