MedFlo AI
Sign inSign upBook a demo
PlatformSolutionsResourcesCompanySign inSign up
Platform · 07 · Payer change detection

Know when coverage changes.
Before the claim tells you.

MedFlo keeps checking coverage on every resident after admission. Plan switches, lost Medicaid eligibility and new secondary coverage are flagged and routed to the team that needs to act.

See the patient journeyBook a demo
Coverage changesEvery resident · all buildings
ResidentChangeEffectiveRouted toStatus
J. Keller, 82Original Medicare → Medicare AdvantageOct 1Case managementAuth required
T. Nguyen, 76Medicaid eligibility endedSep 30Business officeRenewal needed
H. Tran, 91Secondary coverage foundSep 1Business officeNew secondary
A. Singh, 88Managed Medicaid plan changedOct 1Case managementCheck network
R. Morales, 78No change——Verified
Where it sits in the journey

Coverage never goes stale. Changes reach the right team.

Contract terms tell MedFlo what a new plan means for network status, authorization and reviews. Changes go to case management now, and to billing as it arrives.

Fed byContracts
Payer change detection
FeedsCase managementBilling · coming soon
What it does
Every resident, re-checkedCoverage is verified on an ongoing basis, not only at admission.
Plan switchesOriginal Medicare to Medicare Advantage, or one plan to another, with the effective date.
Medicaid eligibilityLost Medicaid eligibility is flagged so renewal work can start.
New secondary coverageSecondary coverage that appears after admission is flagged for your team.
Plan switches

A plan switch, and what it means for you

When a resident moves from Original Medicare to Medicare Advantage, MedFlo shows the new plan next to your contract: whether you are in network, whether authorization is now required and how often reviews are due.

J. Keller, 82Plan switch
BeforeOriginal MedicareFrom Oct 1Medicare Advantage HMO
Network2026 MA agreement · in networkp. 2
AuthorizationRequired from Oct 1p. 9
ReviewsEvery 7 daysp. 11
Coverage re-checkEast 2 · this morning
T. Nguyen, 76MedicaidEligibility ended Sep 30Lost
H. Tran, 91SecondaryMedicaid foundNew
J. Keller, 82PrimaryMedicare Advantage from Oct 1Switched
A. Singh, 88PrimaryManaged Medicaid · no changeVerified
Ongoing checks

Eligibility and secondary coverage, caught

Ongoing checks cover every resident in every building. Lost Medicaid eligibility and newly found secondary coverage show up as changes, not as surprises weeks later.

Routing

Routed to the team that acts

Each change goes where it can be handled: authorization and network questions to case management, eligibility work to the business office, and payer updates to billing once it is available.

Routed for actionFrom today's changes
Case managementJ. Keller · start authorizationAssigned
Case managementA. Singh · confirm network statusAssigned
Business officeT. Nguyen · Medicaid renewalOpen
BillingH. Tran · update secondary payerComing soon
Connected in the journey
ContractsWhat a new plan means under your terms.Case managementWhere plan changes are handled.BillingComing soon: claims that reflect coverage changes.

Start with admissions.
Grow into the whole journey.