Software for Medicaid Premium Billing

Reduce Administrative Costs. Improve Payment Rates.

Improve Medicaid Billing and Collections

Section 1115 Medicaid waivers have enabled states to ask Medicaid enrollees to share in the cost of health insurance. But for some states, the administrative cost of billing exceeds the premiums collected.

Certifi can help. Our modular Medicaid premium billing solution is uniquely designed to improve payment collections, especially the small premium amounts found in Medicaid environments. Plus, our solution is CMS-certified for premium billing and collections for Medicaid, making it easier to plug into your existing process.

CMS-certified Medicaid Premium Billing and Collections.

Configurable Billing

Configurable Design

You likely have unique populations with unique billing rules. Our configurable billing rule design simplifies the management of multiple grace periods, billing frequencies, run and period dates, and more.

Payment Management

Payment Management

In addition to a payment portal accepting one-time and recurring payments, we also accept paper checks and even have a retail cash payment network, which is key when limiting delinquencies from the unbanked or underbanked.

delinquency management

Delinquency Management

Our rules-based delinquency management simplifies collection triggers. Plus, we support unique state requirements, like balance transfers to the Department of Revenue for tax refund assessments.

Medicaid Invoice Management

Invoice Management

Whether it’s a paper invoice, a coupon book, an eBill and/or email notifications, our invoice and billing generation tools simplify billing Medicaid enrollees.

Improve Collection Rates

Collecting the small dollar amounts common in Medicaid billing at minimal cost is a challenge. In fact, many states have found that fewer than half of Medicaid members pay their premiums. In some, it’s as low as 13%.

This means states spend more administering the Medicaid premium billing than they collect from members.

Certifi can help. Our experience with Medicaid premium billing means offering a breadth of payment options – credit/debit, check, and cash through a retail network – and clear, concise billing communications can help improve payment rates.

Improve Medicaid Payment Rates

Reduce Administrative Costs

Automate Medicaid Billing


Certifi automates the billing process from billing rules setup to invoice generation to delinquency notification, saving time and money in the process.

Integrate Medicaid Systems


We integrate with up and downstream systems like state enrollment systems and state finance systems to move information accurately and efficiently, streamlining the process.

Communicate Medicaid Billing


Increase premium payment rates with configurable communications, like invoices and delinquency notifications.

The only CMS-certified Medicaid Premium Billing and Collections solution that improves payment rates.

Designed For Your Unique Medicaid Billing Requirements

We’ve seen it all. Whether you need to integrate with state systems, need varied billing rules for distinct populations, need to apply credits for lifestyle assessments, or need to deposit payments or partial payments into an FSA or HSA, Certifi can automate a workflow based on your unique Medicaid waiver requirements.

Medicaid Process

Seeing is Believing.

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