How to Check Patients’ Affordable Care Act Eligibility

How to Check Patients’ Affordable Care Act Eligibility

One of the US government’s initiatives relating to helping the American people is the Affordable Care Act. Given how healthcare remains one of the most challenging expenses faced by its citizens, in 2014 the Affordable Care Act was once again updated to allow states to give Medicaid coverage to individuals below the age of 65 earning up to 133 percent of the poverty level recognized by the federal government.

This update extends the reach of Medicaid-sponsored healthcare subsidies. An affordable care act enrollment allows for marginalized individuals to participate in the country’s robust healthcare system without having to worry about gargantuan expenses.

The Importance of Eligibility-Checking

If you are a health professional working closely with Medicaid programs, it’s crucial that you accomplish a reliable background check to determine whether your walk-in patients are eligible for the Affordable Care Act. Moreover, you need to be proficient in terms of the workings of the system.

For instance, you must know and be vigilant of the reset period that governs Medicaid benefits. This happens at the beginning of the year and changes coverage stipulations from the specifics of a patient’s benefit plans to these benefits’ responsible payor. Failure to take these annual updates into consideration could result in difficulty, or worst, impossibility, to reimburse your rendered services.

Helpful Resources

The Centers for Medicare and Medicaid Services website has all the crucial information you might need in determining patient eligibility. The main purpose of this resource is to provide healthcare stakeholders with essential data to efficiently conduct their administrative functions, from deciding which services may be given to which patients, to executing Medicare claims in the most efficient way possible.

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Healthcare professionals must consistently stay updated with the government’s Medicare and Medicaid programs, including their most recent updates. This will prove beneficial at the end when you finally submit reimbursement claims for your rendered services.