Medicare reimbursement continues to be a high priority item for hospitals throughout the nation.  Our healthcare reimbursement consulting team includes highly skilled professionals specializing in a number of specific reimbursement areas.  Two of the biggest reimbursement settlement topics are the Medicare Disproportionate Share Hospital (DSH) and Uncompensated Care Payments.

Medicare DSH Analysis

The Medicare Disproportionate Share Hospital (DSH) program provides additional reimbursement to qualifying hospitals that serve a disproportionate share of low-income patients. Our professional staff assist hospitals in maximizing their DSH reimbursement through a thorough review of 100% of the inpatient stays. We verify eligibility for both in-state and out-of-state Medicaid programs.

We use our extensive knowledge of allowable Title 19 eligible programs and known Medicare Administrative Contractors (MAC) audit practices to maximize a compliant DSH percentage. Maximizing the DSH percentage will also ensure the proper inclusion in the 340B drug pricing program.

Our professional staff has more than 50 years of experience assisting hospitals throughout the nation with Medicare DSH reporting. All of our analyses are supported through audits, reopenings, or amended cost reports.

SSI Realignment

As part of our Medicare DSH analysis, we also look into any opportunities for Supplemental Security Income (SSI) realignment. Through our review we can recalculate the SSI percentage to the Hospital’s Fiscal Year End to check for any increased reimbursement potential. The Centers for Medicare & Medicaid Services (CMS) allow hospitals to request a SSI percentage realignment for any cost report period, regardless of the cost report Notice of Program Reimbursement (NPR) status.

Worksheet S-10

The Worksheet S-10 of the Medicare cost report is used to determine a significant portion of the reimbursement providers receive. This is based off the reported amount of charity and bad debt expense write-offs occurring during the year to calculate the total uncompensated care costs. We will work closely with hospital personnel to ensure your reported amounts are in compliance with hospital charity or financial assistance polices as well as meeting the requirements of the Worksheet S-10 instructions.

Our extensive experience with MACs throughout the country has allowed us to develop best practices to accurately compile the large volume of data. This includes utilizing the new CMS required listing templates to ensure cost report acceptance. Additionally, our services include full support through the MAC audits.

Contact Our Medicare DSH and Uncompensated Care Experts

At Blue & Co. we have members of our reimbursement team dedicated to Medicare DSH and uncompensated care. If you would like to learn more about what opportunities may be available to your organization, please fill out the form below and a member of our team will reach out to you.