Frontdesk
Medicaid screening for therapy

AI Medicaid eligibility screener for therapy practices in every state

Frontdesk screens Medicaid eligibility for therapy clients across all 50 states — fee-for-service Medicaid, managed-care MCO plans, and ABA waivers — through Availity, Office Ally, Trizetto Provider Solutions, Waystar, ClaimMD, Apex EDI, and Change Healthcare. Results sync into SimplePractice, TherapyNotes, Jane App, CentralReach, TheraNest, and Fusion Web Clinic.

  • HIPAA-compliant by design
  • 24/7 coverage
  • Works with your EHR

0 + DC

States covered

< 0s

Verification SLA

Availity + 0

Clearinghouses

SimplePractice +0

EHRs

Works with every major EHR & practice management system

SimplePractice

Mental health, speech, OT/PT

TherapyNotes

Mental health practices

Jane App

Multi-discipline clinics

CentralReach

ABA + autism services

TheraNest

Therapy + counseling

Fusion Web Clinic

Pediatric SLP/OT/PT

The Problem

Every state has its own Medicaid system

Medicaid in Texas is not Medicaid in California or New York. Each state has fee-for-service, MCO plans, and waivers — Availity, Office Ally, Trizetto, Waystar, ClaimMD, Apex EDI, Change Healthcare each cover different ones.

Hours per intake on manual verification

Waivers are critical for ABA but invisible

Medicaid ABA waivers (Katie Beckett, autism waivers, HCBS) determine whether a clinic can bill. Without autonomous screening, clinics deliver sessions that won’t be paid.

Denied claims, audit risk, wasted clinician time

MCO assignment changes mid-year

A client on Texas Medicaid may move between Superior, Amerigroup, and Molina mid-year — and the clinic doesn’t find out until claims deny.

Mid-year denials, retroactive billing churn

Spruce Health and reminder tools don’t verify Medicaid

Spruce Health, Klara, Weave, Solutionreach send reminders but don’t verify Medicaid eligibility or surface MCO changes.

Medicaid verification stays manual and slow

How Frontdesk Works

Built for therapy practices and clinics on SimplePractice, TherapyNotes, Jane App, CentralReach, TheraNest, Fusion Web Clinic — and every other major EHR. HIPAA-compliant by design with BAA, encrypted PHI, and audit logs.

Live call

+1 (415) 555-0142

Inbound · Zillow Rentals lead

AI Transcript

“Hi! I’d love to tour the 2-bedroom at Maple Heights. Any availability this Saturday?”

Frontdesk AI

“Yes! The 2BR at Maple Heights is $2,450/mo with a Feb 1 move-in. Saturday 11am or 2pm works for tours. Shall I book one?”

Answered in 0.4s
01

50-state Medicaid verification

Frontdesk verifies Medicaid across every state — fee-for-service, managed-care MCO plans, dual-eligible status — through Availity, Office Ally, Trizetto Provider Solutions, Waystar, ClaimMD, Apex EDI, and Change Healthcare.

  • All 50 state Medicaid + DC
  • Fee-for-service Medicaid verification
  • MCO plan assignment (Superior, Molina, Amerigroup, Centene, Anthem)
  • Dual-eligible Medicare + Medicaid
  • CHIP eligibility
Qualification

Looking for a 2BR around $2,400, move-in mid-February. Do you allow pets?

We have a 2BR at $2,450/mo available Feb 15. Cats and dogs under 50 lbs welcome. What’s your move-in date?

Captured

Budget$2,400
Layout2BR
Move-inFeb 15
Pets1 dog, 35 lbs
02

ABA waiver + autism-specific screening

Frontdesk screens Medicaid ABA waivers including Katie Beckett, HCBS, autism-specific waivers, and state ABA Medicaid plans — surfacing waiver type, remaining sessions, and renewal date.

