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Acentra Health assists Medicaid beneficiaries with mental illnesses, disabilities, and long-term care to review their eligibility for state wavier programs to determine if additional services are needed. The level of care is determined by aligning quality metrics and using standardized assessment content. In addition, we also review previous level of care determinations to ensure accuracy of decisions and current services provided.

We apply nationally recognized, federally governed, or client specific criteria to make medical necessity and level of care determinations.

Our Comprehensive Suite of
Assessment & Administrative Services

readiness-evaluation
Preadmission Screening & Resident Review

Reliable, timely, and clinically-valid PASRR recommendations and determinations.

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Behavioral Health Needs Assessment

Person-centered assessments for mental and behavioral health assessments.

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Application Processing Center

Application service center support to Medicaid and CHIP programs.


Frequently Asked Questions (FAQs)

 

What is Acentra Health’s Level of Care Assessments solution, and who is it for?

Acentra Health’s Level of Care Assessments solution helps determine the right amount of care needed for Medicaid members with mental illnesses, disabilities, or long-term care needs. Built for state agencies, it reviews eligibility for state waiver programs (extra services beyond standard coverage), uses standardized tools to set care levels, and checks past decisions for accuracy.


What does "level of care" mean in Medicaid?

Level of care refers to how much support a person needs - from basic to intensive - to stay safe and healthy, often for long-term services like home or nursing care. Our solution uses quality measures and standard assessments to make these decisions fairly and consistently, ensuring members get the right services in the least restrictive setting.


How does Acentra Health’s Level of Care Assessments solution ensure accurate and timely assessments?

Acentra Health’s Level of Care Assessments solution applies national standards, federal rules, or a state's specific criteria to review needs and make determinations. With thousands of licensed clinicians handling hundreds of thousands of assessments yearly, it delivers reliable, person-centered results quickly while maintaining high accuracy.  


Does Acentra Health’s Level of Care Assessments solution help with compliance and better member outcomes?

Yes. Acentra Health’s Level of Care Assessments solution supports federal requirements for accurate eligibility and service decisions, protects your program from risks, and promotes quality care in the least restrictive environment. This leads to better member experiences, appropriate service matching, and overall program efficiency.


What key benefits will my state see from using Acentra Health’s Level of Care Assessments solution?

You get precise eligibility reviews, fewer errors in past determinations, high satisfaction from members and stakeholders, strong compliance with rules, and optimized use of resources. Backed by Acentra's 30+ years of experience, our solution acts as an extension of your team with proven clinical expertise and minimal disruption.