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Category: Reimbursement Services

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Worksheet S-10 & Medicare DSH Update for Hospitals

FFY2020 Worksheet S-10 audits are in the final stages for most hospitals in the nation and we continue to see significant audit findings and extrapolation factors taking place throughout the industry. Please be sure to review all proposed S-10 audit adjustments closely to ensure your uncompensated care is maximized. Worksheet S-10: Two-Year Average of S-10 […]

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Managed Care Contracting: Outdated Contracts Could be Costing Your Organization

A recent Blue & Co. audit of a small hospital’s existing Managed Care contracts yielded an unfortunate surprise: a nearly twenty-year-old contract with a major insurance company with rates that had not been updated since the original effective date. Not so surprisingly, these rates were woefully inadequate – reflecting a commercial rate that was only […]

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On-Demand Webinar: COVID-19 Vaccine Mandate in the Workplace

President Biden’s administration recently announced its Path Out of the Pandemic action plan which included specific guidance around a COVID-19 vaccine mandate. The action plan calls for employers with 100 or more employees to require employees to be vaccinated or submit to weekly tests, as well as requiring vaccinations for federal employees, contractors, and hospitals […]

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Kentucky Medicaid Managed Care Organizations Changes

Pursuant to KRS 205.640 and managed care contracts, Kentucky Medicaid Managed Care Organizations (MCOs) are required to provide a Paid Claims Listings (PCLs) to all in-state hospitals. The department and each Medicaid Managed Care Organization shall supply a Paid Claims Listing (PCL) to each hospital within ninety (90) days of the last day of the […]

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Volume Decrease Adjustment: What You Need to Know

The Volume Decrease Adjustment (VDA) is a lump sum payment available to Sole Community Hospitals (SCH) or Medicare Dependent Hospitals (MDH) who have experienced more than a 5% decrease in total discharges of inpatients as compared to the immediately preceding cost reporting period. The decrease in total discharges must be caused by circumstances that are […]

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Wage Index Survey: What Hospitals Need to Know

In this environment of uncertainty, it is important for hospitals to optimize all reimbursement opportunities while staying in compliance with Federal Regulations. One way that hospitals can identify additional reimbursement opportunities is by reviewing their Hospital Wage Index Survey. Since the calculation is complex, it is important for hospitals to understand how the data reported […]

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Medicare/Medicaid Crossover Accounts: Are They At Risk?

Medicare recently published updated bad debt regulations and the time is NOW to safeguard your Hospital’s reimbursement. Are you following proper guidelines to ensure you can write-off your Medicare/Medicaid crossover accounts? The first step to ensure you are following proper guidelines is to review the “Must-Bill policy” for reimbursement of crossover bad debts below. The easiest […]

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CMS Finalized Ruling- Medicare Bad Debt Summary

On September 2, 2020, CMS released its final ruling. It is effective beginning October 1, 2020, for FY 2021. This means it will go in to effect the first day of your fiscal year 2021. Below you will find a summary of the finalized regulations put in place by CMS for the Medicare Bad Debt […]

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CMS Attempting to Clarify Regulations Around Medicare Bad Debt 

Have you recently received Medicare bad debt audit adjustments that you felt were unfair? If so, you are not alone. MACs (Medicare Administrative Contractors) have been tightening their auditing standards and practices surrounding Medicare bad debt listings for years. Regulations have been interpreted and enforced differently by MACs, thus causing inconsistent audit standards. Being held to auditing standards […]

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HRSA Now Allows Accelerated Timelines for Offsite Locations

HRSA has indicated it will allow a hospital to accelerate timelines for its offsite locations to begin participating in the 340B Drug Discount Program. Previously, offsite locations were required to be reimbursable on a hospital’s most recently filed Medicare cost report and then registered with HRSA before patients seen at the offsite location could be […]

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Physician Fee Schedule: 2023 CMS Final Ruling

The Centers for Medicare & Medicaid Services (CMS) operates within a budget neutral approach. This occurs at the same time the healthcare community continues to try and find balance between reducing administrative burdens, accurately recognizing and recording services provided, and upholding the highest quality care possible. Over the last three years, there have been significant […]

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Blue & Co., LLC acquires Alerding CPA Group

Blue & Co., LLC acquires Alerding CPA Group

Carmel, Ind. (November 23, 2022) – The accounting and consulting firms of Alerding CPA Group (Indianapolis, Ind.) and Blue & Co., LLC (Carmel, Ind.) have announced their merger. The combined firm will operate as Blue & Co., LLC (Blue & Co.), effective December 1, 2022. This acquisition will provide Blue & Co. with greater market […]

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Not-for-Profit Single Audit Requirements – Evaluation of Revenue Sources

By: Holly Fields, CPA, Senior Manager Not-for-profit organizations (NFPs) that receive federal financial assistance over certain levels, either directly from a federal agency or indirectly through state or local agencies, may be required to have a single audit performed under Federal Uniform Guidance. Single Audit Requirements A single audit includes not only an audit of […]

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