Compete to Win with TMG Health’s Medicaid Solutions

As Health Care Reform progresses, health plans in the government market need to prepare for the unprecedented growth in both the Medicaid and Dual Eligible populations. To be successful, plans in the Medicaid and Medicare markets need to find scalable and flexible solutions to keep pace with Federal & State regulatory requirements and to stay ahead of the competition!

TMG Health’s dedicated Medicaid Services implementation and development team understands the prevailing issues in the Medicaid market and has the knowledge of and ability to implement proven solutions.

TMG Health’s proven, strategic solutions for managed care plans enable you to:

  • Manage Growth
  • Control Operating Costs
  • Meet Strict Compliance Requirements
  • Skillfully Manage Enrollment, Claims and Customer Service Processes
  • Respond Quickly to the Evolving Managed Care Market

For more information about TMG Health’s expert solutions, contact us using the form below.

Services Offered:

  • Enrollment, Eligibility and Reconciliation (CMS and Medicaid)
  • Premium Billing
  • Claims Processing (Medicaid & Medicare) with Crossover
  • Encounters Reporting
  • CMS and State Reporting
  • Member & Provider Call Center Services
  • Financial and Capitation Reconciliation
  • Data Management & Reporting
  • Medical Management

More on our Medicaid Solutions...

Experience Matters!

It takes time, resources, and complex business rules and workflows to skillfully manage the intricacies of serving the diverse populations covered by Medicaid.

With more than 14 years of experience working exclusively with government health plans, we have the experience and broad understanding of the evolving managed care market needed for successful administration of Medicare Advantage, Medicare Part D and Managed Medicaid Plans.

TMG Health serves health plans, both large national plans and small regional plans, totaling upwards of 2.5 million members. Our experience culminates in a broad understanding of the challenging government market and the success markers associated with thriving within that market, including:

  • CMS Interfaces
  • Eligibility Requirements
  • Member Communication
  • Coordination of Benefits
  
  • Grievances
  • Reporting
  • Reconciliation
  • Compliance

Contact us to learn more about our Medicaid Solutions…


TMG Health offers customizable solutions for the following Medicaid lines of business:
  • Medicaid Long Term Care (MLTC)
  • Seniors & People with Disabilities (SPD’s)
  • Medicaid Advantage
  • Medicaid Advantage Plus
  • Integrated Care for Dual Eligibles (MMAI)
  • Traditional Medicaid (TANF)
  • Health Homes
  • Medicaid Special Needs Plan