TripSpark's all-encompassing NEMT and health transportation software, NovusMED is equipped with Claims Management — a platform that simplifies the claim submission process. Claims Management includes interfaces specific to Medicaid eligibility and claims data, making it easy to authenticate client admissibility. In this post, we'll briefly define Medicaid, explain medical claims and billing, and explore some key features of TripSpark's non-emergency medical transportation software.
Medicaid — A Definition
"Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government."1
A Quick Review: Medicare vs. Medicaid – similar, but not the same:
| Medicare | Medicaid |
|---|---|
|
Operates on a federal level, providing health coverage to senior citizens (65 and over) or to those under 65 with a disability, regardless of income |
Operates on both a state and federal level, providing health coverage to those with low income. |
Medical Claims and Billing Explained
Medical billing is a payment structure that is used by the United States health system. Healthcare providers must submit, follow up with, and appeal claims with health insurance organizations to be reimbursed for performed services.2 Since Medicaid is a government funded program, submitted claims must adhere to certain medical coding practices for billing purposes.
Here's a closer look at just some of the features and benefits of TripSpark's Claims Management Software for Providers, Brokers, MCOs and Health Care Organizations:
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When processing claims, providers can tailor their query to view results according to claim status. You can search by Client Medicaid ID, Provider Medicaid ID, and much more
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Trip completion data submission is done entirely through the software, simplifying tracking, and ensuring information is complete
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The user-friendly interface allows funders and providers to oversee claims within a single screen
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Reporting is easy since claims are tracked for medical and customer audits
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Since denied claims are denoted, and the reason for denial is identified unequivocally, claim reconciliation is fast and trouble-free
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The ability to cross reference drivers and providers allows you to qualify payments, ensuring claims are only made for authorized drivers and vehicles
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Extract data in a variety of formats, compatible with most AR systems
By implementing TripSpark's Claims Management module and NEMT software, Bay City Ambulance transformed their previously cumbersome billing processes and is now completing claims faster and with greater accuracy. Check out this article to see how they optimized their processes.
The beauty of Claims Management software lies in its ability to streamline the entire submission and reimbursement processes for Medicaid billing. The level of automation in our NEMT software makes tracking and auditing effortless, since each step is recorded.
To learn more about our health and human services transportation software and modules, check out the resources below:
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