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Medicare/Medicaid Reimbursement & Eligibility Tool

A comprehensive tool for Reimbursement Officers working in Illinois DHS facilities. Performs eligibility assessments for Medicaid long-term care benefits, coordinates Medicare Part B coverage, calculates patient liability amounts, and tracks account adjustments and collections. Built to demonstrate understanding of financial responsibility investigations, benefit coordination, and healthcare reimbursement processes.

Active Cases

247

Pending Reviews

12

Monthly Collections

$142K

Facility

Mabley DC

Individual Information
Enter the resident's identifying information
Financial Information
Income and asset details for eligibility determination

Include SSI, SSDI, pension, wages

Bank accounts, investments, cash value life insurance

Home (if returning), one vehicle, burial funds

Insurance & Benefits Status
Medicare, Medicaid, and third-party coverage
Illinois Medicaid Reference (Projected 2026)

Individual Resource Limit

$2,000

Spousal Resource Allowance

Up to $154,140

Personal Needs Allowance

$30/month

Home Equity Limit

$713,000

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