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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
Medicaid Managed Care Organizations

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

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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Photo of hospital walls. Wage Index Survey general photo.

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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Connect with our team.

To learn more about our services and areas of expertise, send us a message.