Our Expertise

We leverage our decades of experience and operations heritage to identify best practices and lead the healthcare revenue cycle industry.

By sharing insights with our stakeholders and investing in these relationships, we seek to continuously deepen strategic partnerships that deliver value.

Decorative

August 2022 Medicaid Changes

On July 16th, HHS Secretary Xavier Becerra issued a declaration that the COVID-19 Public Health Emergency (PHE) would be renewed for an additional 90 days. CMS created a website dedicated to unwinding and returning to regular operations. Read August 2022 Medicaid Changes

Decorative

July 2022 Medicaid Changes

On July 15th, HHS Secretary Xavier Becerra issued a declaration that the COVID-19 Public Health Emergency (PHE) would be renewed for an additional 90 days. In addition, the states are to receive a letter 60 days prior to the PHE ending which has not been received at this time. Read July 2022 Medicaid Changes

Decorative

June 2022 Medicaid Changes

The PHE is up for re-evaluation on July 16th. CMS advised the states they would receive a letter 60 days prior to the PHE expiring. That letter was expected mid-May and it was not received; therefore, it is expected to be renewed for another 90 days in July. Read June 2022 Medicaid Changes

Decorative

May 2022 Medicaid Changes

The latest US Department of Health and Human Services extension for the PHE is effective through July 15th. CMS published a letter on March 3rd extending the timeframe to wind down Medicaid renewals from 12 months to 14 months, but they did not extend the 60-day notice. Read May 2022 Medicaid Changes

Decorative

March 2022 Medicaid Changes

The Public Health Emergency (PHE) was extended through April 16th. CMS published a letter on March 3rd extending the timeframe to wind down Medicaid renewals from 12 months to 14 months, but they did not extend the 60-day notice. According to this letter, the PHE will not begin winding down any earlier than July 2022. Read March 2022 Medicaid Changes

Decorative

April 2022 Medicaid Changes

The latest US Department of Health and Human Services extension for the PHE is effective through July 15th. CMS published a letter on March 3rd extending the timeframe to wind down Medicaid renewals from 12 months to 14 months, but they did not extend the 60-day notice. Read April 2022 Medicaid Changes

Decorative

February 2022 Medicaid Changes

Open enrollment in most states ended on January 15th. A record 14.5 million Americans signed up for health insurance on the federal and state health exchanges for the 2022 enrollment period. Read February 2022 Medicaid Changes

Decorative

January 2022 Medicaid Changes

The Public Health Emergency (PHE) was renewed again this month to extend through April 16th. CMS will provide states with a 60-day notice prior to the end of the PHE so they can prepare the wind down back to normal Medicaid operations. Read January 2022 Medicaid Changes

Decorative

November 2021 Medicaid Changes

Open Enrollment is now open until January 15th. The Public Health Emergency (PHE) renewed on October 18th to last for another 90 days. Read November 2021 Medicaid Changes

Decorative

Social Security Disability Patient Story

Our Medicaid Eligibility and Advocacy team identifies hundreds of patients for disability on a daily basis. This special case highlights a team member’s success in going above and beyond to fulfill our commitment to the patient and our partner.  Read Social Security Disability Patient Story

Decorative

October 2021 Medicaid Changes

The open enrollment time frame is set for November 1st to January 15th. American Rescue Plan Act COBRA premium assistance flexibilities have ended, which means that the federal government is no longer paying 100% of premiums. Read October 2021 Medicaid Changes

Decorative

Best Practices for Patient Eligibility & Advocacy

What happens in your healthcare organization when benefits—Medicaid, Medicare, Social Security or other—are denied for a patient? Do you have processes in place to advocate on that patient’s behalf or uncover alternative solutions that will serve the patient as well as the provider? Read Best Practices for Patient Eligibility & Advocacy

Decorative

How to Succeed in Medicaid Eligibility While Smiling

Because nobody is prepared for a sudden hospital stay or other medical emergency, many Americans find themselves with medical and financial challenges they are unprepared to meet. As anyone who has experienced this will attest, it is stressful and scary when concerns about your or a loved one’s health are compounded by uncertainties about insurance coverage. Read How to Succeed in Medicaid Eligibility While Smiling

Decorative

Beyond Medicaid: Two Forms of Coverage Is Better Than One

In spite of its name, the ME landscape is not always just about Medicaid. Eligibility in any form means looking at multiple opportunities to qualify a patient for financial relief. Read Beyond Medicaid: Two Forms of Coverage Is Better Than One

