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HPE Eligibility & Compliance

Fast track Medicaid eligibility with CoverMe’s automated Hospital Presumptive Eligibility program. With CoverMe, HPE determinations are provided in real-time, every time.

Hospital Presumptive Eligibility Solutions

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CoverMe can effectively identify patients who will qualify for Medicaid in near real-time through the Hospital Presumptive Eligibility (HPE) program as allowed by the Affordable Care Act.

Medicaid eligibility under HPE allows immediate access to coverage for eligible individuals. HPE improves individuals’ access to Medicaid and necessary services by providing another channel to apply for coverage.

HPE ensures the hospital will be reimbursed for services provided, just as if the individual was enrolled in standard Medicaid at the time of treatment.

We have all the necessary data compiled and scored to help you make accurate determinations. Our software can deliver the completed applications right to the user's desktop within seconds.

The Key Aspects

CoverMe's automation of Hospital Presumptive Eligibility takes the guesswork out of complicated manual processes of Medicaid applications - patients get covered, and providers get paid.


Using our HPE program support, CoverMe guarantees that providers will meet state program compliance requirements without fail. Don’t be deterred - with CoverMe, timeliness and accuracy are assured.


CoverMe's HPE program support replaces the manual processes routinely used by onsite Medicaid vendors, saving providers time and money.

Immediate Coverage

With Hospital Presumptive Eligibility (HPE), an individual or family can be temporarily enrolled in Medicaid immediately if it appears they are eligible.


CoverMe's HPE software is a preferred choice for healthcare providers looking for the fastest and most reliable path to determine a patient’s Medicaid eligibility.
  • Replaces traditional Medicaid eligibility vendors and speeds up your process.
  • Provides a channel to apply for coverage and improves access to Medicaid.
  • Ensures providers an appropriate reimbursement for healthcare services
  • Assists in the screening process and supports providers in making informed recommendations.

Video Compilation

Want to learn more about CoverMe's HPE support? Take a look at this video!

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Talk to our team to learn more about Coverme’s HPE programs
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