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Data Sheet: Source Medicaid Michigan

Source deliveries in-depth MI Medicaid content that includes state-specific fee schedules and payment policies across a wide range of facility and professional provider types.

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Payment Integrity in Michigan Medicaid Programs

Our comprehensive solution for ensuring payment integrity within Michigan Medicaid programs. Our service focuses on providing accurate and compliant pricing data, allowing health plans to optimize member outcomes without the hassle of claims editing and re-work.

Expertise in Michigan Medicaid

With over 15 years of experience, specializing in supporting Medicaid and Duals programs by delivering in-depth, state-specific content, including fee schedules and payment policies for various provider types. Our automatic delivery system updates Medicaid policies bi-weekly, eliminating the need for manual updates and IT efforts.

Key Features

  • Comprehensive Content: We offer detailed Michigan Medicaid policies covering a wide range of services, such as ambulances, ambulatory surgery centers, end-stage renal disease, home health, hospice, inpatient care, nursing facilities, outpatient care, professional services, and suppliers.
  • Accurate Pricing: Our platform includes Medicaid fee-for-service pricing formulas, rates, core payment policies, and national Medicaid edits, ensuring compliance and accuracy.
  • Cloud-based Infrastructure: Our system supports seamless integration with a single API call, enhancing transparency and facilitating audits.
  • Customizable Solutions: We tailor our services to handle complex payment arrangements, improving provider relations and operational efficiency.

Impact and Benefits

Our solution significantly reduces improper payments, which CMS estimates account for $132 billion annually, with over 60% of Medicaid programs. By utilizing our platform, clients can expect:

  • $5 in savings per identified claim due to improved accuracy.
  • 40% reduction in claims needing re-keying from improved workflow.
  • 5-8% of total claims identified with inaccuracies.
  • 25% time savings compared to previous processes.

Conclusion

By leveraging our expertise and advanced technology, we aim to enable our clients to pay claims accurately, quickly, and comprehensively. For more information on how we can help your organization achieve payment integrity in Michigan Medicaid, please contact us today