Integrating benefits for dually eligible Medicare and Medicaid beneficiaries is a challenge, which requires keen attention to details and sophisticated information technology infrastructure to avoid manual work-arounds. Often, the members who qualify for both Medicare and Medicaid— known as dual-eligible beneficiaries are often the ones who have complex and costly health care needs. Ultimately, the goal is to manage members' overall health care use and outcomes across medical, behavioral health, and long-term care.
Systematic tight coordination for Dual Eligible Beneficiaries can mitigate disjointed care, misaligned incentives and costly administrative inefficiencies. Citra’s EZ-Suite allows you to identify the member’s unique coverage needs within one unified view. With advanced secondary payer pricing models and sophisticated Coordination of Benefits workflows, EZ-Suite relieves the burdens.
While dual-eligible patients tend to make up a small percentage of Medicaid enrollees, they are responsible for considerably higher percentage of the program's expenditures and can be closely managed through the integration and configurable options within the EZ-Suite platform.