The Eligibility on Site (EOS) program provides participating facilities with on-site Medi-Cal certification on a full- or part-time basis. Eligible patients can be interviewed and enrolled on site, either before treatment or after discharge, cutting red tape and securing appropriate reimbursements much more quickly. EOS now outstations 49 eligibility specialists at 58 provider locations in Los Angeles and Orange counties. In 2008, EOS certified 21,419 patients and secured more than $305 million for providers.

Who Benefits?

• Patients and their families
• Hospitals
• Primary care providers with a large number of Medi-Cal patients
• Clinics
• Psychiatric facilities

Specific Benefits

EOS participants experience the following outcomes:

• Maximized Medi-Cal reimbursement
• Timely and accurate processing of current, emergency and retroactive Medi-Cal applications
• Pursuit of eligibility for comatose, amnesiac and deceased patients
• Accelerated certification for long-term care placements
• Improved patient retention, once eligibility is established
• Conversion of presumptive eligibles

How the Program Works

County Social Services: The county eligibility specialist takes and processes all Medi-Cal applications on site at the contracted provider facility. The contracted provider screens and refers potentially eligible patients to the county. HASC interfaces with county management on behalf of providers to ensure EOS is effective.

Program Cost

County Social Services: Providers pay HASC management fees of up to $33 per day per assigned county staff. Providers are invoiced quarterly in advance and payment is due within 15 days.

Provider Staff-Trained as Application Takers/County Processes: $140 per person for basic training. Occasional update training and required annual refresher training is $70 per person.