  • Katie Beckett waiver verification
  • HCBS waiver eligibility
  • State autism-specific waivers
  • CentralReach + Rethink Behavioral Health sync
  • Catalyst + AccuPoint + Lumary integration

More capabilities

Everything else your team needs

03

Therapy-specific Medicaid benefits

Frontdesk parses Medicaid benefits per CPT — 90834, 90837, 90847 for mental health; 97155 / 97153 for ABA; 92507 for SLP; 97110 for OT/PT — including session caps and prior-auth windows.

  • CPT-level Medicaid benefits
  • ABA CPT (97151, 97153, 97155, 97156, 97158)
  • SLP CPT (92507, 92508, 92521-92524)
  • OT/PT CPT (97110, 97112, 97140, 97530)
  • Telehealth modifier coverage
04

EHR sync of structured Medicaid benefits

Medicaid eligibility, MCO assignment, waiver status, and remaining-session count flow into SimplePractice, TherapyNotes, Jane App, CentralReach, TheraNest, and Fusion Web Clinic.

  • Medicaid status in SimplePractice + TherapyNotes
  • Jane App + CentralReach + TheraNest + Fusion Web Clinic
  • MCO assignment alerts
  • Waiver renewal alerts
  • Per-session remaining-PA decrement
05

MCO change detection mid-year

Frontdesk runs daily re-verification on active Medicaid clients to catch MCO changes — and alerts the practice before claims start denying.

  • Daily MCO re-verification
  • MCO-change alerts with PA-resubmission workflow
  • Multi-MCO crosswalk handling
  • Auto-resubmission on new MCO
  • Audit log of every MCO change
06

HIPAA-compliant + CMS audit-ready

Every Medicaid verification is logged for audit, PHI is encrypted in transit and at rest, BAA in place, and access is restricted via SSO + RBAC.

  • HIPAA-compliant by design (BAA, encrypted PHI)
  • X12 270/271 audit logs
  • PHI minimization on every transaction
  • SSO + RBAC access controls
  • CMS + state audit-ready reporting

Integrations

Frontdesk is EHR-agnostic and integrates bidirectionally with SimplePractice, TherapyNotes, TheraNest, Jane App, IntakeQ, Practice Better, Kareo (Tebra), athenahealth, eClinicalWorks, WebPT, NetHealth (Optima), ChiroTouch, ClinicSource, Fusion Web Clinic, PtEverywhere, Power Diary, OwlPractice, TherapyAppointment, CentralReach, Rethink Behavioral Health, Catalyst, AccuPoint, Lumary, Total ABA, Theralytics, and TheraBe. New-client intake, scheduling, eligibility, prior-auth, superbills, and recall campaigns sync in real time — and every conversation is HIPAA-compliant by design.

SimplePractice

Mental health, speech, OT/PT

TherapyNotes

Mental health practices

Jane App

Multi-discipline clinics

CentralReach

ABA + autism services

TheraNest

Therapy + counseling

Fusion Web Clinic

Pediatric SLP/OT/PT

Full integration coverage

  • SimplePractice (mental health, speech, OT/PT) bidirectional sync
  • TherapyNotes for solo and group mental health practices
  • Jane App for multi-discipline clinics (SLP / OT / PT / mental health)
  • TheraNest for mental health and counseling practices
  • IntakeQ + Practice Better for HIPAA intake form automation
  • Kareo (Tebra), athenahealth, eClinicalWorks for medical-grade EHR sync
  • WebPT and NetHealth (Optima) for OT/PT clinics
  • Fusion Web Clinic, ClinicSource, PtEverywhere for pediatric SLP/OT/PT
  • CentralReach, Rethink Behavioral Health, Catalyst, AccuPoint, Lumary, Total ABA for ABA + autism services
  • Theralytics, TheraBe for ABA data + clinical operations
  • Eligibility + benefits verification: Availity, Office Ally, Trizetto, Waystar, Change Healthcare
  • Telehealth: Doxy.me, Zoom for Healthcare, SimplePractice telehealth, healow
  • HIPAA-compliant by design: BAA available, encrypted PHI, audit logs

