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While those who are at a higher risk for medical problems may pay more for their health insurance, Medicaid offerings eliminate many of these costs for low-income individuals. However, these plans must often pay out more for those who suffer from health conditions that require frequent visits to the doctor’s office. This is where Medicaid risk adjustment comes into play.

Even the Playing Field

Health insurance works in a way where people basically pay the same amount as everyone else for identical coverage. Some of these individuals will use a greater amount of benefits than others. This leaves insurance companies to even out the money paid for policies between the individuals who are using the policies and those that are not. This is known as Medicaid risk adjustment. While the rules for these adjustments vary by state, the premise is the same: to equalize the money between policies for high-risk patients versus those that are low risk.

The Need for Accurate Documentation

One of the best ways to ensure proper Medicaid risk adjustment, so you can get paid the amount due for services rendered, is to make sure documentation is as accurate as possible. This includes your medical records and any medical billing that takes place. That is why many medical care providers make use of outsourcing for their medical billing and coding. These companies can provide the accurate documentation required to ensure prompt payouts from Medicaid for patients who may visit the clinic on a regular basis.

Why You Need Help?

Outsourcing your Medicaid risk adjustment is essential to ensure you have access to everything you need. These services empower the provider to continue to offer the level of care patients require, all while engaging the patient to encourage wellness visits rather than waiting until they are sick to see the doctor. This can mitigate issues and ensure health problems are detected early when it will cost Medicaid less to provide care.

If you’re interested in how Medicaid risk adjustments can work for you, visit the GeBBS Healthcare Solutions website to learn more.

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