Who we are

Medicaid Made Simple LLC is a North Carolina-based business that provides expert, personalized support with Medicaid and Special Assistance programs. We help seniors, adults with disabilities, and caregivers apply for and maintain benefits that support long-term care, independent living, and financial stability.

We specialize in:

  • Medicaid for the Aged, Blind, and Disabled (ABD)

  • Long-Term Care (LTC) Medicaid

  • State-County Special Assistance (SA) and Special Assistance In-Home (SAIH)

  • Recertifications, spend downs, FL-2 forms, income rebuttals, and appeals

Our work is grounded in deep knowledge of NC DHHS policy and real-world experience supporting clients through some of life’s most challenging transitions.

We serve Lenoir, Pitt, Greene, Wayne, and Craven counties — partnering with families, healthcare providers, DSS staff, and community organizations to make Medicaid and Special Assistance more accessible, understandable, and successful.

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PARTNER WITH US!

Medicaid Made Simple LLC is your trusted local partner for streamlining Medicaid, Special Assistance (SA), and Special Assistance In-Home (SAIH) processes. We help your residents — and your staff — navigate complex eligibility rules, reduce delays, and stay focused on care, not paperwork.

Why Partner With Medicaid Made Simple?

Increase Resident Stability
We help secure Medicaid, SA, and SAIH benefits quickly and accurately — ensuring residents can remain in your care with financial support in place.

Reduce Denials and Overpayments
Our policy-trained team understands NC FAST, income budgeting, FL-2 requirements, and transfer rules, preventing avoidable errors that impact facility billing and resident eligibility.

Free Up Staff Time
We handle applications, recertifications, spend-down strategies, and documentation follow-up, so your staff can focus on care instead of calls with DSS.

HIPAA-Compliant Systems
We safeguard sensitive resident data using encrypted tools and compliant intake workflows, offering secure communication and storage.

Trusted Local Expertise
We serve Lenoir, Pitt, Greene, Wayne, and Craven counties with deep knowledge of each DSS office's processes, and can accompany residents through every eligibility phase.

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Join Us

HOW IT WORKS — Medicaid Made Simple LLC

Supporting Facilities, Residents & Families With Hassle-Free Medicaid Navigation

OUR PROCESS: WHAT WE DO FOR FACILITIES & FAMILIES

Medicaid Made Simple LLC handles the entire Medicaid application process from start to finish — relieving families and facility staff from paperwork, follow-ups, and DSS communication.

Our goal: Fast approvals, accurate documentation, and less stress for everyone.

Below is our streamlined workflow.

1️⃣ Referral or Pop-Up Sign-Up

Residents or families may sign up:
• Through facility referral
• During an onsite Pop-Up Medicaid Day
• Through admissions or social work

We contact them immediately to begin intake.

2️⃣ Intake & Customized Checklist

We gather key information and issue a personalized document checklist depending on the program:
• ABD Medicaid
• LTC Medicaid
• SA
• SAIH

We ensure families understand what DSS needs and why.

3️⃣ Document Gathering

Families don’t struggle — we take over:
• Bank statements
• SSA, pension, and VA income letters
• Property/insurance details
• FL-2 requests
• Proof of residency
• Spend-down documentation
• Lookback information

If the family can’t get it, we get it for them.

4️⃣ Full Application Preparation

We complete every DSS-required form, including:
• DSS-8190
• SA/SAIH forms
• Patient Monthly Liability details
• Resource verification forms
• Spend-down documentation
• Transfer of Assets review

Families never need to go to DSS.

5️⃣ Submission & Case Tracking

We track the application daily:
• Respond to 5097 requests
• Communicate with IMCs
• Ensure documents are not missed
• Prevent delays or denials
• Update families and facilities regularly

Your staff no longer has to chase paperwork.

6️⃣ Facility Update Reports

Facilities receive:
• Submission confirmation
• Verification requests
• Expected timelines
• Approval emails
• PML updates
• Final benefit amounts

This keeps your billing and admissions team fully informed.

7️⃣ Approval & Follow-Up

Once approved, MMS confirms:
• Eligibility start date
• PML amount
• Facility rate details
• SA/SAIH approval levels
• Redetermination dates

We also support the family through next steps.

🟩 HOW WE MAKE THE FACILITY’S JOB EASIER

✔ Eliminates hours of paperwork
✔ Reduces DSS communication burden
✔ Prevents delays and denials
✔ Helps admissions move faster
✔ Keeps census stabilized
✔ Provides reliable resident financial clarity
✔ Reduces unnecessary MDR backlog

We do the work your team doesn't have time for.

💙 HOW WE HELP FAMILIES

✔ Clear guidance — no confusion
✔ Full support — no DSS trips
✔ Hands-on help — no guesswork
✔ Professional, compassionate service
✔ Accurate applications that get approved faster

Families finally get support they can trust.

🧩 FACILITY PARTNERSHIP PROGRAM

Optional — For facilities that want dedicated Medicaid support

Facilities can choose to enter a Partnership Agreement, which includes:
✔ Priority case handling
✔ Monthly or biweekly Pop-Up Days
✔ A dedicated MMS liaison for your building
✔ Staff training and Medicaid education
✔ Intake support for admissions
✔ Built-in workflows for your DSS communication needs

Partnership Payment Structure

If a facility enters a formal contract with Medicaid Made Simple LLC:
The facility pays based on the terms of the partnership agreement.
This may include:
• Flat monthly rate
• Per-case rate
• Tiered service package

Facilities can choose the plan that fits their census and needs.

💰 POP-UP EVENT PAYMENT STRUCTURE

FOR POP-UP EVENTS (NO CONTRACT):

The facility pays nothing.
Residents and families pay for their Medicaid service package.

No cost to the facility.
No obligation.
No risk.

This allows facilities to host Medicaid support days completely free while giving residents access to professional assistance.

WHY FACILITIES VALUE MMS

✔ Faster Medicaid approvals
✔ Stronger cash flow stability
✔ Fewer unpaid months
✔ Less staff burden
✔ More accurate admissions
✔ Happy families who feel supported

We become your trusted Medicaid partner — dependable, professional, and results-driven.

📞 CONTACT US

Medicaid Made Simple LLC
📱 252-286-1033
🌐 medicaid-made-simple.com

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