A financial safety net appears with the words – Press Release: EligibilityAdvocates Excels at Secondary Patient Eligibility Services

EligibilityAdvocates Excels at Secondary Patient Eligibility Services

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Press Release

EligibilityAdvocates Excels at Secondary Patient Eligibility Services

FOR IMMEDIATE RELEASE: May 25, 2022

Walnut Creek, CA:  EligibilityAdvocates excels at secondary patient eligibility services. These services maximize reimbursement efforts by providing healthcare organizations with a support team working behind their current primary eligibility vendor or in-house staff.

A financial safety net appears with the words – Press Release: EligibilityAdvocates Excels at Secondary Patient Eligibility Services

EligibilityAdvocates’ secondary patient eligibility services operate as a safety net for recovering all possible revenue opportunities.

With EligibilityAdvocates’ secondary patient eligibility services, clients can extend their resources through an ancillary team of third-party eligibility experts and gain access to EligibilityAdvocates’ exclusive technology solutions.

These solutions include the comprehensive patient screening tool AdvocatorAI which scrubs accounts against major clearinghouses, the real-time online reporting dashboard EA Pulse that provides full transparency of any account status at any time, and a secure online patient portal to increase patient engagement and facilitate communication with Patient Advocates.

Clients also have the option of utilizing a full-time or part-time Patient Advocate on site at outpatient locations and/or in the emergency department to meet with patients in person.

The secondary patient eligibility services function as a safety net for recovering all possible revenue, are non-intrusive to clients’ current processes, and are risk-free at a contingency-based price.

Jeff Woody, Chief Revenue Officer at EligibilityAdvocates, explained that partnering with the organization allows it to become an extension of your team, as opposed to a replacement:

“We empower our clients to fully leverage third-party funding sources for patient accounts – our team assists their own business offices and provides a safety net for opportunities that their primary vendors may miss.”

“Our eligibility services and technology ultimately support our clients and their patients by helping both parties not only financially, but in a very pragmatic way as well,” said Woody.

In addition to promoting the benefits of its secondary eligibility services, EligibilityAdvocates has launched a rural health campaign to highlight how its services improve healthcare access for rural patients and address challenges faced by rural healthcare facilities.

The company continues to offer on-site primary patient eligibility services along with off-site out-of-state Medicaid services for working complex claims.

To learn more, visit www.eligibilityadvocates.com where the “Services” dropdown on the navigation bar now features links to the Secondary Patient Eligibility Services page and Rural Health page.


About EligibilityAdvocates:


EligibilityAdvocates is a service solution specializing in third-party eligibility, designed to manage your self-pay population and reduce uncompensated care. We utilize real-time coverage verification, our comprehensive screening tool (AdvocatorAI), and expanded on-site coverage hours. We also offer complex claims support, disability specialists, and out-of-state Medicaid services through our experienced off-site business offices. 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. EligibilityAdvocates: Impacting Communities, One Patient at a Time.

Contact Information:


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

A pregnant woman stands in a field and the blog title appears: Improving Healthcare Access for Rural Patients

Improving Healthcare Access for Rural Patients

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EligibilityAdvocates Blog

Improving Healthcare Access for Rural Patients

Posted on Thursday, February 24, 2022

Rural patients are still lacking insurance at a higher rate than non-rural patients.

Statistically, patients with inadequate health coverage may delay or forgo medical care due to financial concerns. This includes “underinsured” patients whose health plans can leave them with high out-of-pocket costs that they cannot afford to pay.

Rural patients face other barriers to healthcare access, which may include:

  • Living long distances from healthcare facilities/specialists.
  • Poverty.
  • Provider shortages.
  • Rural facility service cutbacks.
  • Rural hospital closures.

Unfortunately, the COVID-19 pandemic has exacerbated these issues for rural healthcare.

Hope for Rural Healthcare: Improving Healthcare Access for Rural Patients


A pregnant woman stands in a field and the blog title appears: Improving Healthcare Access for Rural Patients

Together, we can begin improving healthcare access for rural patients in your community.

Addressing potential financial issues for rural patients and their healthcare organizations can significantly improve healthcare access.

Our proprietary screening software, AdvocatorAI, can empower your employees to assist uninsured patients with identifying existing health coverage or alternate funding sources for their medical bills.

By doing so, you can drastically reduce or eliminate out-of-pocket medical expenses for your patients.

Most importantly, you can provide them with the peace of mind that health insurance or financial assistance brings so that monetary worries no longer inhibit them from accessing care.

Furthermore, you will reduce uncompensated care to improve your revenue cycle and better ensure you won’t have to cut back on services and your providers can continue serving your patients and community.

Why EligibilityAdvocates?


EligibilityAdvocates can help you improve healthcare access for rural patients by enhancing the financial outlook of your patients, your organization, and your community.

