Safeguard revenue that’s rightfully yours. EnableComp streamlines Out-of-State Medicaid (OSM) claims to reduce denials and return reimbursements faster.
With fifty states and fifty different Medicaid programs, no two claims look the same. The mix of eligibility rules, billing formats, and payment timelines can derail even the most efficient hospital-based revenue cycle teams.
EnableComp applies unmatched OSM expertise and intelligent automation to:
EnableComp’s OSM claims solution, part of our Complex Claims Suite, delivers measurable impact on its own, but you’ll experience even stronger results when paired with the rest of the Suite.
50%
Average net increase in reimbursement
50%
Average decrease in days to pay
100%
National enrollment coverage
Managing Out-of-State Medicaid (OSM) claims requires deeper expertise than most providers have in-house. Every state plays by different rules, and the process can easily stall without the right systems in place.
EnableComp pairs deep Medicaid knowledge with the power of our e360 RCM® platform to tame OSM complexity, so hospitals see fewer write-offs and stronger margins.
We maintain real-time insight into each state’s Medicaid policies, including border-state agreements and DRG adjustments, to ensure every claim is billed accurately and compliantly.
EnableComp tracks re-enrollment schedules and compliance updates across all programs, preventing credentialing lapses and the denials that follow.
Our in-house experts stay ahead of regulatory changes, payer shifts, and legislative updates that impact reimbursement.
Clients routinely see an average increase of more than 50% in OSM reimbursement after outsourcing to EnableComp. We turn one of healthcare’s toughest claim types into a reliable source of recovered revenue.
We start on day one and work claims from registration to reimbursement for consistently accurate and timely payments.
We inherit your open claims and manage aging accounts to a successful resolution for improved queue management and inventory reconciliation.
We help you negotiate payment with Medicaid when a patient's bill exceeds the allowable amount.
We identify and prevent denials – providing root-cause analysis and reworking even the most complex claims to enhance revenue and yield.
EnableComp’s Complex Revenue Intelligence™ (CRI) gives hospitals command over the most fragmented corners of OSM. By combining adaptive automation with deep payer intelligence, CRI simplifies enrollment, billing, and payment across 50 states with unmatched accuracy.
Built for foresight, CRI turns OSM complexity into predictable revenue.
Each solution in our Complex Claims Suite stands strong on its own. When hospitals bring EnableComp in to manage all four – OSM, Motor Vehicle Accidents, Veterans Affairs, and Workers’ Compensation – the difference is exponential.
Together, our people and technology connect every part of the process to deliver results that go far beyond what any one solution could achieve.
