Unreported Coverage

About 13% of Medicaid recipients have unreported primary coverage.


Dollars Recovered

On average less than 17% of the dollars billed to primary insurers are paid back to plans that paid claims in error.


Wasteful Spending

56% of all improper payments in the Medicaid program due to eligibility errors.


The industry needed a solution for the challenges of data quality and timeliness.

The Medicaid market needed a technology based solution that fits in with any TPL program.

The solution needed to provide Active coverage on Utilizing members (Not old – stale data).

The solution needed to provide Active coverage in Real-Time.

The solution needed to replace “Pay & Chase” with prospective “Cost Avoidance”.




Claims are checked against an e-prescribing master patient index of over 280 million commercially covered lives. This is the largest and most complete database of active healthcare coverage in the nation. This means your Medicaid plan will obtain the best and latest eligibility responses when you need them – saving you the cost of recovery.




Syrtis Solutions stays on the cutting edge of technology, trends and new legislation regarding healthcare cost containment. Keep up to date by visiting our blog!

  • A Medicaid Model That Includes Work Requirements, Premiums, Time Limits & Drug Testing

    Last year the GOP and Trump Administration made numerous attempts to reform Medicaid by trying to repeal the Affordable Care Act (ACA) and impose federal spending caps for the Medicaid program. While these efforts were unsuccessful, the future of the Medicaid program is still vulnerable......

  • Medicaid Funding – Trump’s Budget for Fiscal Year 2019

    The Trump administration has made considerable efforts to reform the Affordable Care Act. Despite all of the failed attempts in 2017, the Whitehouse is once again targeting the nation’s healthcare safety net. The recently released budget for FY 2019 clearly outlines the administration’s intent to restructure......

  • The Managed Medicaid Market In 2018

    Over the past year, the Trump administration and the GOP had a strong push to repeal the ACA along with reforming Medicaid. With the New Year underway, it is clear that the uncertainty in Medicaid’s future is a cause for concern amongst Medicaid managed care......