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Model N’s Medicaid helps you remain compliant and advance best practices with your Medicaid claims process.
Manage and process payments for the federal program as well as state and supplemental programs.
Streamline your processes to support timely payments, avoid interest penalties, and run validation tests to identify invalid units.
Produce a consolidated payment package with all the necessary reports in just one click.
Medicaid complies with government calculation and reporting requirements, translates strategy into execution, and optimizes business insights into ongoing operations.
Ensure compliance with current guidance. RUPs contain the software and documentation necessary to update and process based on the latest regulatory changes. Stay current on the latest MDRP file format changes from CMS.
Correctly calculate unit rebate amounts (URAs). Featuring 50 preloaded formulas, Medicaid also supports changes in URA calculations with a flexible formula builder.
Identify outliers in claims through aggregated or prescription-level utilization data validations, reducing the likelihood of rebate overpayment.
Easily generate electronic Reconciliation of State Invoice (ROSI) and Prior Quarter Adjustment Statement (PQAS) reports.
Model N Medicaid integrates with other components of Model N’s suite to ensure compliance and accurate payments.
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