Who it's for

ABA clinics with Medicaid waiver clients

Community mental-health centers

School-based SLP serving Medicaid kids

Pediatric OT / PT clinics on Medicaid

Multi-state ABA franchises

Substance-use practices on Medicaid

Dual-eligible Medicare + Medicaid practices

CHIP-funded pediatric practices

Practices replacing Spruce Health, Klara, Weave, Solutionreach

The journey

Every step syncs to Yardi, RealPage, Entrata, AppFolio, Buildium, or ResMan in real time.

01

Step 1

AI captures every client and caregiver interaction

Inbound voice, outbound AI voice, HIPAA-compliant SMS, web chat, and email are answered instantly with practice-aware context — across speech-language pathology (SLP), applied behavior analysis (ABA), mental health and counseling, psychiatry, occupational therapy (OT), and physical therapy (PT). Works with SimplePractice, TherapyNotes, TheraNest, Jane App, IntakeQ, Kareo, CentralReach, Rethink Behavioral Health, Fusion Web Clinic, and WebPT.

02

Step 2

Records sync to your EHR, scheduling, and billing

New-client intake, scheduled appointments, reschedules, cancellations, waitlist updates, eligibility checks, prior-authorization status, and superbills flow into SimplePractice, TherapyNotes, TheraNest, Jane App, IntakeQ, Practice Better, Kareo, athenahealth, WebPT, NetHealth (Optima), Fusion Web Clinic, ClinicSource, CentralReach, Rethink, AccuPoint, and Catalyst in real time.

03

Step 3

Automation runs reminders, recovery, and outreach

24h, 2h, and 30min appointment reminders, no-show recovery within 5 minutes, cancellation backfill from the waitlist, eligibility verification, prior-auth follow-up, recall campaigns, review-request automation, and parent/caregiver coordination fire automatically across voice, HIPAA-compliant SMS, and email.

04

Step 4

Analytics surface what matters across the practice

Cross-discipline dashboards track new-client conversion, first-call answer rate, average response time, no-show rate, waitlist-fill rate, recall response rate, schedule density, and revenue impact — across SLP, ABA, mental health, OT, and PT lines of service.

What this page covers

Topics, integrations, channels, practice types, and workflows covered by AI Medicaid Eligibility Screener.

Built for therapy practices serving Medicaid-funded clients — ABA waiver clinics, community mental health, school-based SLP, pediatric OT/PT. Unlike Spruce Health, which doesn’t verify any eligibility, Frontdesk autonomously checks Medicaid status, waiver eligibility, MCO assignment, prior-auth requirements, and session caps in real time. HIPAA-compliant by design with BAA, encrypted PHI in transit and at rest, and audit logs across SLP, ABA, mental health, psychiatry, OT, and PT.

EHR & practice management

  • SimplePractice
  • SimplePractice telehealth
  • TherapyNotes
  • TheraNest
  • Jane App
  • IntakeQ
  • Practice Better
  • Kareo (Tebra)
  • athenahealth
  • eClinicalWorks
  • WebPT
  • NetHealth (Optima)
  • ChiroTouch
  • ClinicSource
  • Fusion Web Clinic
  • PtEverywhere
  • Power Diary
  • OwlPractice
  • TherapyAppointment
  • CentralReach (ABA)
  • Rethink Behavioral Health (ABA)
  • Catalyst (ABA)
  • AccuPoint (ABA)
  • Lumary (ABA)
  • Total ABA
  • Theralytics
  • TheraBe

Telehealth, scheduling & communication

  • Doxy.me
  • Zoom for Healthcare
  • Google Meet for Healthcare
  • SimplePractice telehealth
  • TheraNest video
  • healow
  • Acuity Scheduling
  • Calendly Health
  • NexHealth
  • Solutionreach
  • Weave
  • Spruce Health
  • Klara
  • Updox
  • OhMD

