Problem Statement

Coverage and benefit details must be confirmed and entered accurately before billing, and doing this manually at volume is slow and error-prone. Medicaid status changes month to month and must be checked in the state portal rather than through standard RTE, so verifying manually is a high-volume, repetitive lookup that easily backlogs. Gaps like these surface later as avoidable rework and lost revenue.

Automation Solution

This automation checks Medicaid eligibility status in the state Medicaid portal and updates the EMR with the result.