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Spot it. Identify eligibility shifts early.
* Check eligibility before each visit to spot coverage lapses early and prevent unpaid care.
* Set reminders for 6-month reviews to stay ahead of redeterminations.
* Have a plan for coverage loss by rerouting claims to another payer or self-pay so revenue isn’t left behind.
Nail it. Be audit-ready, with confidence.
* Keep documentation complete and consistent so every service, note, and claim is audit-ready.
* Build checkpoints into your process to catch gaps before they trigger findings for fraud, waste, or abuse.
* Run internal audits regularly to surface and fix issues before external reviewers do.
Fund it. Capture every dollar (and find more).
* Monitor new state and federal programs and flag relevant funding opportunities.
* Apply structured grant processes to strengthen submissions and reduce wasted effort.
* Diversify beyond Medicaid by pursuing braided funding; blending grants, contracts, and partnerships to cover gaps and reduce revenue risk.