Billing, payor & eligibility

  • Availity eligibility
  • Office Ally
  • Trizetto Provider Solutions
  • Waystar
  • ClaimMD
  • Apex EDI
  • Change Healthcare
  • TriZetto
  • Medicaid eligibility verification
  • Medicare eligibility verification
  • Commercial payor verification (BCBS, Aetna, Cigna, UnitedHealthcare, Humana, Kaiser)
  • TRICARE eligibility
  • TriCare West / TriCare East
  • Good Faith Estimate (No Surprises Act)
  • Superbills + self-pay invoicing
  • EAP (Employee Assistance Program) intake
  • Headway / Alma / SonderMind / Grow Therapy panel onboarding

Therapy workflows automated

  • AI new-client intake (HIPAA-aware)
  • AI insurance eligibility + benefits verification
  • AI appointment scheduling and reschedule
  • AI no-show recovery + cancellation backfill
  • AI waitlist management and slot-fill outreach
  • AI prior-authorization coordination
  • AI superbill + receipt generation
  • AI session reminders (24h, 2h, 30min cadences)
  • AI parent / caregiver coordination (pediatric)
  • AI crisis-line and suicide-risk triage with live escalation
  • AI IEP/504 meeting coordination (school-based therapy)
  • AI recurring appointment series management
  • AI discharge planning + handoff
  • AI review-request automation (Google, Healthgrades, Zocdoc)
  • AI referral-source follow-up + thank-yous

Therapy specialties served

  • Speech-Language Pathology (SLP)
  • Pediatric speech therapy
  • Adult speech therapy
  • AAC evaluation and therapy
  • Stuttering / fluency therapy
  • Feeding and swallowing therapy
  • Voice therapy
  • Myofunctional therapy
  • Applied Behavior Analysis (ABA)
  • BCBA-supervised clinics
  • Autism diagnostic evaluation
  • Mental health and counseling
  • Couples and family therapy
  • Teen and adolescent therapy
  • Trauma therapy / EMDR
  • Eating-disorder treatment
  • Substance-use intake
  • Psychiatry / med management
  • Occupational therapy (OT)
  • Pediatric OT / sensory integration
  • Physical therapy (PT)
  • Orthopedic rehab
  • Vestibular therapy
  • Pelvic floor therapy
  • Hand therapy
  • Pediatric PT
  • School-based therapy services

Communication channels

  • Inbound voice (24/7 intake, after-hours hotline)
  • Outbound AI voice (recall, no-show recovery, waitlist fill)
  • HIPAA-compliant SMS and texting
  • WhatsApp Business
  • Web chat (practice site + EHR portal)
  • Email
  • 30+ languages (Spanish-speaking SLP, bilingual mental health, ASL referral routing)

Competitive alternatives

  • SimplePractice Telehealth + Reminders alternative
  • TherapyNotes Telehealth alternative
  • Spruce Health alternative for voice + outbound
  • Klara alternative
  • Updox alternative
  • Weave alternative for SMB therapy
  • Solutionreach alternative
  • NexHealth alternative
  • OhMD alternative
  • Headway / Alma / SonderMind / Grow Therapy front office

FAQ

Common questions about AI Medicaid Eligibility Screener

Frontdesk integrates with Yardi Voyager, Yardi Breeze, RentCafe, RealPage OneSite, Knock CRM, Entrata, AppFolio, Buildium, ResMan, Rent Manager, and MRI Software. Here's what therapy practices and clinics ask most.

Contact support

Yes — fee-for-service Medicaid, managed-care MCO plans, ABA waivers (Katie Beckett, HCBS, autism-specific), and CHIP across all 50 states + DC. Verification runs through Availity, Office Ally, Trizetto Provider Solutions, Waystar, ClaimMD, Apex EDI, and Change Healthcare.

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