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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
As of October 1, 2019, CMS will Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

CMS to Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

On April 4, CMS announced that for cost reporting periods beginning on or after October 1, 2019, providers must comply with a “longstanding” rule to claim reimbursement for crossover bad debts from the Medicare program. After this point, providers will be denied reimbursement for their crossover bad debts unless the underlying balances are logged to […]

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Worksheet S-10 Update

Worksheet S-10 Update

Over the past six months, CMS instructed all MACs to complete audits of the FFY 2015 Medicare Cost Report Worksheet S-10s. Each MAC was required to complete 50 audits (approximately 25% of all DSH eligible providers nationally), and Blue & Co. represented providers in multiple MAC jurisdictions. Here’s what we learned. S-10 Audit Requests & […]

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New Requirements by Humana for 340B Participants

New Requirements by Humana for 340B Participants

Attention 340B covered entities participating with Humana – Managed Care Medicare: Effective January 1, 2019, Humana requires that a “JG,” “TB,” or another relevant modifier be added to claims involving 340B eligible outpatient drugs under the Medicare Outpatient Prospective Payment System (OPPS) with status indicator “K.” If a claim does not include the proper modifier […]

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Connect with our team.

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

Send us a message.