From 90 minutes of manual lookups to results in the inbox before anyone walks in.
How the PAC Program automated Medicaid eligibility verification for their entire caseload — and stopped discovering coverage lapses after the fact.
< 30 sec
to verify the full caseload
Down from 60–90 minutes of manual ePACES lookups
200+
patients verified overnight
Every patient checked before the first appointment
$0
per-transaction cost
Flat monthly fee, unlimited verifications
1–3 days
to go live
From kickoff to verified results in the inbox
The problem
The PAC Program serves over 200 active Medicaid patients across their behavioral health and addiction treatment programs. Like most NYS providers, they relied on ePACES — the state portal — for eligibility verification.
The workflow: a staff member would log into ePACES each morning, pull each patient's CIN from the EHR, type it into the portal, check the result, and move on to the next. For 200+ patients, this took 60–90 minutes — before the first appointment of the day.
The bigger problem wasn't the time. It was what happened when a check got skipped. A patient whose Medicaid coverage had quietly lapsed would come in, receive care, and only weeks later — when the claim came back denied — would anyone find out. That's $500 to $2,000 in unrecoverable revenue per missed check.
And with a caseload that large, something always got missed.
Before EligibilityCheck NY
- 60–90 minutes of manual ePACES lookups every morning
- One patient at a time — copy CIN, check portal, repeat
- Coverage lapses discovered weeks later via claim denials
- No automated alerts when a patient lost coverage
- Staff time spent on administrative work instead of patient care
The solution
We deployed EligibilityCheck NY for the PAC Program in under three days. The setup included eMedNY CORE Web Services enrollment, credential configuration, EHR CSV mapping, and staff training.
The system works like this: every night, it pulls the PAC Program's patient roster, sends an X12 270 eligibility inquiry for every patient directly to eMedNY, and processes the 271 response. Active, Inactive, or Error — every patient, in seconds.
By 6:00 AM, the results are waiting in the billing team's inbox. Staff arrives knowing exactly who's covered. Anyone flagged as inactive gets a call before their appointment — not a denial two weeks later.
After EligibilityCheck NY
- Entire 200+ patient caseload verified in under 30 seconds
- Morning email report waiting before the first appointment
- Coverage lapses caught the night before — not after a denial
- Zero manual ePACES lookups required
- Staff time redirected to patient care
How it works
EligibilityCheck NY uses the same processes used by major health systems and clearinghouses across the U.S.
There are no middlemen, no clearinghouse fees, and no per-transaction charges. The system connects to the same state data that ePACES uses, with the same real-time accuracy.
See it running for your clinic
15-minute demo. We'll show you exactly what the PAC Program sees every morning.