Large Medicaid Program Avoids $1.2B in Claim Payment Errors

Background

Medicaid program fee-for-service population has declined in recent years

Cost avoidance savings continue to climb regardless of volume of lives covered – highlighting the strength and value of FinThrive’s product despite decreasing membership

Solution Highlights

Fee-for-service claims were appropriately billed to third-party payers through identification of other insurance and data maintenance

Accurately identified third-party liability to improve administrative processes

Patented data-matching technology with 300+ query permutations to find insurance

Customer Overview

2M+ member population

Operations managed by Accenture

Northeast Medicaid program

$1.2B

Total cost avoidance savings of $1.2B from 2021-2023

5.6%

Approximately 5.6% of the state’s caseload has major medical TPL on file

880+

880+ payer EDI connections to 98% of US insured lives