Here are just a few reasons to choose EligibilityAdvocates as your rural facility’s partner in patient eligibility services:

  • We operate as an extension of your team, not a replacement: We do not want to take jobs away from your community; we are here to assist your current team members by providing access to resources such as industry-leading technology, clearinghouses, and a support team at our business office for follow-up.
  • All accounts are worked: Our follow-up team works all accounts no matter the balance and all unlinked accounts are closed within 30 days, keeping your A/R days down.
  • Our state-of-the-art technology is designed to serve you and your patients: Utilizing AdvocatorAI, your staff can screen patients to find health coverage or program eligibility in real time while increasing patient engagement and supporting patient advocacy through financial counseling and assistance.
  • Our real-time online reporting platform provides account transparency: Drill down to account-specific detail at any time and easily download reports.
  • Don’t miss out on valuable out-of-state Medicaid reimbursement: We can bill and follow up on out-of-state Medicaid accounts on behalf of your facility and are experienced in all 50+ state Medicaid programs.
  • We believe in impacting communities, one patient at a time: Read our Community Impact Stories to learn how we are making a difference in the communities we serve.

Our complementary goals of promoting patient advocacy and protecting the financial viability of your rural facility go hand-in-hand. Let’s work together and empower your team to break down barriers to healthcare access.

Connect with us. Together, we can begin improving healthcare access for rural patients in your community.


By Stephanie Salmich

The No Surprises Act protects patients from surprise medical bills, like the one received by the patient in this picture.

The No Surprises Act: Protections for Insured & Uninsured Patients

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EligibilityAdvocates Blog

The No Surprises Act:

Protections for Insured & Uninsured Patients

Posted on Monday, November 15, 2021

The bipartisan No Surprises Act will go into effect on January 1, 2022.

The No Surprises Act is intended to protect patients from surprise medical bills (when patients are unknowingly treated by out-of-network providers) and balance billing (when patients are charged for the remainder of what their insurance does not pay).1

Read on for an overview of the new rules and how this law affects both insured and uninsured patients.

Overview of the No Surprises Act


“Requirements Related to Surprise Billing; Part I,” an interim final rule issued July 1, 2021:
  • “Bans surprise billing for emergency services” which “must be treated on an in-network basis without requirements for prior authorization.”1
  • Restricts surprise billing for “non-emergency care from out-of-network providers at in-network facilities,”2 which protects patients who are not given the chance to choose an in-network provider.
  • Restricts surprise billing for “air ambulance services from out-of-network providers.”2
  • Extends protections from balance billing, which is already prohibited by Medicare and Medicaid, to “Americans insured through employer-sponsored and commercial health plans.”1
“Requirements Related to Surprise Billing; Part II,” an interim final rule issued September 30, 2021:
  • “Details a process that will take patients out of the middle of payment disputes.”3
  • Provides “a transparent process to settle out-of-network (OON) rates between providers and payers.”3
  • Outlines “requirements for health care cost estimates for uninsured (or self-pay) individuals.”3

How Does the No Surprises Act Protect Uninsured Patients?


The No Surprises Act protects patients from surprise medical bills, like the one received by the patient in this picture.

The No Surprises Act protects patients from surprise medical bills.

This law requires that providers or facilities inquire about patients’ insurance status when scheduling and “provide a good faith estimate of expected charges for items and services” to uninsured/self-pay patients (those who do not have benefits for an item/service under a health plan or who choose not to have a claim submitted to their plan for the item/service).4

CMS Administrator Chiquita Brooks-LaSure explained, “we are requiring health care providers and health care facilities to provide uninsured patients with clear, understandable estimates of the charges they can expect for their scheduled health care services.”3

If an uninsured or self-pay patient is billed for an amount “substantially in excess” ($400 or more) of the good faith estimate they received, they may be eligible for the “patient-provider dispute resolution process” to determine a payment amount. This process must be initiated within 120 days of receipt of the bill.4


In addition to instituting financial safeguards, the No Surprises Act can also improve healthcare access. As HHS Secretary Xavier Becerra stated, “No patient should forgo care for fear of surprise billing.”1 With these new rules in place, patients may be less likely to postpone or avoid needed healthcare due to concerns about the financial ruin that often comes from surprise medical bills.

Lowering Patients’ Healthcare Costs


The new protections established by the No Surprises Act can help lower both insured and uninsured patients’ out-of-pocket healthcare costs by sheltering them from unexpected and/or excessive medical bills.

EligibilityAdvocates can further reduce patients’ medical expenses by helping them obtain health coverage and/or financial assistance. Our Patient Advocates work one-on-one with patients to determine their eligibility for various insurance plans and benefit programs and assist them with the application process.

