10/5/2006

Healthcare and immigration are two of the hottest topics in Congress and in living rooms all over America.  Combine the issues and the impact can be staggering.  Consider the delivery of emergency health care to the nearly 10 million illegal immigrants or undocumented aliens currently in the country. 

Providing emergency medical care to undocumented aliens can result in huge and uncompensated expenses for hospitals.  Because this population is often fearful of deportation, hospitals are not able to pursue traditional methods of payment and, therefore, lose money for services rendered. 

CBIZ KA Consulting Services, LLC (CBIZ) works with hospitals to reduce this burden by enrolling undocumented aliens who received emergency medical treatment in the federal Emergency Medicaid program.  CBIZ provides the hospitals with Medicaid ID numbers, which allows the providers to bill Medicaid for the services provided, and recover lost revenue.

To be enrolled, the undocumented alien has to meet certain criteria and their eligibility is restricted.  The individual must be admitted through the Emergency Room and only certain diagnosis codes are eligible for Medicaid.  In addition, the qualifications must also be met in every emergency medical care instance.

Assistance Provided for All Categories of “Self-Pay” Patients

The undocumented alien is just one type of “self-pay” patient from whom hospitals may have trouble securing payment.  CBIZ offers services that enroll all types of self-pay patients-including uninsured and under-insured children, 65+ adults and pregnant women-into applicable state and federal programs.  And depending upon its volume of self-pay patients, hospitals can collect as much as three to four million dollars a year through Medicaid with CBIZ’s expertise.

CBIZ works with clients on either a concurrent or retrospective basis. This concurrent program involves placing one or more persons on site at the hospital for what we call “Day One Servicing.”  For “Day One Servicing,” the patient comes in and is immediately referred to a CBIZ team member. CBIZ will screen the patient and assist in enrolling him or her into the program that makes the most sense for the patient’s current situation.

When working retrospectively with a client, the hospital will send CBIZ a file about the patient who has failed to pay for services.  CBIZ will then make a home visit to determine the patient’s Medicaid eligibility and whether he or she can be enrolled after receiving treatment.

 CBIZ’s bilingual and  tri-lingual team members find their work “extremely rewarding.”  Day after day they use their talents to help hospitals and hospital systems recover monies earned. CBIZ also serves as a patient advocate by helping to educate patients about the state and federal resources available to them.

The demand for CBIZ’s Medicaid screening and enrollment services will  continue to grow. According to the U.S Census Bureau, nearly 46 million Americans did not have health insurance in 2004.  A recent study by the Commonwealth Fund, a private New York-based health care policy foundation, also found that the percentage of working-age Americans with moderate to middle incomes who lacked health insurance for at least part of the year rose to 41%  in 2005, up from 28% in 2001.

 As more hospitals face the challenge of unpaid medical bills, CBIZ is ready and waiting with a solution.

A Few Facts About the Undocumented

• Total Number in the U.S.: Latest estimates put the total number of undocumented workers at a minimun of 9.3 million.

• Countries of Origin: Mexicans make up over half of undocumented immigrants (57% of the total).   Another 23% are from other Latin American countries.

• Distribution by State: Almost two-thirds of the undocumented population lives in just six states: California (26%), Texas (12%), Florida (10%), New York (8%), Illinois (4%) and New Jersey (4%).

• Growth Areas: The most rapid growth in the undocumented population since the mid-1990s has been outside these states.

Table 1

2002 Undocumented Immigrants by State

U.S. total (in millions)         9.3

California                               2.4      

Texas                                     1.1

Florida                                    0.9

New York                               0.7

Illinois                                      0.4

New Jersey                            0.4

All Others                               3.5

Source: Urban Institute; www.urban.org/publications/1000587.htmlIf you would like more information on this article or any other issues related to this article, please contact Dora Marques, Director of Medicaid/Charity Care Services at 609-918-0990, extension 117.