Reimbursement

How does your organization stay up to date with new regulation and changes in the reimbursement landscape? How do you improve care and reduce costs?

Our team of reimbursement professionals—including CPAs, former hospital controllers and reimbursement managers, ex-Medicare auditors, and more—provides leading-edge reimbursement services to some of the most prominent hospital systems in the country. Our professionals stay up to date on regulatory changes and help clients save millions of dollars in reimbursement opportunities each year.

Who we serve.

We work with a wide variety of healthcare organizations, including hospitals, skilled nursing facilities, continuing care retirement communities, home health agencies, Rural Health Clinics (RHC), and Federally Qualified Health Centers (FQHC), and more.

Services Overview

  • Medicare/Medicaid cost reports
  • Medicare cost report adjustment review and appeals
  • Medicare bad debts
  • Medicare disproportionate share
  • SSI consulting
  • Medicaid disproportionate share
  • Leveraging programs and supplement payment reviews
  • Self-pay reviews
  • 340B consulting
  • Wage index and occupational mix reviews
  • Managed care contract reviews
  • Interns and resident consulting and analyses
  • Mergers/acquisitions – reimbursement impacts
  • Feasibility studies
Uncompensated Care S-10 Audits are Coming

Uncompensated Care S-10 Audits are Coming

CMS continues to refine the uncompensated care calculation.  Three factors are utilized to calculate uncompensated care reimbursement for IPPS hospitals.  Factor 3 is developed by compiling the cost of uncompensated care that is reported on the Medicare cost report Worksheet S-10.  Effective with federal fiscal year 2020, worksheet S-10 will fully utilize uncompensated care data […]

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Hospital 340B Recertification Reminder

Hospital 340B Recertification Reminder

The Health Resources and Services Administration has set the annual recertification of eligibility for 340B drug discounts for hospitals to begin August 15, 2018, and ends September 12, 2018. Mandatory Requirement Hospitals must complete their recertification through the Office of Pharmacy Affairs Information System (OPAIS). The Authorizing Official and Primary Contact must create their own […]

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Low Volume Payment Update

Low-Volume Payment Update

The Centers for Medicare and Medicaid Services (CMS) recently published the Final 2019 Inpatient Prospective Payment System (IPPS) Rule that modified the definition of a low-volume hospital. While the mileage requirement remained the same, the rule changed the discharge requirement from Medicare discharges to total discharges for Federal Fiscal Years 2019 through 2022. The updated […]

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Connect with our team.

To learn more about our reimbursement services, contact our team here.

Send us a message.