The Problem
Many StoneGate residents required Medicaid to pay for part or all of their stay. Admittance into one of their facilities initiated a long, multi-step application process with the government organization. With applications involving stacks of paperwork and handling by multiple staff members, the lengthy process drowned team productivity. This led to a protracted billing cycle that dramatically impacted their operational revenue.
When working with Medicaid, there are many regulatory procedures to manage and monitor. Once the StoneGate team admits a resident into their facilities, a critical clock starts ticking—StoneGate has 30 days to organize, prepare, and send off the Medicaid application to the state agency. If the team fails to submit an application within this timeframe, the government declines their reimbursement request.
StoneGate and Medicaid staff manually exchanged paperwork back and-forth. Incomplete applications wilted in the system, with limited visibility into their progress. For applications marred by efficiency draining processes, StoneGate frequently missed the 30-day window for requesting reimbursements and ended up financing the resident’s stay until the time they were able to get the resident fully accepted by Medicaid.
The protracted, time-consuming process caused mounting receivables and undue balance sheet stress for the CFO. Delayed applications mounted, translating into a deluge of daily financial losses.
The Solution
StoneGate turned to ProcessMaker for a much-needed solution. The ProcessMaker professional services team custom built and deployed the brand new workflow system in three months with a 100% remote engagement. Using unique integrations and tailored customizations by ProcessMaker, StoneGate was finally able to streamline their Medicaid application and re-certification processes.
The Value Created
The Medicaid application process often requires the hands-on attention of a minimum of five StoneGate staff members:
- Business Office Manager
- Case Worker
- Payor Navigation Agent (Runner)
- Payor Navigation Manager
- Director of Navigation
Instead of gathering information via paper forms, and manually running forms between departments, ProcessMaker helped implement new tools to automate the process. Online forms eased the initial application, enabling smooth collaboration between residents or family with StoneGate staff. Personnel could easily attach digital documents if necessary, establishing an online repository anyone within the workflow could access.
Any missing information was immediately flagged. Automated workflows distributed applications up the ladder to the next step in the approval process. Every staff member had full visibility into the progress of the application, eliminating the costly issue of languishing applications. . ProcessMaker not only increased team productivity and cooperation, but improved overall visibility for the entire organization. New powerhouse workflows resulted in a 25% reduction in accounts receivables in the first 12 months of deployment, securing StoneGate’s revenue flow and allowing them to provide a new level of customer service for their residents.
