RP Sanjiv Goenka Group

Medicaid Redetermination

Mitigate the Impact of Unwinding Medicaid

Help ensure your members’ continued access to care with proactive digital outreach

Ensure continuity of care and maximize revenue

Millions of individuals have lost their Medicaid coverage as states have resumed redetermination – the majority due to procedural reasons.

Helping eligible individuals maintain Medicaid coverage requires immediate action and personalized assistance. With Firstsource Medicaid Redetermination services, you can quickly connect with your members to support renewal and ensure continuity of care.

Improve member communication and outreach with multi-channel outreach

Move from a reactive member follow-up mode to proactive digital engagement – from Day 1

Convert potential member disenrollment and revenue-at-risk scenarios into continuity of care and revenue maximization

Choose all or some of the components based
on your Medicaid redetermination requirements

Multi-Channel Digital Outreach & Reminders

100% Member Coverage and reminders to take action

Live Agent Outbound Calling

Education and awareness

Reduced calling effort by 50% to 60%

Application Assistance

High touch advocacy program

Incremental Digital push of 40% – 60%

Design a solution
that works best for you

Our modular Medicaid Redetermination solution blends digital engagement with proactive outreach, helping you reach your members with critical information about renewal, and improve response rates within 30 days of implementation. With our scalable, compliant, and flexible solution, you can pursue a course of action that best fits your business needs.

Data quality and enrichment

Multi-channel digital outreach

End-to-end application assistance

Stay ahead with Firstsource

Deliver a seamless experience

Improve engagement with a seamless, personalized experience.

Improve member retention

Ensure timely submission and reduce member churn with proactive outreach and support

Ensure compliance

Meet CMS mandates, track performance with dashboards that offer granular visibility into day-to-day progress

Rapid implementation

Ready-to-go platform: secure, cloud-based, no integration with health plan network required

Design a solution that works best for you

MReD – our modular Medicaid Redetermination solution – blends digital engagement with proactive outreach, helping you get closer to your members and improving outcomes within 30 days of implementation. With our scalable, compliant and flexible solution, you can pursue a course of action that best fits your business needs. Leverage your existing systems or deploy our stand-alone solution. Implement one or more modules or utilize the turnkey solution. The choice is yours.

The ready-to-go platform leverages our Medicaid managed clients and CAC staff expertise to reduce your administrative burden while enhancing the member experience.

Multi-channel digital outreach

Live agent outbound calling

End-to-end Application Assistance

Stay Ahead With Firstsource


Years experience across Providers and Plans

750+ Facilities

Eligibility determination for Medicaid and other LOBs for members visiting the hospitals

700K Lives

Medicaid Enrollment & Eligibility approvals in 2020 alone

750 CAC Associates

Certified Application Counsellors

8.2M Lives

Medicaid members served in top national plans

Explore insights

No more time to wait: Five steps to take now — maintain continuity of care as Medicaid continuous coverage unwinds

5 benefits Healthcare Providers can reap by streamlining denial management solutions through Intelligent Automation

Getting Ready for a Historic Medicaid Redetermination Cycle

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Eddie Monteiro

Eddie is currently Chief Operating Officer at Educational Testing Service (ETS), where he sets and drives the transformation agenda across the company and has responsibility for all technology and operations functions in addition to the College Board, K-12, and teacher licensure businesses. He previously ran business and technology services at Pearson, where he built a global team to enable scalable delivery of enterprise functions. Prior to that, while at IBM, he held several executive leadership roles in the US, Mexico and Brazil across a diverse set of industries and clients.