Medicaid Consulting

Meet Medicaid challenges including eligibility and application management, appeals and Adjudication Resolution services.

Richter Healthcare Consultants works with LTPAC providers to implement processes built around Medicaid regulations, and will train staff on the latest billing and reporting requirements. Our team can provide a comprehensive review of claims and documentation to help ensure compliance with the Centers for Medicare and Medicaid Services (CMS) Medicaid Integrity Program.

Richter Healthcare Consultants staff attends industry events to make sure that we maintain the most up-to-date information and training. Our consultants serve on multiple trade association committees and work closely with state and county agencies. From claims resolution to appeals, Richter Healthcare Consultants help LTPAC providers manage Medicaid challenges.

Our Medicaid consulting services include:

  • Application and appeals management
  • Medicaid program education:
    • Eligibility requirements and process
    • Medicaid pending case management
    • Medicaid managed care
  • Adjudication resolution
  • Program compliance audits
To learn more about how Richter Healthcare Consultants can provide customized solutions for your Medicaid challenges starting today, please request more information.

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  • Understanding Targeted Probe and Educate – Medicare’s New Medical Review Strategy
    In 2015, the Centers for Medicare and Medicaid Services (CMS) introduced the Probe and Educate (PE) strategy, first to hospitals and then to home health care agencies. With this new strategy, five claims were selected from every hospital and home health care provider. If a claim was denied, one-on-one education was offered in an effort […]
  • The Proposed Patient-Driven Payment Model (PDPM): 10 Things You Need to Know
    In April 2018, the Centers for Medicare and Medicaid Services (CMS) threw yet another curveball at (MDS) coordinators and skilled nursing facilities (SNFs) across the country. CMS’ original plan to introduce RCS-1 (resident classification system, the proposed new federal payment system) was overturned and replaced by the now proposed patient driven payment model (PDPM). This […]
  • 5 “You-Focused” Tips to Improve Your Organization’s RCM Process
    Revenue cycle management (RCM) is so much more than just a financial process. It is about the procedures that enable your long-term post-acute care (LTPAC) organization to maintain a positive financial picture and, in turn, allow you to focus on day-to-day operations and optimal outcomes. It sounds cliché, but that is why communication is key […]