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
09.10.20 Bad Debt

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 Some of the Regulations Around Medicare Bad Debt

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 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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Connect with our team.

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