Patients lose Medicaid and Medicare coverage silently — redetermination deadlines pass, plans change, enrollment gaps open. Agencies keep billing and discover the lapse weeks later when denials arrive. ClientCare monitors every patient's eligibility on a rolling basis and alerts you the moment coverage drops.
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$34K
Avg. annual loss per agency from coverage lapses
8%
Medicaid patients churn coverage quarterly
4x
Faster detection vs. monthly batch checking
Patients lose Medicaid or Medicare coverage without warning. Redetermination deadlines pass, plan changes take effect, and enrollment gaps open — all while your aides keep visiting and your billing team keeps submitting claims that will deny.
Most agencies discover coverage lapses weeks or months after they happen — when a stack of denied claims comes back. By then you have unrecoverable revenue and patients who need care coordination you cannot bill for.
Some coverage terminations are backdated. A patient who was eligible last Tuesday may not be eligible today — and the termination date may be set to last month. Manual portal checks miss these retroactive changes entirely.
Export a CSV from any EMR — WellSky, Axxess, AxisCare, Homecare Homebase, or anything else. Upload it to ClientCare. No special formatting required; our AI maps your columns automatically.
ClientCare checks each patient on a risk-based interval. New intakes get daily checks. Medicaid patients are verified weekly. Medicare patients monthly. The system adapts to where coverage risk is highest.
When a patient's coverage status changes, you receive an instant alert with the patient name, payer, what changed, and recommended next steps. Stop billing ineligible patients before the denial arrives.
Real-time EDI checks, payer-specific parsing, and risk-based scheduling — not a monthly batch job that misses mid-cycle changes.
ClientCare sends HIPAA 270 eligibility inquiries directly to payers and parses the 271 responses automatically. No manual portal logins, no phone calls to MCOs, no guessing.
Medicaid patients are checked weekly because redetermination churn is high. Medicare patients are checked monthly. New intakes get daily checks for the first 7 days. Risk-based intervals mean faster detection where it matters most.
The moment a patient's eligibility status changes, you get a plain-English alert: which patient, which payer, what changed, and what to do next. No more finding out from a denial.
ClientCare parses eligibility responses across Medicaid fee-for-service, Medicaid managed care (STAR, MediCal, etc.), Medicare Advantage, and traditional Medicare — all from one upload.
Any agency billing Medicaid or Medicare is at risk. These verticals see the highest coverage churn.
Medicaid redetermination churn hits HHAs hardest — weekly checks catch lapses 4x faster.
Coverage verification at admission is not enough. Plans change mid-episode.
Long-stay residents cycle through Medicaid eligibility windows. Continuous monitoring prevents gaps.
High Medicaid population with frequent coverage disruptions during treatment episodes.
Contracted staff serve patients across agencies. Ensure every patient you bill for is covered.
Waiver program eligibility changes silently. Catch drops before they stack into months of unbillable care.
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