EligibilityAdvocates – New Patient Eligibility Service Powered by HealthWare Systems

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Press Release

EligibilityAdvocates – New Patient Eligibility Service Powered by HealthWare Systems


Elgin, IL:  HealthWare Systems has partnered with a new company, EligibilityAdvocates, which offers patient eligibility and out-of-state Medicaid billing services. The new organization is powered by HealthWare Systems’ revenue cycle technology solutions.

EligibilityAdvocates’ on-site patient eligibility and enrollment service helps self-pay and uninsured patients find and obtain health coverage and/or financial assistance. On-site patient advocates and technology facilitate real-time coverage detection, eligible program screening, and timely account appropriation.

The logo of patient eligibility service and out-of-state Medicaid billing company EligibilityAdvocates.

EligibilityAdvocates – New Patient Eligibility Service Powered by HealthWare Systems

EligibilityAdvocates provides expanded coverage hours and ED staffing and its patient advocates utilize tablets/laptops equipped with the company’s proprietary software AdvocatorAI, a comprehensive screening tool that identifies existing coverage or alternative funding sources for patients’ medical bills while supporting patient advocacy through financial counseling and assistance.

The new company also offers an off-site out-of-state Medicaid service that operates as a performance-based extension of its clients’ revenue cycle teams. EligibilityAdvocates is experienced in all 50 states’ Medicaid programs and handles all aspects of out-of-state Medicaid enrollment, billing, and follow-up so that hospitals don’t miss out on this substantial form of reimbursement.

EligibilityAdvocates reduces health organizations’ uncompensated care and account cycle time, increases self-pay conversions, and provides transparency of account status at all times through customizable dashboards, reports, and alerts.

“HealthWare Systems has always believed in creating patient-first technology and developing solutions that improve the financial outlook for all stakeholders in a health system – including patients, providers, healthcare facilities, and the entire community,” stated Steve Gruner, CEO and Founder of HealthWare Systems. “EligibilityAdvocates has created the perfect opportunity to leverage the power of our ActiveWARE products to drastically reduce patients’ out-of-pocket costs and hospitals’ uncompensated care.”

“I am proud of the EligibilityAdvocates team who have already proven their ability to rise above unprecedented challenges during the pandemic as well as their selfless dedication to patient support, especially during this time when patients and their families need it most,” said Gruner.

Jeff Woody, Chief Revenue Officer at EligibilityAdvocates, agrees and said he looks forward to sharing the inspiring stories of how EligibilityAdvocates’ patient advocates go above and beyond for those they serve:

“At EligibilityAdvocates, our motto is ‘Impacting Communities, One Patient at a Time.’ Our patient advocates are truly committed to making a difference in the life of each patient they assist, and they are able to maximize their patient advocacy with the help of HealthWare’s state-of-the-art technology that allows them to more accurately and efficiently serve patients and deliver results.”

To learn more about the patient eligibility service and out-of-state Medicaid billing company, visit www.eligibilityadvocates.com where you will find further details about EligibilityAdvocates’ services, patient resources, and an educational blog covering patient advocacy and out-of-state Medicaid issues.

About HealthWare Systems:

HealthWare Systems is a leading provider of fully integrated, customizable workflow solutions and Revenue Cycle Management software. We specialize in applying robotic process automation (RPA) to healthcare processes to improve both the patient experience and the revenue cycle. Our ActiveWARE suite of products manages pre-arrival, financial assistance, early out, collections, denial management, claims follow-up, and more, and is proven to maximize productivity and profitability so that healthcare teams have more time and resources to spend on quality care.

About EligibilityAdvocates:

EligibilityAdvocates’ patient eligibility and enrollment service utilizes technology proficiencies to enable our patient advocates to optimize one-on-one interaction with self-pay/uninsured patients to reduce uncompensated care. We provide real-time coverage verification, a comprehensive screening tool (AdvocatorAI), and expanded on-site coverage hours. We also offer an experienced off-site team to handle your out-of-state Medicaid enrollment, billing, and follow-up. Our complementary goals of promoting patient advocacy and improving your revenue cycle go hand-in-hand as we strive to create a healthier financial environment for your entire community.

Contact Information:

Name: Stephanie Salmich
Organization: HealthWare Systems
Address: 2205 Point Boulevard, Suite 160, Elgin, IL 60123
Phone: (847) 649-5100

EligibilityAdvocates COVID-19 Response - Thank You, ALL Healthcare HEROES!

EligibilityAdvocates COVID-19 Response

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COVID-19 Response

The coronavirus (COVID-19) is affecting all individuals and organizations in significant ways – physically, emotionally, and financially, to name a few. In addition to creating a national health emergency, more people are out of work and without insurance as a result of this crisis.

EligibilityAdvocates COVID-19 Response - Thank You, ALL Healthcare HEROES!

THANK YOU, from all of us at EligibilityAdvocates!

Thankfully, our patient advocates can continue serving patients during this difficult time. They have been classified as essential staff members and are working on-site to help patients obtain benefits and secure alternative payment methods (including COBRA).

We at EligibilityAdvocates would like to thank all those working in health care who are risking their own safety in order to protect and care for these patients and keep our communities healthy. You are truly health care heroes.

We also want to express appreciation for each one of our patient advocates who is making a critical difference in patients’ lives on the front lines as well.

You are health care heroes too, as you work to minimize the financial impact of this virus on individuals and families.

CMS Waivers

As you may be aware, the Centers for Medicaid and Medicare Services (CMS) issued emergency blanket waivers in response to COVID-19, which have a retroactive effective date of March 1, 2020 until the end of the emergency declaration.

We’d like to draw your attention to these changes in particular, as stated by CMS:

  • 3-Day Prior Hospitalization Waiver for SNF placement – “CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a SNF stay, which provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations, or are otherwise affected by COVID-19. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period (this waiver will apply only for those beneficiaries who have been delayed or prevented by the emergency itself from commencing or completing the process of ending their current benefit period and renewing their SNF benefits that would have occurred under normal circumstances).”
  • CAH Length of Stay Waiver – “CMS is waiving the requirements that CAHs limit the number of beds to 25, and that the length of stay be limited to 96 hours under the Medicare conditions of participation for number of beds and length of stay at 42 CFR §485.620.”

States and territories may submit a request for a waiver of statutes and regulations related to Medicaid and CHIP programs using the 1135 waiver checklist; CMS provides these examples of flexibilities they may seek:

  • “Waive prior authorization requirements in fee-for-service programs.
  • Permits providers located out of state/territory to provide care to another state’s Medicaid enrollee impacted by the emergency.
  • Temporarily suspend certain provider enrollment and revalidation requirements to increase access to care.
  • Temporarily waive requirements that physicians and other health care professionals be licensed in the state in which they are providing services, so long as they have an equivalent licensing in another state; and,
  • Temporarily suspend requirements for certain pre-admission and annual screenings for nursing home residents”
Please see the complete COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers document or contact us for more information.

As always, we are here to help you navigate these new regulatory flexibilities and to assist your patients with the financial challenges they may be facing. We are all in this together as we work to protect the physical and financial health of your patients and their families.