Making the Medicaid Cut

Medicaid has been touted as welcome news for lower-income families and persons with disabilities. The real challenge though, is learning whether they qualified at all.

State-dependent eligibility

Since Medicaid is both a federal- and a state-funded program, each state has their own say on the rules and policies on Medicaid applications. This means that one individual who was deemed eligible for Medicaid in Virginia may or may not be qualified when he or she relocates to SC and applies for Medicaid there.

In SC, paper documents from applicants are not sufficient for the SCDHHS to process an application. They further verify information like income, age, and Social Security number through data sources like the Social Security Administration and the Departments of Homeland Security and Labor.

Appealing a denial

Applicants denied for Medicaid will be notified accordingly. For the meantime, if they would need medical care, they can seek hospitals and clinics who open their doors to the uninsured. In turn, hospitals can refer these uninsured patients to eligibility specialists, like the ones from DECO Recovery Management, to learn more about their eligibility and appeal the denial.

Patients who are approved for SC’s Medicaid program play a vital role in healthcare revenue cycle management systems. However, SC has eligibility requirements that patients must comply with first. Once they are deemed eligible, they can enjoy the benefits of Medicaid including a comprehensive medical coverage.

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