Lutheran Medical Center Medicaid Reimbursement Case Study

Lutheran Medical Center is a community-based hospital in Brooklyn, New York that serves a large underprivileged population. Because Medicaid comprises approximately 20% of the Medical Center’s revenue, it is important to collect these payments in a timely manner. The Capstone team assessed the Medicaid reimbursement cycle of the Medical Center to determine if it would be possible to improve the rate of collection. The team reviewed delayed and denied Medicaid claims to identify any bottlenecks. As a result, the team identified three areas that contributed to the delay or denial of payment from Medicaid: 1) delays in the Medicaid application process, 2) delays in coding by Medical Records, and 3) improper patient account/billing procedures.