Longer waits for reimbursement is occurring in states transitioning to managed Medicaid, along with added delays in validating residents eligibility.
Multiple states have been working toward a transition to managed Medicaid from the traditional state-run program, but there have been concerns about reimbursement timing and insufficient payment amounts due to the change. And that’s just the first layer of challenges.
Payment portals unique to each managed Medicaid contractor is another hurdle to overcome, in addition to the Medicaid revalidation process currently underway. But, nursing home operators are striving to get a bigger seat at the table from the very beginning, with a strong advocacy force behind them.
Stulick, A., (2024, October 15). Transition to managed Medicaid causing chain reaction of challenges, as nursing homes also contend with redetermination. Skilled Nursing News. https://skillednursingnews.com/2024/10/transition-to-managed-medicaid-causing-chain-reaction-of-challenges-as-nursing-homes-also-contend-with-redetermination/
Improve Medicare Advantage reimbursements with payer contract management that puts payer rules in the hands of clinicians & billers.