Additionally, we can help patients resolve their patient balances and understand their patient responsibility.

Contact us to learn more about how the No Surprises Act will affect patients or to get in touch with a Patient Advocate.

Sources

1 CMS (U.S. Centers for Medicare & Medicaid Services). “HHS Announces Rule to Protect Consumers from Surprise Medical Bills.” (2021). Retrieved from https://www.cms.gov/newsroom/press-releases/hhs-announces-rule-protect-consumers-surprise-medical-bills

2 CMS (U.S. Centers for Medicare & Medicaid Services). “Overview of rules & fact sheets.” (2021). Retrieved from https://www.cms.gov/nosurprises/Policies-and-Resources/Overview-of-rules-fact-sheets

3 HHS (U.S. Department of Health & Human Services). “Biden-Harris Administration Advances Key Protections Against Surprise Medical Bills, Giving Peace of Mind to Millions of Consumers Plagued by High Costs.” (2021). Retrieved from https://www.hhs.gov/about/news/2021/09/30/biden-harris-administration-advances-key-protections-against-surprise-medical-bills.html

4 CMS (U.S. Centers for Medicare & Medicaid Services). “Requirements Related to Surprise Billing; Part II Interim Final Rule with Comment Period.” (2021). Retrieved from https://www.cms.gov/newsroom/fact-sheets/requirements-related-surprise-billing-part-ii-interim-final-rule-comment-period


By Stephanie Salmich

A patient is prepped to receive a COVID-19 vaccine and the blog title appears – COVID-19 Services for Uninsured Patients: FAQs

COVID-19 Services for Uninsured Patients: FAQs

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EligibilityAdvocates Blog

COVID-19 Services for Uninsured Patients: FAQs

Posted on Thursday, August 26, 2021

Currently, COVID-19 testing, treatment, and vaccines may be free to anyone without health insurance.1

Below are answers to frequently asked questions that many uninsured patients have.

FAQs: COVID-19 Services for Uninsured Patients


A patient is prepped to receive a COVID-19 vaccine and the blog title appears – COVID-19 Services for Uninsured Patients: FAQs

At this time, free COVID-19 services for uninsured patients include COVID-19 testing, treatment, and vaccines.

Which COVID-19 services are free to uninsured patients?

COVID-19 testing, treatment, and vaccines are all available as free services to uninsured patients.1

Why are these COVID-19 services free?

COVID-19 services for uninsured patients are paid for by the federal HRSA COVID-19 Uninsured Program.1

What if I receive a bill for COVID-19 services?

You should contact your provider/healthcare facility and request that they bill the HRSA COVID-19 Uninsured Program instead of you.1

What if I have already paid the bill I received for COVID-19 services?

You may be entitled to a refund if your provider billed HRSA as well. First, check if the bill lists HRSA reimbursement for the COVID-19 services. Also, contact the provider/healthcare facility who billed you to discuss a possible refund.2

If you cannot obtain a refund that you believe you are due, you may file a complaint with the HHS Office of Inspector General by calling the hotline at 1-800-HHS-TIPS or visiting their website (https://TIPS.HHS.GOV).2

You may be responsible for payment if the care was not eligible for HRSA reimbursement or the provider did not submit the claim to HRSA. However, at this time, any provider administering COVID-19 vaccines cannot charge you for the vaccine or administration of the vaccine.2

Does immigration status affect eligibility for free COVID-19 services?

No; all uninsured patients are eligible for free COVID-19 services regardless of immigration status.1

Will my immigration status be reported to an immigration agency if I receive free COVID-19 services?

According to HRSA, “Testing, treatment or vaccinations paid for by the federal government will not affect anyone’s immigration status or be shared with immigration agencies.”1

Do I need a Social Security Number or government ID to obtain free COVID-19 services?

No; although you may be asked for this information by the healthcare facility or pharmacy, you can still receive free COVID-19 testing, treatment, and/or vaccination if you unable to provide it.1

EligibilityAdvocates: Helping Uninsured Patients


EligibilityAdvocates assists uninsured patients with finding health coverage and/or applying for other programs to help cover their medical costs. Our services are free to patients.

To learn more about how we help patients, please read the stories of how our Patient Advocates are making a real difference in patients’ lives.

Contact us to reach an EligibilityAdvocates Representative or for more information on COVID-19 services for uninsured patients.


Sources

Answers to the questions above were obtained from:

1 HRSA (Health Resources & Services Administration). “Uninsured Patient COVID Services Poster.” (2021). Retrieved from https://www.hhs.gov/sites/default/files/uninsured-patient-covid-services-poster.pdf

2 HRSA (Health Resources & Services Administration). “Impact on Patients.” (2021). Retrieved from https://www.hrsa.gov/provider-relief/patient-impact/


By Stephanie Salmich