NFLOC
Platform Rewrite
Smart Data rewrote a legacy NFLOC system and identified data issues that helped a major Medicaid provider recover millions in lost revenue.
16+ Million in lost revenue returned to the client
Client
Ohio's Largest Healthcare Plan Provider
Industry
Healthcare
Timeline
4 Weeks
Project Overview
Smart Data partnered with a leading Medicaid provider to enhance their Nursing Facility Level of Care (NFLOC) Historic File process. Initially brought on to implement a retroactive code update required by the Ohio Department of Medicaid (ODM), our team quickly identified deeper systemic issues in the existing data pipeline that were silently leaking revenue.
Project Challenge
The legacy NFLOC system wasn’t equipped to handle retroactive eligibility data, causing claims mismatches and unclaimed reimbursements. While addressing the ODM update, our team noticed patterns that indicated broader issues—data discrepancies that had gone undetected for years.
