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.
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 […]
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 […]
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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