How can we track Medicaid reimbursements?
Question:
How can we track Medicaid reimbursements?
Answer:
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Most SOAR programs that have a hospital collaboration will work with the hospital’s billing department to collect information on reimbursed expenses for each SOAR applicant approved. Some are able to separate out Medicaid and Medicare reimbursements; others have just a total for all reimbursements. The information isn't any more complicated than: "We helped 100 individuals get approved for SSI/SSDI and the hospital has been reimbursed $500,000 in the past year in Medicaid/Medicare expenses for these individuals." It can be helpful to also collect the totals for unreimbursed expenses for those same individuals for the year prior to approval to use as a comparison. One SOAR provider looked at emergency room usage for the year prior and the year after approval to see if there was a reduction. They found a 24 percent reduction in ER usage and 52 percent reduction in psychiatric ER usage.
Some SOAR providers will meet monthly with the billing department and collect reimbursement data, others will do it quarterly. We would recommend doing whatever works best for the staff at the hospital and the SOAR staff.