ConvertPE
What is presumptive eligibility?
When an uninsured patient presents to the ED, the hospital can grant immediate temporary Medicaid coverage — called Presumptive Eligibility.
The PE period lasts up to 60 days. The hospital must initiate a full application before that window closes or coverage lapses permanently, with no reinstatement pathway.
ConvertPE is the valet of Medicaid coverage for hospitals we ensure patients are fully covered instead of temporarily.
Three Governed Windows. One Platform.
Every hospital faces the same three failure points. ConvertPE governs each one in sequence.
Acute Care PE Conversion.
Secure coverage before the patient leaves. ConvertPE ensures the application is initiated while the patient is still in the building, when documentation can be completed and questions resolved in real time. Enrollment starts before discharge, not after.
Post-Discharge Completion.
Finish the case after the patient leaves. The patient is gone. The case is not. Without ownership and deadlines, cases do not move toward resolution. They age toward expiration. Outreach attempts accumulate. Confirmed contact rarely happens. ConvertPE keeps every case owned and active after discharge. A named owner is assigned, an escalation clock is maintained, and trusted community partners are activated when standard outreach fails. Cases are completed, not abandoned.
Retroactive Eligibility Recovery.
Recover revenue after the encounter is written off. Many patients were eligible. No one captured it in time. The recovery window remains open for up to 90 days, but most hospitals do not track it, assign ownership, or confirm recovery before it closes. It becomes 30 days in 2027. ConvertPE surfaces eligible written-off encounters, assigns a named owner with a countdown clock, and activates community partners to complete documentation when needed. Coverage is confirmed retroactively. Write-offs are reversed. Revenue is recovered in real time.
What ConvertPE Produces
Three outputs. Generated automatically.
Continuity Record
A complete timestamped record of every governed case from detection through outcome. Every owner, action, and escalation documented. Coverage confirmed or lapse explained. Audit-ready in seconds. Structured for compliance and billing workflows.
Coverage Preservation Ledger
Financial proof of what was protected and recovered. Revenue recovered from retroactive eligibility. Uncompensated care prevented. Coverage preserved across the full window. Updated in real time for CFO reporting.
Conversion Rate
The metric that makes the work visible. Which cases converted and which did not. Who owned each case. Where contact was confirmed versus attempted. Every missed conversion visible as permanent revenue loss. Every recovery attributed to the action that closed it.
The Result
ConvertPE turns coverage windows into confirmed outcomes. Patients stay covered. Hospitals protect revenue. Every case is accounted for.
Built by Operators
Designed for hospitals where Medicaid exposure is operational and financial
ConvertPE was built from real operating experience inside health systems where Medicaid demand was not abstract. It was visible in the emergency department, the discharge process, the ambulatory network, the finance review, and the revenue line.
Olusan understands the larger operating architecture and the specific intervention points inside it. The platform is built for governed outcomes, not process activity.
- Built from executive operating experience across public, safety-net, and multi-hospital systems.
- Grounded in Medicaid strategy, hospital operations, revenue exposure, and board-level accountability.
- Designed for environments where coverage, conversion, finance, and proof have to hold together.
ConvertPE — Hospital Scenario
James comes into the emergency department on a Tuesday evening with chest pain. He is uninsured. The social worker initiates a Presumptive Eligibility determination before he goes up to the floor. The determination is approved. James has one PE window — one per calendar year — to convert to full Medicaid enrollment before it closes in 60 days.
He is discharged on Thursday. The application is 40 percent complete. Standard outreach attempts reach him twice in the first week and then stop. On day 22 the case goes cold. On day 61 the PE window closes. The application is abandoned. James is recorded as uncompensated care. The hospital writes off the encounter.
Three months later James comes back. Still uninsured. Still uncompensated care.
What ConvertPE does.
A governance flag is placed on James’s record at PE determination. An owner is assigned from determination through confirmed enrollment. A time-bound escalation sequence runs — Day 3, Day 7, Day 14.
When standard outreach does not confirm contact by Day 7, the community execution layer activates. A community health worker from a qualified community partner is dispatched to James’s neighborhood. Contact is confirmed on Day 9. The application is completed on Day 11. Enrollment is confirmed before Day 30.
The Continuity Record documents every step from the initial flag through confirmed enrollment. The community health worker encounter is structured as a billable Medicaid visit. James is counted in the DSH calculation. The written-off encounter is recovered through the retroactive eligibility window.
James’s return visit three months later is a fully reimbursed Medicaid encounter.
Olusan Platforms
ConvertPE is one part of a broader Medicaid governance infrastructure system
Conversion failure is one expression of a larger Medicaid infrastructure problem. Olusan governs the seams where coverage, continuity, policy execution, and operating architecture break across institutions.
ContinuityOS
Coverage continuity governance for health plans
Plans use ContinuityOS to govern high-risk renewal failure, procedural coverage loss, escalation, and continuity records across fragmented Medicaid environments.
CoverageWorks
Policy-response infrastructure for public systems
Public agencies use CoverageWorks to govern workforce-to-coverage transitions, documentation, exemptions, and reporting under Medicaid work requirement pressure.
Coherence+
Governance and execution architecture
Health systems use Coherence+ to define where demand enters, where the operating model breaks, where ownership should live, and what infrastructure is required before execution begins.
Start the Conversation
Govern conversion before the window closes
A ConvertPE pilot starts with a defined pathway, existing operational data, clear ownership, and a 90-day path to measurable conversion control.