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Medicaid/ Long Term Care Subsidy Management (Nursing Homes)

The Long Term Care Subsidy Management (LTC) System is a ProviderGateway™ system for managing transactions and communicating information between nursing homes, counties and the state. The LTC configuration assists Medicaid subsidized agencies to accomplish the following objectives for Nursing Homes:

  • Automate all transactions between nursing homes and the county and state Medicaid agencies;
  • Maintain all client information in an accessible electronic format;
  • Coordinate the confirmation of eligibility for Medicaid on a timely basis to all concerned
  • Communicate changes in demographic and other information to the Medicaid program;
  • Eliminate the potential for duplicate client information
  • Create the State claim document (EDI 837), applying appropriate edits as claims data is accumulated throughout a reporting period
  • Eliminate paper processing of all communications, and claims submission

The LTC configuration leverages the ability to share data instantaneously across the provider networks, maintaining transparency of services while tracking all the rules that maximize reimbursement opportunity and eliminate errors. Unbilled services, duplicate claims, poor coordination between nursing homes becomes a thing of the past.

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