A patient’s Medicaid eligibility status can change at any time. While a patient may not have had Medicaid coverage on the date of their original encounter, many times that same patient can go on to become a Medicaid enrollee long after their initial visit. That potentially makes the patient’s original encounter with the healthcare provider eligible for Retroactive Medicaid reimbursement.
Unfortunately, the task of tracking thousands of historic self-pay encounters on a daily basis to determine Medicaid eligibility is not only cost-prohibitive, its virtually impossible. As a result, many perfectly good retro-billable opportunities will go unnoticed and expire beyond their respective timely filing periods.