Decorative

August 2021 Medicaid Changes

May 31st was the enrollment deadline for companies to submit their election notices to those who are eligible for the 100% COBRA subsidies. Those who are eligible for the COBRA subsidies have 60 days to submit the election notices once received by the employer. Read August 2021 Medicaid Changes

Decorative

Beyond Medicaid: Going the Extra Mile to Investigate on the Provider’s Behalf

The art of conversation is a key skill in the Medicaid eligibility (ME) advocate’s tool kit, along with diligence, persistence and the willingness to ask just one more question. It breaks down barriers created by a combination of unfortunate circumstances, fear, uncertainty and perhaps skepticism. Read Beyond Medicaid: Going the Extra Mile to Investigate on the Provider’s Behalf

Decorative

July 2021 Medicaid Changes

Texas, among several other states, filed a lawsuit to deem the Affordable Care Act (ACA) as unconstitutional. On June 17th the Supreme Court ruled to uphold the ACA. This is the third time the ACA has been questioned and upheld.  Read July 2021 Medicaid Changes

Decorative

Uncover the Keys to Operational Success with Eligibility Enrollment

You are only as good as your employees. Equip your enrollment team for success by structuring processes aided by technology and reporting. Successful management in the eligibility realm stems from two overarching themes that are fundamental to operational excellence... Read Uncover the Keys to Operational Success with Eligibility Enrollment

Decorative

Platforms for Excellence in Medicaid Eligibility Operations

The infrastructure of any successful Medicaid eligibility operation includes, at its core, comprehensive data generation, robust reporting and targeted sharing, along with machine learning. Read Platforms for Excellence in Medicaid Eligibility Operations

Decorative

June 2021 Medicaid Changes

On March 9th, Secretary Alejandro N. Mayorkas announced that the federal government will no longer defend the Public Charge rule, which is a law that had the potential to deny someone legal permanent residency status if they are reliant on Medicaid or food assistance. Read June 2021 Medicaid Changes

Decorative

May 2021 Medicaid Changes

Special Open Enrollment for the Health Insurance Exchange and other news. Read May 2021 Medicaid Changes

Decorative

April 2021 Medicaid Changes

All states are now participating in the special open enrollment period for the Health Insurance Exchange, although the dates may vary or change. If a state is not listed then it is federally facilitated and the special enrollment period has been extended to August 15th.  Read April 2021 Medicaid Changes

Decorative

Beyond Medicaid: Thinking Outside the Box

On the surface, the mission of a Medicaid eligibility (ME) team is simple: qualify patients for financial and medical relief, while increasing reimbursement to the provider Read Beyond Medicaid: Thinking Outside the Box

Decorative

March 2021 Medicaid Changes

All states are now participating in the special open enrollment period for the Health Insurance Exchange, although the dates may vary. Read March 2021 Medicaid Changes

Decorative

Right Technology Enables Bill Resolution, Patient Peace of Mind, Provider Reimbursement

Bill resolution. Patient peace of mind. Provider reimbursement. These goals are top priorities for any Medicaid eligibility department. Read Right Technology Enables Bill Resolution, Patient Peace of Mind, Provider Reimbursement

Decorative

February 2021 Medicaid Changes

Parallon’s eligibility and advocacy team continues to monitor the state of Medicaid eligibility as impacted by COVID-19. Read February 2021 Medicaid Changes

Decorative

January 2021 Medicaid Changes

Parallon’s eligibility and advocacy team continues to monitor the state of Medicaid eligibility as impacted by COVID-19. Notably, we are keeping a close eye on the Supreme Court decision over Medicaid work requirements. Read January 2021 Medicaid Changes

Decorative

The United (and Differing) States of Medicaid

Medicaid eligibility is complicated by regulations that tend to change from year to year (and from one presidential administration to the next) and vary widely from state to state and, in some cases, by locality. Read The United (and Differing) States of Medicaid

The Suitcase Story

Everybody loves a story with a happy ending — especially a true one. The following real-life account involving a client’s patient has become known in-house as “the suitcase story.” It’s a beautiful example of going above and beyond, and of how an approach focused on solving one person's problem can can create positive outcomes beyond. Read The Suitcase Story