Problem Statement

When Medicaid is the secondary payer, the primary payer's portion has to be billed first, and then a secondary claim has to be filed with Medicaid to collect the remaining copay. For Texas Medicaid, that secondary claim can't be sent electronically the usual way; someone has to open the state portal and key in the claim details by hand. It's repetitive manual entry, and until the secondary claim is filed the copay balance sits uncollected, aging in AR on money the plan is owed.

Automation Solution

This automation opens the Texas Medicaid portal and keys in the claim details to process Medicaid copay secondary billing.