Post-approval Medicaid retro-eligibility: the money hiding in your write off column
Self-pay at the visit, Medicaid coverage approved weeks later, backdated to cover it. Nearly 3 in 10 self pay balances turn out to be insured. NxtPivot hunts them for you.
A patient is seen while their Medicaid application is pending, or with no coverage at all. Weeks later they are approved, and the approval is backdated to cover the visit you already wrote off as self-pay. The money is legitimately yours. Nobody sends you a letter about it.
It happens far more than most billing companies believe. Industry coverage sweeps have found billable insurance on nearly 3 in 10 self pay accounts. Your write off column is not a graveyard. A third of it may have a payer attached right now.
And in many states, a retroactive eligibility decision starts a brand new filing window, dated from the decision, not the visit. A balance you gave up on months ago can become filable today.
One more thing worth knowing: federal law cuts the retroactive lookback from three months to as little as one, starting January 2027. Whatever is recoverable in that column is more recoverable this year than it will ever be again.
NxtPivot hunts this for you. On a schedule, under a budget you set, with balances you had written off coming back as claims you can file. How we find them is the part we show you in person.
Send us the claims you gave up on. Free, and the findings are yours either way.