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Eligibility

We identify undiscovered eligibility after hospital staff and other contractors have exhausted efforts to determine eligibility for patient accounts. Our process enables us to find money for hospitals by searching deeper and farther than any other eligibility review process, whether internal or external.

DSH Enhancement

As a byproduct of our service, we increase the number of Medicare and Medicaid days linked to disproportionate share hospital federal funds. In some cases, the accounts we identify make up the difference in whether or not a hospital meets the minimum threshold for receiving federal dollars under DSH.

Patient Advocacy

Now, more than ever, patient satisfaction is paramount. One key element in providing excellent care is patient advocacy. 2020 RMP brings this important concept to bear by identifying payers other than the patient. Discovering a patient’s retroactive eligibility benefits the hospital and the patient by reducing the number of accounts that go to self-pay.

 

Testimonials

  • After all of our internal efforts were exhausted, we came up short on DSH days to qualify for millions in federal dollars in FY 2014. We needed to find 340 additional days in order to hit the minimum threshold for DSH. We had other vendors look at our accounts and relevant data, but we were told that there was no way for us to hit the mark. Kim and her team asked for a chance to review our data, so we let 2020 RMP take a look. Their team identified an additional 430 days, which meant we were able to identify the additional days necessary to qualify for our fiscal year's DSH reimbursement.

     -  Georgia Hospital Client

The 2020 RMP Difference

Dual-Look Method

Most eligibility vendors rely solely on pushing data through a computer program in order to find eligibility. At 2020 RMP, we use an advanced, proprietary algorithm, but we don’t stop there. We employ a manual review process which allows us to catch linkages and use judgement that a computer simply cannot.

CMS/SSA Relationships

Instead of navigating the government system as it was, our CEO, Kim Bohnsack, decided to challenge the status quo. Over the last several years, Kim and the team at 2020 RMP have leveraged relationships with CMS and SSA to change regulations in order to make determining eligibility simpler, and to get hospitals compensated faster.

Patient Advocacy

2020 RMP assists patients first and foremost by identifying eligibility. In addition to this benefit, we engage third party and government payers on behalf of patients. When other payers are identified and pursued, the pressure of being designated as a self-pay account is removed.

Advanced Data Mining

 Where others only skim the surface of found money potential, 2020 RMP digs deep by examining and managing data in unique ways to maximize results. For example, most eligibility services look at data from an “event” perspective, examining specific services for eligibility. Our system uses multiple sources to build an ever-growing database of patient-centered data, allowing us to  link eligibility across providers and dates of service.

Customized Service

 Our team treats every client as if they are the first client with whom we have worked. We build a customized service that takes into account the processes and people that are unique to that hospital or system. We strive to make as little impact as possible to our provider’s staff, while making a huge impact to the bottom line.

Dedicated Experts

Our staff has decades of experience in the healthcare industry, specifically in the realm of eligibility and overall revenue enhancement. Over the years, we have innovated and invested in change. We aren’t just experts because our results are far and above the competition; we are experts because we become a partner for our clients and constantly seek new ways to solve persistent problems.

 

450 Bed Hospital Annual Projection (8% Self-Pay)

 

475,000

Total Visits Per Year

35,600

Uncompensated Care Visits

1,780

Payable Claims

$1,271,000

Projected Hospital Benefit