What changes
The day before MedFlo, and the day after.
Without MedFloWith MedFlo
Learning a patient’s benefits after they arriveFull verification of benefits before admission
Missing the Medicaid or supplemental plan nobody mentionedSecondary coverage discovered on the referral
Contracts in a shared drive only finance can findEvery payer contract in one searchable library
“Are we in network?” questions from admissionsAdmissions sees network status on the referral
Finding a plan switch when a claim comes backPlan switches flagged the day they happen
Discovering lost Medicaid eligibility months laterEligibility changes routed to the right team
Built for business office
Verified before admissionMedicare, Medicare Advantage, Medicaid and commercial — days used and authorization requirements, checked before the patient arrives.
Secondary coverage foundMedFlo looks for coverage beyond what the referral lists, so secondary payers are known from the start.
One contract libraryNetwork status, rates, carve-outs, auth rules and review cadence, searchable by every team and applied across the journey.
Payer change detectionOngoing coverage checks on every resident flag plan switches, lost eligibility and new secondary coverage.
Contracts
Contract terms, where the work happens
Upload your payer agreements once. Rates, carve-outs, authorization rules and review cadence become searchable for every team — and MedFlo applies them to admissions, authorizations, reviews and MDS.
Commercial PPO agreementContract library
NetworkIn network · skilled nursingp. 2
RatesPer diem by level of carep. 4
Carve-outsHigh-cost drugs billed outside per diemp. 16
AuthorizationRequired before admissionp. 9
ReviewsConcurrent, every 7 daysp. 11
Used by admissionsCase managementMDS
T. Nguyen, 88Coverage change
PreviousManaged Medicaid · active
NowMedicaid eligibility ended
EffectiveSep 30
Routed to
Case managementReview payer source for October
Business officeStart renewal paperwork with the family
Payer change detection
Coverage changes, caught and routed
When a resident’s plan switches or Medicaid eligibility ends, the change is flagged with what it means and sent to case management and the business office — before the claim finds it for you. Billing, coming soon, will pick up from here.
The modules you'll use