“FIRM RCM advocates for both our patients and our facility. They provide expert assistance to our patients to help them navigate a complex system to secure benefit eligibility, so that our facility has an ongoing payer source.” Eligibility Client testimonial

Medicaid Eligibility Services – Primary and Secondary Presumptive Eligibility Conversion

At FIRM RCM we are advocates for both the patient and the hospital. We work to ensure the financial health of the hospital that has worked so hard to ensure the physical health of the patient.

Supported by Medical Assistance Specialists with years of experience in providing linkage to entitlement programs, our specialists will pursue all avenues to transition self-pay accounts to Medicaid payable, or other qualified program status.  FIRM RCM can act as the hospitals eligibility screening department, or integrate a program with your hospitals existing protocols and resources to provide overflow and field screening coverage.

We can work on-site at the hospital and will develop a schedule and program that ensures we intervene when a self-pay patient is identified. Our staff will work both inpatient and out-patient accounts. We develop programs that ensure coverage (days and hours) that are consistent with the hospital policy and patient volumes.

Medicaid Eligibility Services

We also offer programs to come behind internal hospital eligibility efforts to perform application follow-up and completion. For facilities in states with presumptive eligibility, presumptive eligibility is only a true benefit if you are following through and having the patient complete and file their eligibility application. FIRM can help your facility significantly increase your presumptively eligible patient conversion rates through proactive follow-up and advocacy.

As an added benefit and if warranted, FIRM RCM will provide attorney driven appeal functions under our claim resolution service for no additional fee. In addition to identifying payer sources for your self pay and indigent patients, we can also assist hospital staff with charity screening consistent with the facilities policies and guidelines.